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

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.

Sept. 6, 2016 Europe

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

Piloting integrated health networks to improve type 2 diabetes care in Andorra

Primary care nurse-physician teams were introduced to lead new diabetes health networks, with the aim of connecting providers across sectors and strengthening primary care gatekeeping; collaboration with stakeholders in the early design stages of the initiative encouraged multistakeholder buy-in from the outset; updated evidence-based care pathways published in a guidebook helped streamline and standardize care; extensive patient education and coaching on self-management skills enabled patients to engage in their own care; pragmatic intermediary solutions were found to address pressing challenges; for example, implementing paper medical records carried by the patient to counter poor communication between providers in the absence of ...

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

Reorienting the model of care, Creating an enabling environment

Identifying high-risk chronic patients for targeted primary care intervention in Veneto, Italy

Adjusted Clinical Groups were introduced in primary care as a means to proactively target patients at high risk for chronic disease with personalized health interventions and preventive services; when designing the initiative, leaders sought out existing solutions from abroad which could be adapted for application in Veneto; gradual implementation of the initiative through a three-phase pilot project allowed time to explore, verify and refine activities before scaling up across Veneto; services were reoriented to become more proactive, nurses were awarded additional responsibilities related to patient outreach and patients’ own role in their care was increased; Veneto's existing strong data ...

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.

Aug. 17, 2016 Africa

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

Creating a sustainable model of spine care in underserved communities in Botswana

As identified in the Global Burden of Disease report (2012), spine disorders present an enormous burden on individuals, their families, communities and societies and are the leading cause of disability worldwide. In Botswana, the burden of low back pain has been estimated to be the 5^th leading cause of disability adjusted life years (DALYS) in 2013 and neck and back pain combined is ranked as the number 1 cause of years lived with disability (YLDs), increasing from the third position in 1990 to the first position in 2013. In the developing world the burden of spine disorders is expected ...

July 29, 2016 Americas

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

Telemedicine for improved access to diagnostic services for remote populations in Paraguay

Telemedicine system introduced to improve access to specialist services for remote populations; primary and secondary health centres now collaborate with specialists from tertiary level hospitals on diagnostic services; telemedicine system transmits medical images to specialists; specialists provide diagnostic services to isolated health centres.