Centring health systems around people remains a major challenge for all countries. Traditionally, a fragmented landscape of health providers has determined what services to offer and how they are delivered, while patients have had limited options to choose, participate or even co-produce.
People demand now a more active role in their health care and a better response to their expectations as social values have progressed and information asymmetries have shrunk with the advent of new forms of communication and participation. Hence, it has become a health systems practitioners’ mandate to walk the talk of valuing choice and the preferences of individuals, de-institutionalizing services for increased community-based care closer to home, involving individuals and their caregivers in managing long-term care needs, engaging multiple care disciplines, promoting the exercise of personal choice, and extending services beyond physical limits into virtual modalities.
This book provides a comprehensive and necessary analysis of the multi-pronged concept of people-centredness to set a common background to health reformers, practitioners and researchers. Its editors and chapter authors explore what health strategies and innovations can contribute to effectively make health systems more people-centred, empowering community participation, measuring people’s perceptions and enabling choice of providers and payers. They also provide evidence-based guidance on how health services can be more person-centred by engaging patients in decision-making, empowering them as managers of their own care and, overall, fostering self-management.
It comes at a timely moment when health systems celebrate historical landmarks like the foundation of the World Health Organization in 1948. In 2018 we also commemorated the 40th anniversary of the Declaration of Alma Ata and the 10th anniversary of the Tallinn Charter that shape modern health policies aiming to achieve health for all underpinned by the vision put forward by Health 2020. They all share the vision of people-centred health systems based on the principles of equity, social justice, community participation, health promotion, the appropriate use of resources and intersectoral action.
Against this backdrop, 21st century health systems need to be rethought and strengthened to successfully face a changing world context characterized by ageing societies, globalization, climate change and technological progress. People-centred health systems based on strong primary health care and integrated health services across the life-course are vital to reach the Sustainable Development Goals and achieve universal health coverage by 2030 and this book is an accurate compass to guide the way forward.
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