IPCHS Practices

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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Jan. 17, 2020 Americas

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

Comprehensive Primary Health Care Reform in Costa Rica

In the past, Costa Rica was characterized by a duplicative and fragmented public primary healthcare system. In 1994, the country initiated a sweeping reform of the health system, including primary health care. Bureaucratic reorganization of the Ministry of Health (MOH) and the Social Security Agency (CCSS) led to the integration of all healthcare delivery under the CCSS, from public health activities to tertiary care. Comprehensive multidisciplinary primary healthcare teams (EBAIS)—comprised of a doctor, nurse assistant, community health worker, and data specialist—were created to care for approximately 5,000 patients each. A system of geographic empanelment was implemented to ...

May 26, 2016 Americas

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

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; multiple partnerships support long-term sustainability and educational collaboration; supportive leadership and internal champions created momentum for change and mitigated internal and external barriers to change; active and ongoing engagement of patients, community and health team members in program design and implementation.