Policy by Pilot? Learning From Demonstration Projects for Integrated Care; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study”

Analysis of policy implementation for chronic disease in Belgium highlights the difficulties of launching experiments for integrated care in a health system with fragmented governance. It also entreats us to consider the inherent challenges of piloting integrated care for chronic disease. Sociomedical characteristics of chronic disease –political, social, and economic aspects of improving outcomes – pose distinct problems for pilot projects, particularly because addressing health inequity requires collaboration across health and social sectors and a long-term, life-course perspective on health. Drawing on recent US experience with demonstration projects for health service delivery reform and on chronic disease research, I discuss constraints ...

Estimating the threshold of health workforce densities towards universal health coverage in Africa

There have been past efforts to develop benchmarks for health workforce (HWF) needs across countries which have been helpful for advocacy and planning. Still, they have neither been country-specific nor disaggregated by cadre—primarily due to data inadequacies. This paper presents an analysis to estimate a threshold of 13 cadres of HWF density to support the progressive realisation of universal health coverage (UHC).The analysis found that a unit increase in the HWF density per 10 000 population is positively associated with statistically significant improvements in the UHC SCI of countries (β=0.127, p<0.001). Consistent with current knowledge ...

How do three components of professional commitment influence nurse-reported patient-centred care and care quality?

Patient-centred care and care quality are the two critical care outcomes. However, no study has yet examined how the three components of professional commitment are related to nurse-reported patient-centred care and care quality, showing a research gap. This study shows that affective professional commitment is positively associated with nurse-reported patient-centred care, which is positively associated with nurse-reported care quality.

Family Planning Experiences and Needs of Young Women Living With and Without HIV Accessing an Integrated HIV and SRH Intervention in Zimbabwe-An Exploratory Qualitative Study

People living with HIV have higher unmet family planning needs compared to those without HIV. This is heightened for young people. However, the provision of family planning for young people within HIV programmes is uncommon. We investigated family planning uptake, acceptability of, and engagement with a service offering integrated HIV and sexual and reproductive health services for youth in a community-based setting in Zimbabwe.

Recommendations for an HIV and family planning integrated service for young people living with HIV include: offering a range of services (including method-mix contraceptives) to choose from; supporting their agency to engage with the services which ...

2022 Progress report on the Global Action Plan for Healthy Lives and Well-being for All. Stronger collaboration for an equitable and resilient recovery towards the health-related Sustainable Development Goals – Incentivizing collaboration

As COVID-19 continued to dominate global health over the last year, the direct and indirect impact of the pandemic has led progress against the health-related SDGs to fall even further behind.  At the same time, crises such as armed conflict, increasing food insecurity, political and economic instability and the growing impact of climate change threaten to derail recovery from the pandemic.

A key way to respond to and ensure an equitable and resilient recovery from COVID-19 is for multilateral agencies to collaborate even more closely in providing effective and efficient joint support to countries, which is the foundation of the ...

Heterogeneity in preferences for outcomes of integrated care for persons with multiple chronic diseases: a latent class analysis of a discrete choice experiment

For an integrated care programme to be successful, preferences of the stakeholders involved should be aligned. The aim of this study is to investigate to which extent outcomes beyond health are valued and to study the heterogeneity of preferences of those involved in integrated care.

The acceptability of integrated healthcare services for HIV and non-communicable diseases: experiences from patients and healthcare workers in Tanzania

In sub-Saharan Africa, the prevalence of non-communicable diseases (NCDs) has risen sharply amidst a high burden of communicable diseases. An integrated approach to HIV and NCD care offers the potential of strengthening disease control programmes. We used qualitative methods to explore patients’ and care-providers’ experiences and perspectives on the acceptability of integrated care for HIV-infection, diabetes mellitus (DM), and hypertension (HT) in Tanzania.

Person-centred care planning as foundational to clinical practice

The World Health Organization recently issued new guidance and technical packages for community mental health services, entitled “Promoting Person?Centred and Rights?Based Approaches”. As these documents make clear, within the sphere of mental health, the provision of person?centred care is itself an issue of human rights. This is not only true in the cases of involuntary or coercive treatments – when precautions and oversight must be exercised to ensure preservation of dignity and respect under exceptional circumstances – but with regard to all forms of mental health care. All mental health care, including clinical practice, needs to be fundamentally re ...

The role of primary care in informing and supporting people with limited health literacy in the Netherlands during the COVID-19 pandemic: a qualitative interview study

During the coronavirus disease 2019 (COVID-19) pandemic, people have been confronted with a large amount of information about the virus and the governmental measures against its spreading. However, more than a quarter of individuals have limited health literacy (HL), meaning that they have difficulty finding, understanding, and applying health information. The purpose of this interview study was to investigate how individuals with limited HL acquire information about COVID-19 and governmental measures, what difficulties they experience in understanding and applying it, and what may be needed to overcome these difficulties. We also addressed other problems that they might face as a ...

Rebuilding for sustainability and resilience: strengthening the integrated delivery of long-term care in the European Region

The pandemic of coronavirus disease 2019 (‎COVID-19)‎ has revealed and accentuated important gaps in the provision of appropriate, community-based, long-term care services for a rapidly growing number of people experiencing decline in functional ability, across the WHO European Region. As countries work to rebuild and strengthen health and long-term care systems, it is essential to support broad dialogue, a common vision forchange and focused interventions to bridge existing divides. This policy brief proposes a conceptual framework that maps long-term care actions within the health and social policy landscape and highlights the need and potential for deeper integration and coordination across ...