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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Sept. 6, 2016 Europe

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

Advancing the role of nurses in Finland to improve patients’ access to care

The Ministry of Social Affairs and Health promoted the shift of responsibilities from physicians to nurses through implementing supportive policies, legislation and incentives; partnerships and international networks facilitated information exchanges and offered inspiration for activities during the initiative’s design; national legislation provided the necessary framework for aligning changes in the professional scope of practice for nurses; the development of postgraduate advanced nursing programmes in partnership with universities supported the sustainability of the initiative and ensured the continuing development of nursing skills; advancing nursing roles contributed to professional empowerment and improved workplace well-being for both nurses and physicians.

Sept. 6, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Strengthening prenatal and obstetric care in Belarus

Improving maternal and child health was established as a key government priority. Strong top-down support for change reinforced by legislation provided a guiding framework for transformations; Investigation into key challenges leading to a strong understanding of root causes ensured health reforms responded to needs; prenatal screening recommendations were developed and changes to resource distribution, provider training and incentives were implemented to promote uptake and adherence to new guidelines; financial incentives for patients helped encourage desired participation in prenatal care by women; service delivery reforms took time and adoption of a long-term vision was needed.

Sept. 6, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Comprehensive health system reform to improve health in Azerbaijan

A health sector reform project was launched by the Government of Azerbaijan with the financial and technical support of the World Bank, leading to the adoption of a comprehensive National Master Plan for health in 2008; a strong understanding of the political context and environment proved important in determining an acceptable pace for proposed reforms; top-down leadership from the Ministry of Health ensured national ownership over internationally-supported reforms; strengthening the stewardship capacity of the Ministry was important; investment in human resources, including formalizing medical training and developing new medical specializations, was critical to driving sustainable change.

Aug. 30, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Establishing a unified emergency medical service in Latvia

Latvia’s 39 separate emergency service organizations were merged to form the single, centralized State Emergency Medical Service; implementing a unified structure for the provision of prehospital emergency medical services reduced fragmentation, standardized care and improved the coordination of services; formalizing provider training and education embedded new practices as the professional norm and helped ensure high-quality care delivery according to the guidelines in place; strong national leadership, along with a clear narrative and communication plan, helped gain stakeholder support for the initiative; widespread population support was secured by making services available free of charge.

Aug. 30, 2016 Europe

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

House of Generations Schwaz: A one-stop shop for providing health and social services in Austria

The Municipality of Schwaz reorganized local health and social services around the purpose-built House of Generations; co-location of services increased coordination and improved access for vulnerable groups; shared living spaces, group activities and cooperative initiatives within the House of Generations generated a sense of community, fostering a supportive and inclusive environment for vulnerable groups; strong leadership helped forge effective partnerships with municipal and regional politicians through clearly communicating aims and objectives, contributing to the initiative’s successful development; extensive involvement and linkages with the wider community generated a new hub for community-based health and social services.

Aug. 30, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Introducing compassionate use treatment for extensively drug-resistant tuberculosis in Armenia

Compassionate use TB treatment with the experimental drug Bedaquiline was introduced by MSF in partnership with the Government of Armenia to expand treatment options available to XDR-TB patients; MSF’s prior experience of compassionate use initiatives in other contexts supported the initiative’s effective implementation and provided an immediate solution to the lack of available treatment options; donor support and a close partnership with the Ministry of Health allowed initial barriers, including the lack of a comprehensive legal framework, to be overcome; closely aligning reforms with ongoing programmes reduced the investment needed in new infrastructure and helped secure greater professional ...

Aug. 30, 2016 Europe

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

Developing multi-professional group practices in France

National and regional incentives and programmes were applied to encourage primary care providers to reorganize into multi-professional group practices (MSPs). MSPs enable providers to share resources and workloads and allow a wider range of services to be offered; sufficient autonomy for local actors spurred innovative solutions to local health system challenges, including the MSP concept; national frameworks and policies supported the widespread rollout of MSPs; financial incentives, including funding for initial start-up costs and pay-for-performance bonuses, stimulated providers to reorganize into MSPs; participation in MSPs was voluntary; this helped reduce stakeholder conflicts as change was not forced on providers.

June 24, 2016 Europe

Strengthening governance and accountability, Creating an enabling environment

Developing an integrated e-health system in Estonia

A system-wide electronic health information system was introduced by the government and a national e-health foundation was established to guide change; development of e-health aligned with a broader government information strategy, enabling change and motivating necessary political support; early introduction of legislation provided a clear framework for activities and the Estonian Health Information System Development Plan 2005–2008 mapped out the change process; legislation coupled with aligned incentives encouraged widespread uptake of e-health by providers; partnerships with the private sector, universities and research organizations helped drive innovation; features of the electronic system (including electronic medical records, digital imaging, e-prescriptions and ...

June 24, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care

Peer-delivered HIV/AIDS community testing and prevention services in Lisbon, Portugal

A community centre was opened in Lisbon to provide free, anonymous and peer-delivered HIV testing and prevention services targeted to the MSM community; generating political buy-in took considerable time and was described as a “long and persuasive process” with a need to “repeat the message endless times”; strong grassroots advocacy and persistent lobbying efforts by a patient organization were essential for securing funding; incorporating the target population in the provision of services helped ensure wider community engagement and trust; absence of a formal legislative framework and financial incentives required partnerships with self-motivated health professionals to be sought out.

May 23, 2016 Europe

Engaging and empowering people and communities, Strengthening governance and accountability, Creating an enabling environment

Disparity reduction strategy in Israel’s Clalit Health Services

Creation of a composite disparity score allowed health disparities in Clalit Health Services to be identified, assessed and then targeted for intervention; top-down leadership from senior management within Clalit Health Services was essential for creating the conditions needed for change; locally-designed initiatives provided tailored solutions for achieving targets set by senior management; capitalizing on preexisting strengths and resources minimized the need for costly investments; data-driven performance measures were the backbone of the initiative and provided evidence of the need for intervention, helped incentivize performance improvements and allowed monitoring and evaluation of progress; regular feedback and monitoring fostered a culture of ...