Integrated people-centred care

Approximately half the world's population lacks access to essential health care. Where health care is accessible, it is often fragmented and of poor quality. For health care to be truly universal, it requires a shift from health systems designed around diseases and health institutions towards health systems designed for people. A renewed focus on service delivery through an integrated and people-centred lens is critical to achieving this, particularly for reaching underserved and marginalized populations to ensure that no one is left behind.

An integrated and people-centred approach is needed for:

• Equity in access: For everyone, everywhere to access the quality health services they need, when and where they need them.
• Quality: Safe, effective and timely care that responds to people’s comprehensive needs and are of the highest possible standards.
• Responsiveness and participation: Care is coordinated around people’s needs, respects their preferences, and allows for people’s participation in health affairs.
• Efficiency: Ensuring that services are provided in the most cost-effective setting with the right balance between health promotion, prevention, and in- and-out patient care, avoiding duplication and waste of resources.
• Resilience: Strengthening the capacity of health actors, institutions and populations to prepare for, and effectively respond to, public health crises

Adopted with overwhelming support by Member States at the World Health Assembly in May 2016, the WHO Framework on integrated people-centred health services (IPCHS) is a call for a fundamental shift in the way health services are funded, managed and delivered. It supports countries progress towards universal health coverage by shifting away from health systems designed around diseases and health institutions towards health systems designed for people.

The vision for the Framework on integrated people-centred health services is a future in which all people have equal access to quality health services that are co-produced in a way that meets their life course needs and respects their preferences, 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.

WHO recommends five interwoven strategies that need to be implemented in order to achieve this vision:

• Engaging and empowering people and communities;
• Strengthening governance and accountability;
• Reorienting the model of care;
• Coordinating services within and across sectors;
• Creating an enabling environment

Integrated people-centred health services:

• Means putting the comprehensive needs of people and communities, not only diseases, at the centre of health systems, and engaging and empowering people to have a more active role in their own health.
• Is a more holistic way of thinking about health and looks beyond the disease or the intervention to see a whole person and the continuum of care that is needed throughout their lifespan.
• Means providing health services at the right time, in the right place in the right way, locating services close to people and communities.
• Is about building a long-term relationship between people, providers and health systems where information, decision-making and service delivery become shared.
• Means care that is respectful and more responsive to the needs of people and strives to keep them healthy and free of illness. It means that people know where and how to seek care, they know what to expect from providers, and they are also aware of their responsibilities.
• Requires commitment from the whole of government, engaging all stakeholders in a comprehensive development agenda.
• Is for all countries in the world, whether high-income, middle-income or low-income. Each country’s context and health system is different, and fragmentation and poor-quality care occurs everywhere in different ways.