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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Oct. 4, 2016 Europe

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

Integrating nutrition programmes in primary care in Kyrgyzstan

A programme to distribute micronutrient sprinkles, locally known as “Gulazyk”, was introduced with donor support. Following successful piloting of the programme, activities were scaled up nationally in 2011; aligning with existing infrastructure and services helped support and stabilize reforms implemented under the initiative; building trust between primary care providers and patients was essential for ensuring uptake of micronutrient supplementation; community health volunteers aided trust building; developing a consistent message across all providers, even those not directly involved with the initiative, safeguarded changes against being undermined at different care levels; encouraging participation of mothers and community members proved valuable in overcoming ...

Oct. 4, 2016 Europe

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

Developing guidelines to reduce under-five child mortality in the Republic of Moldova

The government developed an under-five child mortality reduction initiative and established new standards and protocols for the observation of childhood illness; research conducted prior to the initiative identified the root causes of problems and provided evidence of the need to act; guidance and support from the Ministry of Health led to coordinated intersectoral action Educating and expanding providers’ competencies challenged pre-held attitudes regarding the detection and treatment of childhood illness; joint-sector delivery by health providers and social workers facilitated more comprehensive and coordinated care for patients; national ownership over the initiative was important; activities were fully integrated into national standards ...

Sept. 22, 2016 Europe

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

Establishing ambulatory care for patients with tuberculosis in Uzbekistan

Médecins Sans Frontières (MSF), in partnership with the Government of the Republic of Karakalpakstan, introduced ambulatory care from day one (ACD1) as an alternative model for TB care; a strong understanding of service delivery challenges led to a solution that met patients’ needs; a supportive political and legal framework, developed prior to implementation, helped to sustainably embed reforms within the health system; strong relationships between key actors who had a history of working together aided the initiative.

Sept. 7, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care

Integrating delivery of TB services in primary care in Tajikistan

Following on from previous national efforts to address high TB incidence rates, the third National TB Programme 2010–2015 was approved by the government to systematically address service delivery gaps and continue to develop TB services in primary care; building on previous actions taken to reduce TB and learning from these experiences enabled a stronger approach moving forward; cross-ministry partnerships ensured united government support and greater stability for the initiative; partnerships between the government and international organizations provided an infusion of technical expertise and resources; adjusting resource allocation was used as a mechanism to drive organizational shifts in service delivery.

Sept. 7, 2016 Europe

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

Outpatient rehabilitation services for working-age patients with brain injuries in Bern, Switzerland

An outpatient rehabilitation centre specifically adapted to the needs of working-age patients recovering from brain injuries was opened in Bern; Direct clinical experience of the multi-professional leadership team helped draw awareness to service delivery gaps and aided the design of practical services to address observed needs; co-location of providers within the rehabilitation centre increased service coordination and improved access for patients, while external networking between providers helped generate referrals; gradual expansion of the initiative allowed time for sufficient resources to be collected and necessary partnerships to be established, ensuring steady and sustainable growth.

Sept. 7, 2016 Europe

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

Pioneering integrated organizational models for improving elderly people’s care in Ängelholm, Sweden

A new integrated care organization (Hälsostaden) was established to merge primary and hospital care with elderly and social care. Hälsostaden is jointly managed by its regional and municipal government and employs 600 professionals across health and social sectors; early investments in stakeholder relationships and trust building were essential for securing the future of the initiative and developing a foundation based on teamwork; finding the uniting objective of improving care for elderly people enabled stakeholders to move forward with planning; contextualizing the initiative within emerging political priorities helped generate political support and secure the necessary legal frameworks; identifying individual ...

Sept. 7, 2016 Europe

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

Developing an integrated primary care model in Slovakia

Networks of primary-level integrated health care centres (IHCC) that co-locate providers and promote interdisciplinary team working are being developed and piloted; piloting of reforms will enable gradual introduction and testing of planned changes; a national-level framework provided the initiative with a strong starting base from which to develop, set clear goals for change and supported the alignment of activities; regional authorities will lead implementation of reforms to allow adaptations based on local needs; the creation of a new agency to provide analysis and implementation support increased the government’s capacity to lead change.

Sept. 7, 2016 Europe

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

Introducing palliative care in Serbia

The Ministry of Health established the Palliative Care Task Force and adopted the National Strategy for Palliative Care to guide the development of palliative care across Serbia; partnerships with international organizations, local NGOs and supportive government actors helped secure buy-in at the national level; developing a legislative and political base was essential for creating a foundation on which to build the initiative; securing EU funding provided additional resources to support activities; incorporating a new palliative care philosophy within professional culture required extensive training, communication, advocacy and time; formalizing educational opportunities through university partnerships helped to ensure sustainability.

Sept. 7, 2016 Europe

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

Integrating health and social care in San Marino

In 2004, the Government of San Marino began the process of integrating the health and social care system to improve care coordination and efficiency, and published the first social-health plan in 2006 to help guide change; health and social care reforms reinforced already widespread informal practices in service delivery and nurtured the existing spirit of mutual respect, collaboration and effective communication; familiarity and close professional relationships across health and social care sectors were integral to the development of the initiative; integration of management structures at the system level provided a strong platform from which to drive integration at the service ...

Sept. 7, 2016 Europe

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

Advancing nursing roles to improve disease prevention services in Samara, Russian Federation

Polyclinic 15 led an initiative to expand health promotion and disease prevention services by advancing nursing roles. Nurses now independently care for lower-risk patients, perform screenings and deliver health education; expanding nurses’ scope of practice helped to overcome physicians’ capacity barriers. Physicians now report having more time for high-risk patients; continuous training, backed by supportive legislation and incentives, helped to institutionalize new practices; international partnerships supported the transfer of knowledge and advancement of nursing; health education helped empower patients to self-manage their conditions and adopt lifestyle changes.