IPCHS

This growing repository holds WHO documents, scientific publications, policy documents, implementation reports, presentations and others with information and insights about integrated people-centred health services. Share your publication by clicking “Add publication”.

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April 27, 2016 Africa

Engaging and empowering people and communities, Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

People-centred health systems, a bottom-up approach: where theory meets empery

BACKGROUND AND METHODS:

Health systems are complex and constantly adapt to changing demands. These complex-adaptive characteristics are rarely considered in the current bureaucratic top-down approaches to health system reforms aimed to constrain demand and expenditure growth. The economic focus fails to address the needs of patients, providers and communities, and ultimately results in declining effectiveness and efficiency of the health care system as well as the health of the wider community. A needs-focused complex-adaptive health system can be represented by the 'healthcare vortex' model; how to build a needs-focused complex-adaptive health system is illustrated by Eastern Deanery AIDS Relief Program ...

April 26, 2016 Africa

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors

Effects of community health interventions on under-5 mortality in rural Guinea-Bissau (EPICS): a cluster-randomised controlled trial

Background

Evidence suggests that community-based interventions that promote improved home-based practices and care-seeking behaviour can have a large impact on maternal and child mortality in regions where rates are high. We aimed to assess whether an intervention package based on the WHO Integrated Management of Childhood Illness handbook and community mobilisation could reduce under-5 mortality in rural Guinea-Bissau, where the health service infrastructure is weak.

Methods

We did a non-masked cluster-randomised controlled trial (EPICS) in the districts of Tombali and Quinara in Guinea-Bissau. Clusters of rural villages were stratifi ed by ethnicity and distance from a regional health centre, and ...

April 26, 2016 Americas Europe Western Pacific

Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Integrating funds for health and social care: an evidence review

Objectives

Integrated funds for health and social care are one possible way of improving care for people with complex care requirements. If integrated funds facilitate coordinated care, this could support improvements in patient experience, and health and social care outcomes, reduce avoidable hospital admissions and delayed discharges, and so reduce costs. In this article, we examine whether this potential has been realized in practice.

Methods

We propose a framework based on agency theory for understanding the role that integrated funding can play in promoting coordinated care, and review the evidence to see whether the expected effects are realized in practice ...

April 26, 2016 Global

Reorienting the model of care, Coordinating services within and across sectors

Can service integration work for universal health coverage? Evidence from around the globe

Universal health coverage (UHC) is at the heart of the new 2030 Agenda for SustainableDevelopment. Health service integration is seen by World Health Organization as an essen-tial requirement to achieve UHC. However, to date the debate on service integration hasfocused on perceived benefits rather than empirical impact. We conducted a global reviewin a systematic manner searching for empirical outcomes of service integration experimentsin UHC countries and those on the path to UHC. Sixty-seven articles and reports were found.We grouped results into a unique integration typology with six categories – medical stafffrom different disciplines; patients and medical staff; care package for ...

March 30, 2016 Global

Coordinating services within and across sectors, Creating an enabling environment

Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist.

The WHO mHealth Technical Evidence Review Group developed the mHealth evidence reporting and assessment (mERA) checklist to improve the reporting of mobile health (mHealth) interventions.The development process for mERA consisted of convening an expert group to recommend an appropriate approach, convening a global expert review panel for checklist development, and pilot testing the checklist. The guiding principle for the development of these criteria was to identify a minimum set of information needed to define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features), to support replication of the intervention ...

March 28, 2016 Global

Engaging and empowering people and communities, Strengthening governance and accountability

Universal Health Coverage’s evolving location in the post-2015 development agenda: Key informant perspectives within multilateral and related agencies during the first phase of post-2015 negotiations

In 2001, technocrats from four multilateral organizations selected the Millennium Development Goals mainly from the previous decade of United Nations (UN) summits and conferences. Few accounts are available of that significant yet cloistered synthesis process: none contemporaneous. In contrast, this study examines health’s evolving location in the first-phase of the next iteration of global development goal negotiation for the post-2015 era, through the synchronous perspectives of representatives of key multilateral and related organizations. As part of the Go4Health Project, in-depth interviews were conducted in mid-2013 with 57 professionals working on health and the post-2015 agenda within multilaterals and related ...

March 18, 2016 Africa Europe Western Pacific Global

Reorienting the model of care, Coordinating services within and across sectors

Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries

For most women in low and middle income countries (LMIC), antenatal care (ANC) plays a highly important dual role: not only does ANC provide effective interventions to reduce the risks associated with pregnancy and childbirth, it can also serve as a delivery platform for other health services. Particularly in settings where the prevalence of HIV/AIDS, sexually transmitted infections (STIs), tuberculosis (TB) and malaria is high, integrating services for these conditions with ANC can significantly expand their reach. In fact, the World Health Organization (WHO) identified integration of ANC with other health programmes as a key strategy for reducing missed ...

March 18, 2016 Americas Global

Reorienting the model of care, Coordinating services within and across sectors

Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses

Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a “diagonal approach.” We ...

March 18, 2016 Americas

Reorienting the model of care, Coordinating services within and across sectors

Primary Care and Public Health Services Integration in Brazil’s Unified Health System

Objectives: We examined associations between transdisciplinary collaboration, evidence-based practice, and primary care and public health services integration in Brazil’s Family Health Strategy. We aimed to identify practices that facilitate service integration and evidence-based practice.

Methods: We collected cross-sectional data from community health workers, nurses, and physicians (n = 262). We used structural equation modeling to assess providers’ service integration and evidence-based practice engagement operationalized as latent factors. Predictors included endorsement of team meetings, access to and consultations with colleagues, familiarity with community, and previous research experience.

Results: Providers’ familiarity with community and team meetings positively influenced evidence-based practice engagement and ...

March 17, 2016 Americas

Strengthening governance and accountability, Reorienting the model of care, Coordinating services within and across sectors

Health-system reform and universal health coverage in Latin America

Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions ...