IPCHS

Contents tagged: health service delivery

May 15, 2016 Europe Publication

Engaging and empowering people and communities, Strengthening governance and accountability, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Lessons from transforming health services delivery: Compendium of initiatives in the WHO European Region

In order for health services delivery to accelerate gains in health outcomes it must continuously adapt and evolve according to the changing health landscape. At present, the case for change is compelling. In the context of both new challenges and opportunities, initiatives to transform services delivery across the WHO European Region has emerged. This Compendium demonstrates the diversity in activity, describing examples of health services delivery transformations from each Member State in the Region. The initiatives vary greatly in their scope and stages of implementation, from early changes to initiatives at-scale. When taken together, these examples offer unique insights for setting-up, implementing and sustaining transformations. A summary of 10 lessons learned attempts to synthesize key findings and consolidate insights derived from experiences.

effective care transitions, health service delivery, lessons learned, quality of care, transformational change

Dec. 2, 2016 Africa Publication

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

Patient-Centered Care and People-Centered Health Systems in Sub-Saharan Africa: Why So Little of Something So Badly Needed?

Patient–centered care (PCC) is increasingly recognized as a key dimension of quality healthcare, but unfortunately remains poorly implemented in practice. This paper explores the current state of PCC in sub-Saharan Africa and potential barriers to its implementation, with a focus on public first line health services. They develop an analytical framework based on expert knowledge, field experience, and a conceptual literature review. Factors contributing to the (lack of) implementation of PCC are structured in three distinct but interacting layers. The first layer encompasses factors that influence and shape the performance of providers. The training of health workers is key in that respect. Training models remain dominated by a biomedical perspective, with little attention for psychosocial dimensions of the illness experience. The second layer of determinants relates to the structural and organizational features of the health system. The emphasis in many African health care systems on specific programmatic outputs, and ...

health service delivery, health systems, patient-centered care, primary health care, sub-saharan africa

June 16, 2020 South-East Asia Publication

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

A narrative review of gaps in the provision of integrated care for noncommunicable diseases in India

Low- and middle-income countries (LMICs) account for a higher burden of noncommunicable diseases (NCD) and home to a higher number of premature deaths (before age 70) from NCDs. NCDs have become an integral part of the global development agenda. This paper reinforces the need for an integrated comprehensive model of NCD care especially at primary health care level to address the growing burden of these diseases.

continuum of care, follow-up and referral, health service delivery, monitoring systems, noncommunicable diseases, private health sector, screening for ncds, urban health

Nov. 20, 2020 Americas Publication

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

The reimagination of sustainable integrated care in Ontario, Canada

To encourage clinical and financial efficiency, the Canadian province of Ontario initiated an integrated care program – Integrated Funding Models (IFMs) that required collaboration and coordination across acute and post-acute care sectors. This research shows how program implementers went beyond policy-makers’ original designs, to make integrated care sustainable for chronic diseases.

Highlights

Integrating care across sectors was challenging for chronic disease programs.
Participants adopted creative sustainability strategies, unique to each program.
Their designs transcended policymakers’ original conceptualization of integration.
Fostering accountability and patient-centred care was key to sustainability for program stakeholders.
Differences in policymakers’ and program implementers’ understanding of integrated care are indicated.

funding of integrated care, health service delivery, models of care, models of service integration, sustainability

June 10, 2022 Americas Publication

Policy by Pilot? Learning From Demonstration Projects for Integrated Care; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study”

Analysis of policy implementation for chronic disease in Belgium highlights the difficulties of launching experiments for integrated care in a health system with fragmented governance. It also entreats us to consider the inherent challenges of piloting integrated care for chronic disease. Sociomedical characteristics of chronic disease –political, social, and economic aspects of improving outcomes – pose distinct problems for pilot projects, particularly because addressing health inequity requires collaboration across health and social sectors and a long-term, life-course perspective on health. Drawing on recent US experience with demonstration projects for health service delivery reform and on chronic disease research, I discuss constraints of and lessons from pilot projects. The policy learning from pilots lies beyond their technical evaluative yield. Pilot projects can evince political and social challenges to achieving integrated chronic disease care, and can illuminate overlooked perspectives, such as those of community-based organizations (CBOs), thereby potentially extending the terms of policy ...

chronic disease, health equity, health service delivery, policy learning, social determinants of health, social services