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

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.