Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability.

Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts. 

Methods: The Context and Capabilities for Integrating Care (CCIC) Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks ...

Power and Integrated Health Care: Shifting from Governance to Governmentality

Integrated care occurs within micro, meso and macro levels of governance structures, which are shaped by complex power dynamics. Yet theoretically-led notions of power, and scrutiny of its meanings and its functioning, are neglected in the literature on integrated care. We explore an alternative approach. Following a discussion on governance, two streams of theorising power are presented: mainstream and second-stream. Mainstream concepts are based on the notion of power-as-capacity, of one agent ­having the capacity to influence another—so the overall idea is ‘power over ’. Studies on integrated care ­typically employ mainstream ideas, which yield rather limited analyses. Second-stream concepts ...

Meeting the Needs of the Growing Very Old Population: Policy Implications for a Global Challenge

Very old adults are one of the fastest-growing age groups worldwide. Yet they rarely constitute a targeted group for public policies. Drawing on the results of the centenarian studies presented in this special issue, we highlight major challenges that arise from the increase of this population. We outline several promising approaches for policy makers and professionals to develop evidence-based policies and programs that are tailored to the needs of very old adults and their families. We focus our discussion on three key topics essential to life care: the importance of integrated care to meet the complex care needs of the ...

Understanding integrated care: a complex process, a fundamental principle

Recent Editorial in the International Journal on Integrated Care, written by Nick Goodwin, emphasising the importance of the Framework. Around the past year Nick Goodwin has been involved in a range of research and development activities that seek to understand and/or promote the successful adoption of integrated care. In each of these, a common opening statement from protagonists is to typically say that “there is no universally accepted definition of integrated care, no one model of care that can be replicated locally, and little evidence to tell us that it works”. Whilst the latter might be disputed it remains ...

No universal health coverage without primary health care

Correspondance

Universal health coverage is currently the aspiration of many countries worldwide. We commend Michael Reich and colleagues for analysing lessons learned from different country experiences, but we believe there is a crucial element neglected within the ongoing universal health coverage debate.

Health-care system development requires more than financing and human resource considerations. Although essential, these components must be integrated into an overall framework for organising and delivering care that best meets population needs. Primary health care provides such a framework, builds the backbone of an effective health-care system, and can improve health, reduce growth in costs, and lower inequality ...

Briefing note: Policy dialogue: What it is and how it can contribute to evidence-informed decision-making

This briefing note brings together knowledge generated through the EU-Luxembourg-WHO Universal Health Coverage Partnership, which currently supports policy dialogue processes in 28 countries.

Good governance for health (part of Strategy 3 of the Framework on Integrated People-Centred Health Services) involves broad, continuous and consultative policy dialogue on crucial health sector issues amongst and between all relevant social, technical and political stakeholders. Yet there exists little guidance and analysis on what actually constitutes policy dialogue, how it can contribute to better policies, and what countries can concretely do to better engage in participatory dialogue processes. This Briefing note is a first ...

10 Best resources on… intersectionality with an emphasis on low- and middle-income countries

Intersectionality has emerged as an important framework for understanding and responding to health inequities by making visible the fluid and interconnected structures of power that create them. It promotes an understanding of the dynamic nature of the privileges and disadvantages that permeate health systems and affect health. It considers the interaction of different social stratifiers (e.g. 'race'/ ethnicity, indigeneity, gender, class, sexuality, geography, age, disability/ability, migration status, religion) and the power structures that underpin them at multiple levels. In doing so, it is a departure from previous health inequalities research that looked at these forms of social stratification ...

Universal Health Coverage’s evolving location in the post-2015 development agenda: Key informant perspectives within multilateral and related agencies during the first phase of post-2015 negotiations

In 2001, technocrats from four multilateral organizations selected the Millennium Development Goals mainly from the previous decade of United Nations (UN) summits and conferences. Few accounts are available of that significant yet cloistered synthesis process: none contemporaneous. In contrast, this study examines health’s evolving location in the first-phase of the next iteration of global development goal negotiation for the post-2015 era, through the synchronous perspectives of representatives of key multilateral and related organizations. As part of the Go4Health Project, in-depth interviews were conducted in mid-2013 with 57 professionals working on health and the post-2015 agenda within multilaterals and related ...

WHO global strategy on people-centred and integrated health services

This interim report, the WHO global strategy on people-centred and integrated health services, presents a compelling case for a people-centred and integrated health services approach, along with a look at the way forward. It is accompanied by the document "People-centred and integrated health services: an overview of the evidence".

Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities

BACKGROUND:

Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research.

OBJECTIVE:

To explore the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries.

METHODOLOGY:

We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- ...