The WHO Framework on integrated

people-centred health services

Geneva Health Forum

19-21 April 2016, Geneva

Climate change Ageing

NCDs

Innovation Globalization

Urbanization Citizen voice

The changing global context:

challenges and opportunities

Rising costs

Source: WHO Global Health Observatory Data Repository, 2015

Unequal access

Poor quality/safety

Deficient participation

Low satisfaction

Health system challenges

HEALTH

SYSTEM

Unhealthy behaviours

& lifestyle choices Double-burden

of disease and multimorbidity

Greater citizens

expectations

Need for cost efficiency and

accountability

Increased need to

self-manage care

Limited intersectoral action

Lack of community

empowerment and engagement

Service fragmentation and

inappropriate

service delivery model

Insufficient and misaligned

financing

Sub-optimal

health workforce

EMERGING DEMANDS SYSTEM CONSTRAINTS

Integrating

HIV/AIDS and

TB in Mali

Mobilizing

communities to

reduce maternal

and neonatal

deaths in Malawi

Shared

accountability

contract for

population

health

outcomes,

Kinzigtal,

Germany

Promoting

service

coordination in

Lithuania

Integrated health

care networks in

Chile

Social

participation in

Tupiza, Bolivia

People-centred

and integrated

health services

in the NUKA

health system,

Alaska, USA

Case

management in

Torbay, UK

Promoting

HIV/AIDS literacy

in Angola

Integrated health

care networks in

Brazil

Family medicine

in Thailand as

part of UHC

Community-

owned primary

care networks in

Mali

Integrated care

in South Karelia,

Finland

Balanced

scorecard to

promote

accountability,

Afghanistan

Integrating

traditional and

complementary

medicine in Asia

What are the

experiences to date?

What outcomes

have been achieved?

Improved

access to care

for marginalized

groups

Reduced

unplanned

hospitalizations

Increased

ability to self-

manage

Workforce role

enhancement

Reduced

costs

Greater community

engagement &

participatory

representation

Shared

decision-making

Shift in the

balance of care,

allocating

resources

closer to needs

Better

coordination

of care

Increased

access to care

Greater

community

influence & better

relationships with

care providers that

build awareness

and trust

Improved

health literacy

Reduced

perinatal and

neonatal mortality

Increased

health coverage

Greater

quality of care

What outcomes

have been achieved?

Source: Adapted from Amelung et al. 2014, Transform Proposal

Lessons from implementation:

challenges to achieve sustainability and scale

Project’s duration

Su

cces

s

Time (years)

t1 t2 t3

1 Project failure

2 Slow death

3 Struggling projects

4 Sustainable projects

5 Scaling up

6 System transformation

“All people have equal access to quality health services

that are co-produced in a way that meets their life course

needs, are coordinated across the continuum of care and

are comprehensive, safe, effective, timely, efficient and

acceptable; and all carers are motivated, skilled and

operate in a supportive environment”

The vision

Defining integrated people-centred health

services delivery

Source: Adapted from National Voices (2013)

Coordinated

Preventive

Goal oriented

Evidence-

informed

Empowering

Respectful

Co-produced

Endowed with rights and

responsibilities Equitable

Continuous

Shared

accountability

Comprehensive

Ethical Led by whole-

systems thinking

Sustainable

Collaborative

Holistic

Integrated people-

centred

services delivery

© World Health Organization 2015

A model for integrated people-centred

health services delivery

The way forward: five strategies

© World Health Organization 2015

© World Health Organization 2015

The way forward: five strategies

Stategy1.

Empowering & engaging people

Improving health literacy

Examples of interventions

Sharing decision making between

people & health professionals

Giving people access to personal

health records

Supporting self-management

Promoting personal care

Fostering community participation

Boosting community awareness

Enhancing community delivered care

Harnessing patient and user groups

Addressing structural factors that

marginalize at-risk communities

Parallel processes in the

development and implementation

of the Framework

Parallel processes in the

development and implementation

of the Framework

Framework consultation

Interim report

Public consultation

Consultation with WHO Regional Offices

Executive Board

World Health Assembly

2015

2016

Call for action for IPCHS

Piloting and development of

demonstration sites

Assessment and implementation

toolkits

Monitoring and evaluation

Exchanging knowledge and

facilitating change

Implementation support

Supporting the implementation of the

Framework: aims and objective

© World Health Organization 2015

Developing a web platform Supporting

demonstration sites

Fostering partnerships

Exchanging

knowledge

and facilitating

change

Developing a web platform Integratedcare4people

www.integratedcare4people.org

CONTACT INFORMATION

Services Delivery and Safety Department

World Health Organization

Avenue Appia 20

CH-1211, Geneva 27

Switzerland

For more information on health services delivery visit

http://www.who.int/servicedeliverysafety/areas/people-

centred-care/en/