What is people-centred health care?
The term ‘people-centred health care’ is not to be confused with patient-centred health care. People-centred health care is an umbrella term which better encapsulates the foremost consideration of the patient across all levels of health systems. Therefore, this term would cover patient-centred health care.
Values and guiding principles of people-centred health care
The underlying values and guiding principles of people-centred health care have been articulated in WHO and other international declarations that contribute to global welfare and are of significance regionally. Table 1 highlights the major relevant declarations.
Table 1: Key WHO and international declarations
The core values embedded in these declarations are:
- The central role of the family and community in any process of development, and
- An end to gender and all other forms of discrimination.
The right and duty of people to participate individually and collectively in all aspects of their lives has largely been emphasized in relation to health and development. The implications of these values are clear: people have the right and duty to participate in making decisions about their health care, and not only in issues of treatment and management, but for broader issues of health care planning and implementation. This reinforces the notion of the people-centred approach to health care and reflects the fact that this concept is not contemporary or new, but originally stems from the human rights movement articulated over half a century ago.
Characteristics of people-centred health care
People-centred health care represents a major shift in thinking. It has a long history in research, clinical practice, and medical education and in recent decades, there have been concerted efforts to re-orient health care services to make it a practical reality. Despite its long history and increasing popularity, people-centred health care has not been satisfactorily and collectively enunciated at the health system level, to encapsulate the needs, wants and expectations of individuals, families and communities, and how health practitioners, health administrators, and bureaucrats could respond.
The key characteristics of people-centred health care include:
For individuals, patients and their families:
- Access to clear, concise and intelligible health information and education that increase health literacy;
- Equitable access to health systems, effective treatments, and psycho-social support;
- Personal skills which allow control over health and engagement with health care systems: communication, mutual collaboration and respect, goal setting, decision making, and problem solving, self-care; and
- Supported involvement in health care decision-making, including health policy.
For health practitioners:
- Holistic approach to the delivery of health care;
- Respect for patients and their decisions;
- Recognition of the needs of people seeking health care;
- Professional skills to meet these needs: competence, communication, mutual collaboration and respect, empathy, health promotion, disease prevention, responsiveness, and sensitivity;
- Provision of individualized care;
- Access to professional development and debriefing opportunities;
- Adherence to evidence-based guidelines and protocols;
- Commitment to quality, safety and ethical care;
- Team work and collaboration across disciples, providing co-ordinated care and ensuring continuity of care.
In health care organizations:
- Accessible to all people needing health care;
- Commitment to quality, safe and ethical care;
- Safe and welcoming physical environment supportive of lifestyle, family, privacy and dignity;
- Access to psychological and spiritual support during the care experience;
- Acknowledgement of the importance of all staff - managerial, medical, allied health, ancillary – in the delivery of health care;
- Employment and remuneration conditions that support team work people-centred health care;
- Organisation of services that provide convenience and continuity of care to patients;
- Service models that recognise psycho-social dimensions and support partnership between individuals, their families and health practitioners.
In health systems:
- Primary care serves as the foundation;
- Financing arrangements for health organisations that support partnership between health practitioners and people accessing health care;
- Investment in health professional education that promotes multidisciplinary team work, good communication skills, an orientation towards prevention, and integrates evidence about psychosocial dimensions of health care;
- Avenues for patient grievances and complaints to be addressed;
- Collaboration with local communities;
- Involvement of consumers in health policy;