Patient-Centered and Integrated Services (PCIS): Is it Primary Health Care (PHC) by another name?

This morning, October 1, 2014, a panel that was moderated by Edward Kelley, Director for Service Delivery and Safety at the WHO, introduced and explored the rationale and strategic directions outlined in a new WHO strategy on People-Centered and Integrated Health Services. The strategy outlines four core priorities for health systems: empowering users and population groups; strengthening engagement and accountability; coordinating services and setting and implementing system priorities. The principles that underpin the strategies include: country led and owned process; equity focused; people’s voices are heard; recognition of interdependence of different levels of health system; learning and action cycles.

A provocatively interesting question from the audience was: what is the difference between PCIS and PHC? And what have we learned from the failures of PHC to make the new PCIS strategy successful. Part of the solution lies in the ability of the research and policy community to use evidence to articulate a compelling case on the need for change – basically demonstrate that the current models of care are fragmented and are excluding many people and creating a culture of “us” and “them”. It also emerged that the narrative for change should not necessarily be premised on cost-containment but bringing people to the center of the health system, with strong emphasis on responsiveness and people’s perspectives. Once a coalition of support has been established, the next step is to invest in implementation know-how and the governance infrastructure that is required to make it happen, and to understand what works by doing.

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