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Making Progress in People-centred Care: Country Experiences and Lessons Learnt

Hernan Montenegro, Caroline Ramagem, Rania Kawar, Don Matheson, Rafael Bengoa, Ricardo Fábrega Lacoa, Robinah Kaitiritimba, Gérard Schmets, Denis Porignon, Carissa Etienne, Wim Van Lerberghe

Abstract


Orienting healthcare towards people-centred primary care is one of the four policy directions for the renewal of primary healthcare outlined in the World Health Report 2008, Primary Health Care: Now More than Ever - along with universal coverage, health in all policies and more inclusive health governance. During the Fourth Geneva Conference on Person- centred Medicine, WHO organized a session on policies and health system interventions that help make care more people- centred. Case studies from Chile, New Zealand, Spain (Basque Region) and Uganda illustrated that the implementation of people-centred care (PCC) varies greatly across countries.  Despite these variations, three key lessons emerge. First - efforts to make care more people-centred may more likely succeed when they are linked to or are part of other major drivers of change such as improving equity in health, establishing rights or addressing chronic diseases. Second - such efforts tend to be long-term processes that require sustained political will and leadership as well as consistency over time. Top-down, supply-driven reforms need to be complemented with bottom-up, demand-driven measures to facilitate change. Third - participation of all interested parties (policy-makers, providers and users) as well as other sectors is vital for ensuring success. The case studies suggest that people-centred care is more likely to succeed when it is implemented using system- wide approaches that make use of multiple policy instruments intervening at different levels while guaranteeing sustainable financing and alignment of financial incentives.


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References


World Health Organization (2008). World Health Report 2008: Primary Health Care: Now More than Ever. Geneva: WHO.

Pan American Health Organization/World Health Organization (2007). Renewing Primary Health Care in the Americas: A Position Paper of the Pan American Health Organization (PAHO/WHO). Washington, D.C.: PAHO/WHO.

Mead, N., & Bower, P. (2000). Patient-centredness: a conceptual framework and review of the empirical literature. Social science & medicine (1982), 51(7), 1087–1110.

Stewart, M., Brown, J., & Donner, A. (2000). The impact of patient-centered care on outcomes. Journal of Family Practice (2000), 49(9), 796-804.

Little, P., Everitt, H., Williamson, I., Warner, G., Moore, M., Gould, C., Ferrier, K., et al. (2001). Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. British Medical Journal (Clinical research ed.), 323(7318), 908–911.

World Health Organization: Resolution WHA62.12. Primary health care, including health system strengthening. In: Sixty-Second World Health Assembly, Geneva, 1822 May 2009. Resolutions and Decisions. Geneva, 2009 (WHA62-/2009/REC/1).

Information on Geneva Conferences on People-Centered Medicine. International Network for Person-centered Medicine (INPCM) [homepage on the Internet]. Available from: http://www.personcenteredmedicine.org/events.php

International Network for Person-centered Medicine (INPCM) [homepage on the Internet]. Available from: http://www.personcenteredmedicine.org/index.php

WHO (2010). Technical report on People-centered Care in Low and Middle Income Countries. Department of Health System Governance and Service Delivery, Third Geneva Conference on Person-Centred Medicine May 5, 2010.

Montenegro, H. Plenary Session on Making Progress in People-centered Care: Country Experiences: Lessons and Way Forward. Presented at the Fourth Geneva Conference on Person-centered Medicine. Switzerland, 2011.

Instituto Vasco de Estadística (Eustat).

Población estimada de la C.A. de Euskadi a 31 de diciembre. 1975-2009. Available at: http://www.eustat.es/elementos/ele0000600/ti_Poblacion_estimada_de_la_CA_de_Euskadi_a_31_de_diciembre_1975-2009/tbl0000660_c.html#axzz1Xt1RDuj2.

Bengoa, R. Fourth-Geneva Conference on Person-Centered Medicine. Presented at the Fourth Geneva Conference on Person-centered Medicine. Switzerland, 2011.

Instituto Nacional de Estadísticas & CEPAL. CHILE: Proyecciones y Estimaciones de Población. Total País 1950-2050. Available at: http://www.ine.cl/canales/chile_estadistico/demografia_y_vitales/proyecciones/Informes/Microsoft%20Word%20-%20InforP_T.pdf

UNICEF. Chile Statistics. Available at: http://www.unicef.org/infobycountry/chile_statistics.html.

Fabrega, R. People-centred medicine in health systems: The “Chile Grows with You” support programme for biopyschosocial development. Presented at the Fourth Geneva Conference on Person-centered Medicine. Switzerland, 2011.

Statistics New Zealand. Estimated resident population of New Zealand. Available at: http://www.stats.govt.nz/tools_and_services/tools/population_clock.aspx.

New Zealand Ministry of Health. Tracking Disparity: Trends in ethnic and socioeconomic inequalities in mortality, 1981 – 2004. Public Health Intelligence Occasional Bulletin No. 38. August 2007. Available at: http://www.moh.govt.nz/moh.nsf/indexmh/tracking-disparity-inequalities-mortality-1981-2004.

Matheson, D. New Zealand’s Journey towards People Centred Care. Presented at the Fourth Geneva Conference on Person-centered Medicine. Switzerland, 2011.

Uganda National Health Users’/Consumers’ Organization (UNHCO) [homepage on the Internet]. Available from: http://unhco.or.ug/.

Robinah, K. Country Experiences with People Centered Care – Uganda. Presented at the Fourth Geneva Conference on Person-centered Medicine. Switzerland, 2011.

World Health Organization. Health Systems Strengthening Glossary. Definition of People-centred care. Available at: http://www.who.int/healthsystems/hss_glossary/en/index8.html.

Bardach, E (2009). A Practical Guide for Policy Analysis (3rd edition).

Brownson, R. C., Baker, E. A., Leet, T. L., & K. N. Gillespie. (2003). Evidence-based public health. Oxford and New York: Oxford Univ. Press.

Walt, G. & Gilson, L. (1994). Reforming the health sector in developing countries: the central role of policy analysis. Health Policy and Planning 1994 (9): 353-70.

Fiscella, K. et al. (2004). Patient trust: is it related to patient-centred behavior of primary care physicians? Medical Care 2004 (42): 1049-55.




DOI: https://doi.org/10.5750/ijpcm.v2i1.93

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