IPCHS. Integrated People-Centred Health Services


Learn from real-life experiences with health services reform. We distinguish three types: emerging, promising and leading practices. Share your practice by clicking "Add practice".

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June 24, 2016 Europe

National rollout of Healthy Life Centres in Norway

Problem: Rising lifestyle-related risk factors for chronic disease; growing burden of chronicity, notably cardiovascular disease, type 2 diabetes and cancer; rising economic pressures linked to increasing burden of complex chronic conditions.

Solution highlights: Municipally-managed Healthy Life Centres staffed by multidisciplinary public health teams were established across Norway to advance local health promotion; government commitment to addressing chronic disease through strengthening health promotion provided a platform for change and fostered widespread scale-up of activities; the Healthy Life Centre concept was invented locally and continues to depend on locally-driven efforts, with municipalities given significant autonomy over activities; a structured approach to the ...

June 24, 2016 Europe

Implementing clinical audits to improve care standards in Turkey

Problem: Overprovision of medical services, particularly minor operations, radiological exams and hospital admissions; inconsistent adherence to care standards and guidelines by providers; weak monitoring and evaluation systems resulting in a lack of accountability.

Solution highlights: Clinical audits were implemented to improve adherence to national guidelines through increasing transparency and accountability for service delivery across health care institutions; lengthy discussions with stakeholders and clear communication of the initiative’s aims were essential for establishing sufficient buy-in to begin implementation; establishing data collection and analysis systems was a critical step for improving and optimizing care. Strong data collection, followed up with monitoring ...

June 24, 2016 Europe

Peer-delivered HIV/AIDS community testing and prevention services in Lisbon, Portugal

Problem: Rising prevalence of HIV among MSM population in Lisbon; limited HIV/AIDS health promotion targeted to the MSM community; low rates of care-seeking behaviour by the MSM population linked to care access barriers.

Solution highlights: A community centre was opened in Lisbon to provide free, anonymous and peer-delivered HIV testing and prevention services targeted to the MSM community; generating political buy-in took considerable time and was described as a “long and persuasive process” with a need to “repeat the message endless times”; strong grassroots advocacy and persistent lobbying efforts by a patient organization were essential for securing funding; incorporating ...

June 24, 2016 Europe

Beyond bariatric surgery: A pilot aftercare programme for bariatric patients in Germany

Problem: Rising prevalence of obesity and associated comorbidities; absence of standardized post-operative care guidelines for bariatric patients; lack of support structures to enable bariatric patients to adopt required post-operative lifestyle changes.

Solution highlights: A pilot aftercare programme offering a six-month nutritional counselling and weight monitoring service to qualifying bariatric patients was initiated by KKH, a major health insurer in Germany; thoughtful presentation of evidence and effective communication of observed problems by KKH staff was crucial for gaining the managerial support needed to start the initiative; capitalizing on existing infrastructure minimized the need for additional resource investments; active patient participation has ...

May 26, 2016 Americas

Enhancing primary healthcare delivery in the inner-city community in Toronto, Canada

Problem: Underserved, vulnerable population with complex health care needs and people unattached to primary care services; high impact of social determinants of health including health inequity; lack of access to services, insufficient coordination of care, and inadequate funding mechanisms for health and social care delivery.

Solution highlights: A very participatory evaluation process with broad involvement of all stakeholders, including patient and community members, led to consensus on priorities and gaps in services; prioritization of an innovative, patient-centred, model of health and social care led to development of an integrative Family Health team working from a social determinants of health lens ...

May 23, 2016 Europe

Disparity reduction strategy in Israel’s Clalit Health Services

Problem: Observed health inequalities in vulnerable populations; higher costs linked to overrepresentation of vulnerable populations enrolled in Clalit Health Services.

Solution highlights: Creation of a composite disparity score allowed health disparities in Clalit Health Services to be identified, assessed and then targeted for intervention; top-down leadership from senior management within Clalit Health Services was essential for creating the conditions needed for change; locally-designed initiatives provided tailored solutions for achieving targets set by senior management; capitalizing on preexisting strengths and resources minimized the need for costly investments; data-driven performance measures were the backbone of the initiative and provided evidence of the ...

May 20, 2016 Europe

Strengthening local capacity to implement integrated community health services in rural Romania

Problem: Inequitable care access and wide health disparities, particularly affecting rural and vulnerable populations; limited provision of outreach and community services in rural areas and fragmentation with social services; limited managerial capacity within rural municipalities to fulfill their mandate of organizing community health services.

Solution highlights: Through strengthening leadership capacity of local leaders, the initiative hopes to improve health and social services delivery within local communities; a longstanding international partnership built from experience collaborating on other projects was important for establishing the initiative; training was necessary to strengthen the management skills of local leaders to enable them to assess, coordinate ...

May 20, 2016 Europe

Campaigning to improve obstetric care in Poland

Problem: Absence of obstetric care standards resulting in variability of services and outdated practices; limited involvement or choice for women in the obstetric care process; lack of information relating to obstetric care or patient rights available. 

Solution highlights: The Childbirth with Dignity Foundation was established to advocate for improved obstetric care through uniting the voices of thousands of women and bringing evidence to light on key issues. Advocacy efforts ultimately led the Ministry of Health to establish obstetric care standards; systematically collecting and documenting patient experiences served as an important advocacy tool and engaging with the target population helped build ...

May 19, 2016 Europe

Implementing an integrated cardiology programme in Eastern Lithuania to improve cardiovascular health

Problem: High rates of cardiovascular disease, particularly in the eastern region; primary and secondary settings ill-equipped to provide cardiovascular care and perceived as lower quality by patients, leaving tertiary settings overburdened.

Solution highlights: The initiative strengthened cardiovascular care in primary and secondary settings, providing new training and equipment to providers to establish infrastructure for improved cardiology care outside of specialist settings; a detailed situational analysis informed the initiative’s design and provided evidence supporting the intervention; strong leadership by senior management at Vilnius University Hospital provided technical expertise and generated stakeholder support, while backing from the Ministry of Health added ...

May 16, 2016 Europe

Shifting acute care delivery from hospitals to homes in Ireland

Problem: Overreliance on institutional services and lack of community care alternatives; long waiting times for acute care services and frequent shortages of hospital beds.

Solution highlights: Community-based acute care services delivered by mobile nursing teams were introduced by Caredoc, a private nonprofit organization contracted by the Irish Health Services Executive; first-hand insights of providers enabled identification of services delivery challenges and supported development of relevant solutions; supportive senior management generated momentum for change and helped secure necessary approval for activities from authorities; stakeholder engagement was described as time consuming, but crucial to success; electronic medical records and new technologies facilitated ...