The Integrated Care Workforce: What does it Need? Who does it Take?

The health and care workforce was under pressure long before the pandemic due to the development of new technologies, recurring policy reforms and dwindling ressources. It has though taken the outcry in the aftermath of COVID-19 for researchers and policymakers to realise that something fundamental needs to change. In the integrated care literature and in this journal, the fact that integrated care implementation does not work without the involvement and support of the workforce has been a recurring theme, but also little heeded. Concepts like the Quadruple Aim or the WHO European Framework for Action for integrated health services delivery ...

Towards applying the essential public health functions for building health systems resilience: A renewed list and key enablers for operationalization

The COVID-19 pandemic, climate change-related events, protracted conflicts, economic stressors and other health challenges, call for strong public health orientation and leadership in health system strengthening and policies. Applying the essential public health functions (EPHFs) represents a holistic operational approach to public health, which is considered to be an integrated, sustainable, and cost-effective means for supporting universal health coverage, health security and improved population health and wellbeing. As a core component of the Primary Health Care (PHC) Operational Framework, EPHFs also support the continuum of health services from health promotion and protection, disease prevention to treatment, rehabilitation, and palliative services ...

Inter-Disciplinary Work in the Context of Integrated Care – a Theoretical and Methodological Framework

Inter-disciplinary team working is an essential mechanism for the delivery of integrated care. This paper summarises a narrative review of the research on the ‘work’ that teams do to develop inter-disciplinary practices, addressing the question ‘How do interdisciplinary teams ‘become’ in the context of models of integrated care?’.

The narrative review identities a gap in our understanding of the active boundary work that different disciplines working together to deliver care integration engage in when creating new interdisciplinary knowledge, creating an inter-disciplinary team identity and negotiating new social and power relations. This gap is particularly significant in relation to the role ...

What is successful integrated community care (ICC)?

The ageing process vastly impacts the need for care and support, as it is often associated with a decrease in health and function. Governments of ageing populations are using “ageing in place” as the main policy perspective, in which people receive care and support in their personal environment. Although great value is within this perspective, recent studies accentuate that the location where people live vastly impacts their need for care and support. This highlights the need for the development of new, long-term care systems to address these challenges. Scholars argue that the issue can be resolved by implementing locally, integrated ...

Person-centred sexual and reproductive health: A call for standardized measurement

Person-centred sexual and reproductive health (PCSRH) care refers to care that is respectful of and responsive to people's preferences, needs, and values, and which empowers them to take charge of their own sexual and reproductive health (SRH). It is an important indicator of SRH rights and quality of care. Despite the recognition of the importance of PCSRH, there is a gap in standardized measurement in some SRH services, as well as a lack of guidance on how similar person-centred care measures could be applied across the SRH continuum. Drawing on validated scales for measuring person-centred family planning, abortion, prenatal ...

Person-centred long-term care for older persons: a new Lancet Commission

The UN declared 2021–30 to be the Decade of Healthy Ageing, and efforts are being made to maximise the functional ability of people over their life course. Yet older people are marginalised and perceived as a burden, particularly those with ongoing loss in capacity. Nowhere is this more conspicuous than in the context of long-term care (LTC) worldwide, where older people in some settings encounter a loss of independence and other violations of their human rights. Such experiences can range from deprivation of liberty and loss of legal capacity and consent to coerced institutionalisation, exposure to abuse, neglect,and ...

Integration of HIV care into maternal and child health services in the global IeDEA consortium

The WHO recommends the integration of routine HIV services within maternal and child health (MCH) services to reduce the fragmentation of and to promote retention in care for pregnant and postpartum women living with HIV (WWH) and their infants and children exposed to HIV (ICEH). During 2020–2021, we surveyed 202 HIV treatment sites across 40 low- and middle-income countries within the global International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. 

The impact of artificial intelligence on the person-centred, doctor-patient relationship: some problems and solutions

Artificial intelligence (AI) is often cited as a possible solution to current issues faced by healthcare systems. This includes the freeing up of time for doctors and facilitating person-centred doctor-patient relationships. However, given the novelty of artificial intelligence tools, there is very little concrete evidence on their impact on the doctor-patient relationship or on how to ensure that they are implemented in a way which is beneficial for person-centred care. Given the importance of empathy and compassion in the practice of person-centred care, we conducted a literature review to explore how AI impacts these two values. Besides empathy and compassion ...

Universal health coverage evolution, ongoing trend, and future challenge: A conceptual and historical policy review

The goal of universal health coverage (UHC) from the United Nations (UN) has metamorphized from its early phase of primary health care (PHC) to the recent sustainable development goal (SDG). In this context, we aimed to document theoretical and philosophical efforts, historical analysis, financial and political aspects in various eras, and an assessment of coverage during those eras in relation to UHC in a global scenario. Searching with broad keywords circumadjacent to UHC with scope and inter-disciplinary linkages in conceptual analysis, we further narrated the review with the historical development of UHC in different time periods. We proposed, chronologically, these ...

Primary healthcare competencies needed in the management of person-centred integrated care for chronic illness and multimorbidity: Results of a scoping review

Chronic disease management is important in primary care. Disease management programmes focus primarily on the respective diseases. The occurrence of multimorbidity and social problems is addressed to a limited extent. Person-centred integrated care (PC-IC) is an alternative approach, putting the patient at the centre of care. This asks for additional competencies for healthcare professionals involved in the execution of PC-IC. In this scoping review we researched which competencies are necessary for healthcare professionals working in collaborative teams where the focus lies within the concept of PC-IC. We also explored how these competencies can be acquired.