Abstract
BackgroundPeople-centred health care (PCC) services are identified by the WHO as important building blocks towards universal health coverage. In 2016 the WHO formulated a comprehensive framework on integrated PCC services based on an international expert consultation. Yet, expert opinions may fail to recognize the needs of all health system stakeholders. Therefore, a consultation method that includes the health workforce and laypersons, can be instrumental to elaborate this framework more in-depth. This research sought to identify participants’ perspectives on policy options and interventions to achieve people-centred health care services from a multi stakeholder perspective.MethodsStudy participants, both laypersons and health professionals, were recruited in Belgium. A total of 53 participants engaged in one of the seven concept mapping workshops. In this workshop the concept mapping methodology developed by Trochim, a highly structured qualitative group method for brainstorming and idea sharing, was used to generate and structure participants´ perspectives on what is needed to achieve PCC services. The method was validated using the WHO framework.ResultsThe seven workshops together resulted in 452 different statements that were structured in a framework forming 35 clusters and four overarching domains. The four domains with their most prominent clusters were: (1) governance & policy with intersectoral health policies and affordable health for all; (2) health workforce with excellent communication skills, appreciation of health literacy challenges and respectful attitude based on cultural self-awareness; (3) integrated health services with a greater emphasis on prevention, health promotion and the availability of health education and (4) patient, person and community empowerment and participation with support for informal care, promotion of a healthy lifestyle and contextualised health education. Additionally, this study generated ideas that fitted into every single approach described in the WHO framework.Discussion and conclusionThis study shows that in order to achieve PCC a participative approach involving all stakeholders at all levels is needed. The concept mapping process is one of these approaches that brings together diverse stakeholders and foments their egalitarian and respectful participation. The framework that resulted from this study can inform future debate regarding planning, implementation and monitoring of PCC.
Highlights
People-centred health care (PCC) services are identified by the World Health Organization (WHO) as important building blocks towards universal health coverage
“People-centred health care is defined by the WHO as an approach to care that consciously adopts individuals’, carers’, families’ and communities’ perspectives as participants in, and beneficiaries of, trusted health systems that respond to their needs and preferences in humane and holistic ways” [6]
Given the international interest and potential power of people-centred health care, and the need to understand from all viewpoints how people and not health services can retake the central position towards their health, this study explored laypersons’ and health professionals’ perspectives on policy options and interventions to achieve people-centred health care services
Summary
People-centred health care (PCC) services are identified by the WHO as important building blocks towards universal health coverage. Since the WHO (World Health Organization) stated the importance of organising primary health care around people’s needs in its 2008 World Health Report [1], integrated people-centred health care (PCC) is considered the service model towards universal health coverage. This model surmounts the overall recognized patient centred care [2], towards the “person” [3], including prevention and health promotion and towards “people”, emphasizing the interconnectedness of persons, the importance of the community context and participation, the intersectoral nature of health [4] and the right to health (Universal Declaration of Human Rights, 1948). The PCC approach to improve maternal and neonatal health in El Salvador enhanced community capacity, ownership, and leadership, improved relations with health services, strengthened intersectoral links and coordination mechanisms and resulted in a drop in maternal deaths to zero since 2006 in 90% of the municipalities involved [15]
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