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

Main Article Content

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.

Article Details

Section
Making progress in people-centered care: country experiences
Author Biographies

Hernan Montenegro, World Health Organization Regional Office of the Americas

Health Systems and Services

Caroline Ramagem, World Health Organization Regional Office of the Americas

Health Systems and Services

Rania Kawar, World Health Organization

Health System Governance and Service Delivery

Don Matheson, Massey University

Centre for Public Health Research

Rafael Bengoa, Basque Government

Department of Health

Ricardo Fábrega Lacoa, Central University, Santiago

Faculty of Health Sciences

Robinah Kaitiritimba, Uganda National Health Users'/Consumers'Organisation (UNHCO)

Uganda National Health Users'/Consumers'Organisation (UNHCO)

Gérard Schmets, World Health Organization

Health System Governance and Service Delivery

Denis Porignon, World Health Organization

Health System Governance and Service Delivery

Carissa Etienne, World Health Organization

Health Systems and Services

Wim Van Lerberghe, World Health Organization

Health system Governance and Service Delivery

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