The Lancet Global Health Commission on financing primary health care: putting people at the centre

Person-centred care and measurement: The more one sees, the better one knows where to look

Determining the quality of a health system is a complex and challenging endeavour. The variety of perspectives needed to determine quality means that increasingly complex measurement frameworks are often employed. Providing the best possible health care has always been a priority for health system leaders, individual professions and individual professionals. But the importance and significance of measuring quality has increased since the evolution of quality-improvement methodologies for health-care quality standardisation in the 1990s.

Audit and feedback systems evolved into quality-control methods with the increased industrialisation of health systems. As the patient voice became increasingly important, with the rise in advocacy ...

Measuring with quality: the example of person-centred care

Qualitative data analysis should be embedded in routine health service measurement, management and organizational practices. The rigorous use of such analyses should become an institutional norm, comparable to the routine use of quantitative data. Our case is intended to have general relevance, but we develop it by reference to person-centred care and patient-centred outcome measures (PCOMs). The increased use of qualitative data analysis of individualized PCOMs is a crucial complementary counterweight to steps towards the standardization of PCOMs. More broadly, our argument is that health care organizations cannot make confident judgements about whether they are offering appropriate care without collecting ...

Benefit design: the perspective from health financing policy

Given the central importance of public financing to make progress towards universal health coverage (UHC), government policy on benefit design, including both service entitlements and conditions of access, significantly influences health system performance. Benefit design considers how all public funds are used and should be based on evidence and developed through a systematic process involving key stakeholders. Reducing uncertainty over entitlements and conditions of access, in particular co-payments, both reduces barriers to accessing services and improves financial protection. Finally, aligning benefit design with a range of health financing policies, as well as service with delivery objectives, provides a powerful way ...

Have we forgotten the moral justification for patient-centred care?

Patient-centred care has attracted intense attention over the last 50 years. First articulated in the late 1960s, and inspired by Roger’s Client-Centred Therapy and Balint’s concept of the therapeutic relationship, its early focus was on the relationship between a patient and their physician. Over the last couple of decades, patient-centred care has become a foundation for health professional education, a guiding principle for health disciplines and an explicit focus of the patient-centred medical home. Perhaps the debates about frameworks, definitions and terminology have distracted us. Is it time for educators, researchers and clinicians to move their focus beyond ...

Framework for countries to achieve an integrated continuum of long-term care

The framework for countries to achieve an integrated continuum of long-term care identifies key aspects necessary to achieve an integrated continuum of long-term care service provision and to facilitate the integration of long-term services within existing health and social care systems.

The framework will guide countries in assessing system-level components to implement sustainable and equitable long-term care actions. By applying this framework, countries can begin to develop and shape their long-term care systems as part of their universal health coverage programmes and promote investment in long-term care and the health workforce, including carers.

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Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review

The objective of this research was to systematically review and synthesize quantitative studies that assessed the association between socioeconomic inequalities and primary health care (PHC) utilization among older people living in low- and middle- income countries (LMICs). Most studies reported that higher income, higher educational levels and enrollment in health insurance plans were associated with increased PHC utilization. Several studies suggested that people who were unemployed and economically inactive in older age or who had worked in formal sectors were more likely to use PHC. Our findings suggest a pro-rich phenomenon of PHC utilization in older people living in LMICs ...

Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context

Since the Alma Ata Declaration of 1978, countries have varied in their progress towards establishing and sustaining comprehensive primary health care (PHC) and realizing its associated vision of 'Health for All'. International health emergencies such as the coronavirus-19 (COVID-19) pandemic underscore the importance of PHC in underpinning health equity, including via access to routine essential services and emergency responsiveness. This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework.

The Effect of Integration of Family Planning Into HIV Services on Contraceptive Use Among Women Accessing HIV Services in Low and Middle-Income Countries: A Systematic Review

There is substantial unmet need for family planning (FP) among women living with HIV (WLHIV), leading to unintended pregnancies and may contribute indirectly to increasing the risk of transmission of HIV. This review aims to determine whether integration of FP into HIV testing and care results in increased use of contraception, a reduction in unmet need for FP, improved use of safer conception methods and a reduction in unintended pregnancies in low and middle-income countries. The primary outcome of the review was contraceptive uptake and secondary outcomes included unmet need for FP, safer conception and unintended pregnancy.

The European Health Data Space: A step towards digital and integrated care systems

In December 2021, EGIDE, the Expert Group for integrated Care and Digital Health Europe, has launched a paper ‘The European Health Data Space: A step towards digital and integrated care systems’.

The paper aims to represent the views of the chronic disease community. It provides a unique combination of perspectives from academia, healthcare professionals, patients and industry. The authors acknowledge too many patients across Europe are experiencing fragmented and delayed care. COVID-19 has highlighted the weaknesses of our healthcare systems and the need for rapid transformation. The European Health Data Space can act as a catalyst for change in several ...