The challenge of making health services people-centred: how are policy-makers in Asia approaching it?

摘要

As early as 2005, the World Health Organization's Regional Office for the Western Pacific (WPRO) had worked closely with countries in its region to promote people-centred health care and provide practical guidance on health policies and interventions that can lead to better quality of health care, better health outcomes and improved well-being. The people-centred approach to health makes the perspectives of individuals, families and communities central to the organization of health services and systems, and is critical in improving service quality and contributing to progress towards Universal Health Coverage (UHC). WHO convened a policy roundtable to in Asia on the topic of "People-Centred Integrated Health Services", and brought together 36 policy-makers and experts from 12 countries in the WHO Western Pacific Region. Challenges of implementing people-centred, integrated health services were shared and good practices for developing health services that were people-centred and integrated were discussed. The sessions discussed good practices on engagement with patients and families, ideas to strengthening governance and accountability, and coordination of services around the needs of people. Participants shared on the challenges of the current health systems, which were historically developed to provider-centric and hospital-centric, built on the bio-medical model of health. Recent changes in population demographics, healthcare needs and community expectations require health systems to evolve and adapt, to be more needs- and value-based. However in many settings, health services and social services are not well-integrated, and have contributed to poor outcomes and resource optimization. These can be worsened by technological or system barriers to timely communication and information sharing between healthcare providers. In several areas, lack of regulatory oversight has led to over-commercialization and commoditization of healthcare services. To advance people-centred, integrated health services and move towards universal health coverage, patients, families and communities need to be recognized as key partners and stakeholders in health, and be engaged accordingly. Links between health and social sectors need to be strengthened at all levels to better address the co-dependency between social and health for the population. Health systems need to promote communications and teamwork between providers and create platforms to facilitate information sharing. Alignment of policy directions and incentives is critical to generate the desired behaviors in healthcare providers and users. Health systems should collect data on what is meaningful to patients, families and communities, and shift our health systems’ KPIs to become more value-based.