November 17, 2023
How Integrated Person-Centered Care Can Pave the Path Towards Universal Health Coverage
Translating Learnings from the HIV Response
Following the United Nations High Level Meeting on Universal Health Coverage (UHC), policymakers and communities are looking for tangible approaches to accelerate progress toward the 2030 UHC goal. We would be remiss if we didn’t look at the robust global HIV response and lessons it can provide in reaching people with high-quality health services.
Pioneered through the HIV response, integrated person-centered care (IPCC) has proven to be transformative in the global fight against HIV/AIDS. An IPCC approach to health focuses on empowering communities and individuals to actively engage in their health, placing them at the center of the health system. Considering the success that IPCC has had in improving access to, uptake of and continued engagement in care within the global HIV response, Friends of the Global Fight, PATH and JSI recently released the Integrated Person-Centered Health Services: Translating Learnings from the HIV Response to Pave the Way to Universal Health Coverage report, which delves into lessons learned from delivering IPCC through the HIV response and offers recommendations for how we can systematically build on and translate application of these lessons to other health areas, ultimately moving towards people-centered health systems.
HIV programs have adopted IPCC in several ways, such as integrating health services by offering multi-disease screening during HIV-related care, or diversifying how, where and by whom health care services are offered, whether virtually via telemedicine platforms, through mobile outreach or by peers. The HIV response demonstrates that a one-size-fits-all approach is unrealistic if we are to achieve health equity , as different circumstances—such as urban versus rural contexts or populations—require different approaches to health service delivery.
Increasing the accessibility of health services improves health outcomes and can be achieved through a variety of approaches. One approach, known as “one-stop shops,” offers access to a variety of health services at a single site, increasing the likelihood for more coordinated care and minimizing the need for clients to visit multiple service locations. Other approaches include differentiated service delivery, which adapts health service delivery to cater to individual needs and technological innovations, such as self-administered diagnostics and treatment, while maximizing clients’ choice and convenience.
Greater inclusion of civil society in health governance also stands out as an essential factor in IPCC implementation, as engaging communities helps minimize gaps in health systems and ensures that the needs of individuals and communities are voiced and accounted for in health care delivery.
To build on these various lessons and mainstream IPCC, governments and health care systems around the world need to work to further increase the scale of IPCC, both within the HIV response (specifically prevention efforts), and other health areas, including the broader primary health care platform. At the same time, it is equally important to consider and recognize that not all situations call for service integration and IPCC. Many marginalized communities may not currently be well-served by their primary health care system, due in part to issues of bias and discrimination. Here, a more effective approach to IPCC can involve designing and offering integrated service packages within delivery modalities that are preferred and/or cater to communities’ unique needs and circumstances more specifically.
The process of integrating health care services should be carried out in stages, monitored at each step of expansion and prioritize community involvement along the way. Investing in the health workforce and in health systems, as well as incentivizing innovation in service delivery efforts, will help scale up IPCC and advance global efforts to achieve UHC.
To fulfill the potential of IPCC, this new report calls for three key actions: investing in the health workforce, strengthening and supporting community responses and advancing mechanisms to monitor client feedback and ensure service quality. Action is necessary from international donors, the World Health Organization, governments and communities to help all individuals access health services tailored to their specific needs. IPCC can enable this level of care for all populations, specifically those who are marginalized, and help us to collectively move towards UHC.
To hear more insights from our report and engage in discussions on advancing IPCC across global health systems, please join us on at 9 AM EST on Wednesday, January 31st.