WCIC4 – 4th World Congress on Integrated Care: “Investing in our Future: Improving the Health of People and Communities”

Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities

BACKGROUND:

Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research.

OBJECTIVE:

To explore the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries.

METHODOLOGY:

We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- and middle-income countries. The initial search yielded 3,092 articles, of which 260 articles with more than nominal community participation were identified and included. We further excluded 104 articles due to lower levels of community participation across the research cycle and poor description of the process of community participation. Out ...

Enhancing governance and health system accountability for people centered healthcare: an exploratory study of community scorecards in Afghanistan

BACKGROUND:

The premise of patient-centered care is to empower patients to become active participants in their own care and receive health services focused on their individual needs and preferences. Afghanistan has evidenced enormous gains in coverage and utilization, but the quality of care remains suboptimal, as evidenced in the balanced scorecard (BSC) performance assessments. In the United States and throughout Africa and Asia, community scorecards (CSC) have proved effective in improving accountability and responsiveness of services. This study represents the first attempt to assess CSC feasibility in a fragile context (Afghanistan) through joint engagement of service providers and community members in the design of patient-centered services with the objective of assessing impact on service delivery and perceived quality of care.

METHODS:

Six primary healthcare facilities were randomly selected in three provinces (Bamyan, Takhar and Nangarhar) and communities in their catchment area were selected for the study. Employing a multi-stakeholder strategy ...

Exploring perceptions of community health policy in Kenya and identifying implications for policy change

BACKGROUND:

Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change.

METHODS:

We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those who will influence or be influenced by CHS policy change in Kenya (policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members) in two purposively selected counties: Nairobi and Kitui. Qualitative data were digitally recorded, transcribed, translated and coded before ...

WCIC4 Extended deadline for submission of abstracts

The International Foundation of Integrated Care (IFIC), in partnership with General Practice New Zealand (GPNZ) and Healthcare Quality and Safety Commission (HCQSC) , presents the 4rd World Congress on Integrated Care “Investing in our Future: Improving the Health of People and Communities” to take place in Wellington, New Zealand 23 to 25 November 2016.

They extended the call for submission of abstracts until Friday 1 July 2016. Follow the link below for more information. 

Create Space & Place for Community Voice: East Denver Neighborhoods Build a Plan

Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was held in May 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health.

One highlight of the meeting was interviewing community collaborations funded by The BUILD Health Challenge. The BUILD Health Challenge is a national awards program designed to support community collaborations that are working to give everyone a fair chance to be healthy.

Overview

We know that every young child and family in East Denver has the potential to thrive, but not every family has the same starting place. East5ide Unified is committed to establishing a community-driven, community-led effort to develop an East5ide Unified Action Plan designed to level the playing field for young children before they start school. We are focused on children in five neighborhoods in East Denver: Cole, Clayton, Five Points, Whittier and Skyland.

About the Practical Playbook ...

Create Space & Place for Community Voice: East Denver Neighborhoods Build a Plan

Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was held in May 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health.

One highlight of the meeting was interviewing community collaborations funded by The BUILD Health Challenge. The BUILD Health Challenge is a national awards program designed to support community collaborations that are working to give everyone a fair chance to be healthy.

Overview

We know that every young child and family in East Denver has the potential to thrive, but not every family has the same starting place. East5ide Unified is committed to establishing a community-driven, community-led effort to develop an East5ide Unified Action Plan designed to level the playing field for young children before they start school. We are focused on children in five neighborhoods in East Denver: Cole, Clayton, Five Points, Whittier and Skyland.

About the Practical Playbook ...

A guide to enabling the spread of person- and community-centred approaches for health and wellbeing

This guide is addressed to people who champion person- and community-centred approaches in health and social care. It is part of the NHS England-funded Realising the Value programme led by Nesta and the Health Foundation, which seeks to develop person- and community-centred approaches for health and wellbeing. Two main contents are included in the guide: a framework for understanding and changing behaviour, and real-world examples of how these changes happen in practice.
Change is more likely to spread when both statutory organisations and community-based organisations align approaches. For this reason the guide feature case studies from both parts of the system.  They are colour coded to enable different audiences to navigate the guide easily.

Centers of excellence in healthcare institutions: what they are and how to assemble them

Centers of excellence-specialized programs within healthcare institutions which supply exceptionally high concentrations of expertise and related resources centered on particular medical areas and delivered in a comprehensive, interdisciplinary fashion-afford many advantages for healthcare providers and the populations they serve. To achieve full value from centers of excellence, proper assembly is an absolute necessity, but guidance is somewhat limited. This effectively forces healthcare providers to pursue establishment largely via trial-and-error, diminishing opportunities for success. 

Utilization of community-based health planning and services compounds in the Kintampo North Municipality: a cross-sectional descriptive correlational study

The Community-based Health Planning and Services (CHPS) initiative was introduced to improve coverage and utilization of basic health services for people in remote rural communities whose use of orthodox health services was hitherto limited by distance. So the objectives of this study were to examine the extent of patronage of CHPS compounds in the Kintampo North Municipality , factors associated with their use and challenges faced by community members regarding the use of these facilities. 

Translating the Elements of Health Governance for Integrated Care from Theory to Practice: A Case Study Approach

Against a paucity of evidence, a model describing elements of health governance best suited to achieving integrated care internationally was developed. The aim of this study was to explore how health meso-level organizations used, or planned to use, the governance elements. 

Communities and health

The role of communities in improving health is receiving increasing, and long overdue, attention in health policy and practice. Stronger recognition of the role communities can play and greater involvement are needed if there is to be a successful move to population health systems. As part of this shift in focus, sustainability and transformation partnerships and integrated care systems need to take the role communities can play in improving and sustaining good health seriously. 

Patient vs. Community Engagement: Emerging Issues

The value proposition of including patients at each step of the research process is that patient perspectives and preferences can have a positive impact on both the science and the outcomes of comparative effectiveness research. How to accomplish engagement and the extent to which approaches to community engagement inform strategies for effective engagement need to be examined to address conducting and accelerating comparative effectiveness research.
The objective was to examine how various perspectives and diverse training lead investigators and patients to conflicting positions on how best to advance engagement.

Does supportive supervision enhance community health worker motivation? A mixed-methods study in four African countries

Supportive supervision is an important element of community health worker (CHW) programmes and is believed to improve CHW motivation and performance. A group supervision intervention, which included training and mentorship of supervisors, was implemented in Ethiopia, Kenya, Malawi and Mozambique. In three of the countries, this was combined with individual and/or peer supervision. A mixed-methods implementation study was conducted to assess the effect of the supervision intervention on CHWs’ perceptions of supervision and CHW motivation-related outcomes. The study suggests that there is potential for integrating supportive group supervision models in CHW programmes. A combination of group with individual or peer supervision, preferably accompanied with methods that assess CHW performance and corresponding feedback systems, could yield improved motivation and performance.

A guide to enabling the spread of person- and community-centred approaches for health and wellbeing

This guide is addressed to people who champion person- and community-centred approaches in health and social care. It is part of the NHS England-funded Realising the Value programme led by Nesta and the Health Foundation, which seeks to develop person- and community-centred approaches for health and wellbeing. Two main contents are included in the guide: a framework for understanding and changing behaviour, and real-world examples of how these changes happen in practice. Change is more likely to spread when both statutory organisations and community-based organisations align approaches. For this reason the guide feature case studies from both parts of the system. They are colour coded to enable different audiences to navigate the guide easily.

Ghana country assessment report on ageing and health

Ghana, like many other countries, is experiencing a demographic transition with its ageing population. To provide reliable evidence for policy-making in ageing and health, this assessment report is prepared to identify priority issues on ageing in Ghana. By reviewing evidence from the WHO Study on global AGEing and adult health (SAGE) in Ghana and other sources, this document reveals the health status of older people in Ghana as well as the health systems response and policies relevant to ageing. The report also proposed 5 priorities relating to the prevention, treatment and care needs of older people in Ghana.

A qualitative appraisal of stakeholders’ perspectives of a community-based primary health care program in rural Ghana

The Ghana Community-based Health Planning and Services (CHPS) initiative is a national strategy for improving access to primary health care services for underserved communities. Following a successful trial in the North Eastern part of the country, CHPS was adopted as Ghana’s flagship programme for achieving the Universal Health Coverage. Recent empirical evidence suggests, however, that scale-up of CHPS has not necessarily replicated the successes of the pilot study. This study examines the community’s perspective of the performance of CHPS and how the scale up could potentially align with the original experimental study.

Variation in Chronic Diseases Across Households, Communities, Districts, and States in India

Globally, chronic noncommunicable diseases are the leading cause of death and accounted for 6 million deaths in India in 2016. However, the extent to which variation in chronic disease can be attributed to different population levels in India is unknown, as is whether variation in individual-level factors explains outcome variation at different population levels.

Community Responses to COVID-19: From the Horn of Africa to the Solomon Islands

While this pandemic has the potential to fracture societies, it is the resilience, solidarity, strength, and ingenuity of communities that will help overcome this crisis.

Highlights

• Community-driven development (CDD) programs, which put people at the center of designing their own solutions, are a critical part of the World Bank’s response to the global COVID-19 crisis.

• The Bank is supporting countries in Horn of Africa and in Solomon Islands through CDD programs that are delivering cash and basic services to the most vulnerable.

• To tackle a crisis of this magnitude and scale, countries need an equitable, whole-of-society approach, which lies at the heart of CDD programs.

The COVID-19 pandemic continues to have devastating impacts on people, with a disproportionate impact on the poor and the most vulnerable, who lack the coping mechanisms and essential services they need.

In a crisis of this magnitude, no single intervention is enough, and countries ...

Shared Governance: Working Together to Enable People-Centred Integrated Care

Now more than ever, healthcare systems and communities must work together to improve outcomes for patients, caregivers and populations. Shared governance is an essential piece of the journey towards an integrated, people-centred health system; one that must be co-designed in partnership to breakdown barriers in care.

Join this session to learn from the first-hand experiences from a patient partner, a senior health care leader, a Canadian policy maker and an international expert, as they discuss:

• Examples of how shared governance models have been co-designed to enable collaborative, people-centred health systems across the continuum of care; and
• Key practices and implementation resources based on the latest evidence.

Leadership in integrated care networks: A literature review and opportunities for future research

This article reviews research on leadership in integrated care networks. It is timely as scholars and policy makers regard integrated care as a key part in reforming healthcare systems to cope with demographic aging, the rising prevalence of chronic diseases and the growing demand for long-term care.

In many countries, elderly patients with chronic conditions require a web of services delivered by several providers collaborating in inter-organisational networks. In view of their global importance, it is surprising how little we know how these networks are led. Like traditional organisations, networks require leadership to function effectively. This paper reviews central characteristics of leadership in integrated care networks and proposes opportunities for future research.

In this article, 73 studies published in the main academic journals are analyzed. This article consolidates the research on means, practices, activities and results of leadership, covering the levels of analysis of networks, policies and organizations.

Age Friendly, Healthy, Connected Communities. IFIC Scotland Integrated Care Matters: Build Back Better Webinar Series

IFIC's new report, Realising the true value of integrated care describes the steps we must take to create a radically different future beyond Covid-19. The report is a powerful call to reset our compass to a new reality based on solidarity and collaboration for population health. IFIC Scotland and partners will explore this new future in series 5 of their Integrated Care Matters webinars. Guest panelists, members of IFICs international Special Interest Groups, will share their experiences and insights and challenge us to design a better future that improves lives and opportunities for all. Each webinar will be accompanied by a topic resource with links to further information. All who register will receive links to the recordings and topic resources.

Professor Anne ...

IFIC Ireland Patient Empowerment Mini-Series with CEmPaC

The World Health Organization (WHO) defines Empowerment for Health as ‘a process through which people gain greater control over decisions and actions affecting their health. Empowerment may be a social, cultural, psychological or political process through which individuals and social groups are able to express their needs, present their concerns, devise strategies for involvement in decision-making, and achieve political, social and cultural action to meet those needs.’

Integrated care systems are an opportunity to reset the relationship between health services and the public

‘The more we concentrate on merely reworking our existing institutions, the more we fail to see or understand the nature of the new challenges that surround us.’
Hilary Cottam, Radical help

Putting the ‘I’ Back into Integrated Care

Charlotte Augst, CEO of National Voices, reflects on progress with integrated care since the charity co-produced the I statements with people with lived experience of health and social care services.

Primary Care for Everyone: An Urgent To-Do List for Reform

Worldwide, the health systems with the best outcomes are the ones that get primary care right. Canada’s federal, provincial and territorial governments are recognizing the critical importance of improving primary care in their recent funding agreements.

The time for bold action is now. New federal funding is entering the system as bilateral agreements are being signed with provinces and territories. “Family health” is front and centre, with all levels of government and people across the country on the same page. It’s time to supercharge the reform.

The Public Policy Forum’s Taking Back Health Care project is a year-long initiative to assemble and promote the best thinking about actions necessary to address Canada’s health-care crisis. This paper is the second in a series of commentaries that the project is producing. The first paper, Taking Back Health Care: How to Accelerate People-Centred Reform Now, was an overview of ...

Primary care: the sleeping giant of research delivery

A sustainable NHS requires a shift from reactive acute care to proactive ambulatory care, from secondary care to primary care, with a focus on health creation by empowering people and communities. This will require evaluation of transformed models of care to create a new evidence base, which in turn requires a strong primary care research delivery infrastructure.

Citizen Leadership & Integrated Care Report

Integrated care is at its heart about health, social care and wider services being better coordinated around people, families, and communities. This requires those who plan, design, and deliver services to understand what is important to people on an individual and collective basis. People’s circumstances and aspirations may change with their health conditions and social situations and through new challenges arising in wider society. It is therefore important that opportunities to influence and co-produce services are not a one-off exercise, but rather are ongoing and responsive to people’s interests and perspectives.

Professor Robin Miller and Dr Caroline Jackson (Social Care theme) have been collaborating with research partners in Europe and Canada to understand how people with lived experience of health and/or social care can influence the development of integrated care.

The first report from the research is now available for download: Citizen Leadership & Integrated Care Report.

Transnational Forum on Integrated Community Care (TransForm)

Integrated care strategy, health and wellbeing board and joint forward plan guidance: what you need to know

Key points

• The Department for Health and Social Care has released guidance for:

1. the preparation of integrated care strategies by integrated care partnerships
2. health and wellbeing boards and how they will work with and within integrated care systems
3. principles for integrated care partnership engagement with adult social care providers
4. principles for integrated care partnership engagement with health overview and scrutiny committees.

• NHS England has released guidance on developing the joint forward plan, to support integrated care boards and their partner trusts to develop their first 5-year joint forward plans.
• Integrated care partnerships may wish to publish an initial interim strategy by December 2022 if they want to align and influence integrated care boards' first five-year joint forward plans.
• Integrated care boards (ICBs) and their partner trusts are required to prepare a joint forward plan before the start of each financial year, and share the final version with their integrated care ...

Primary health care case studies in the context of the COVID-19 pandemic

Overview