Using Person-centered Care to Accelerate Progress toward the Sustainable Development Goals
Few would question the connection between person-centered care and Sustainable Development Goal (SDG) 3 to ensure healthy lives and promote well-being for people at all ages. The global health community agrees that effective, equitable health services must include individuals and communities as participants in their own care. After having the opportunity to moderate JSI’s three-part livecast series, I’ve come to realize that person-centered care is not only an important component of SDG 3, but needs to be applied across sectors if we want to reach SDGs by 2030.
The 78th United Nations General Assembly (UNGA) opened on September 5. The theme of this year’s assembly is “Rebuilding trust and reigniting global solidarity: Accelerating action on the 2030 Agenda and its Sustainable Development Goals towards peace, prosperity, progress and sustainability for all.” To achieve this, we must respect peoples’ needs and preferences, while considering the physical and social environment in which they live and how it influences their ability to make decisions and take action.
Health outcomes are influenced by our health care, social, governmental, economic, and environmental systems — all dimensions of sustainable development. After hearing from our colleagues and partners during the livecast series, it is clear that we must expand our conceptualization and application of person-centered approaches beyond the health system and interactions in doctor’s offices, and look for ways these approaches can help reach all 2030 SDGs.
A policy and financing environment that is conducive to person-centered care can improve health, education, and livelihoods.
An enabling environment for person-centered care requires multi-sectoral partnerships and a shift of public resources toward essential services that affect health and well-being, including primary care, education, and public works. Government and civil society leaders need to involve individuals, communities, and service providers in planning and decision-making to ensure that the right resources are available at the right time, and that they reflect people’s needs and priorities.
In Uganda, JSI strengthened collaboration between immunization personnel and “non-health stakeholders” such as chief administrative officers, local council chairpersons, and community leaders to improve immunization service delivery. This resulted in repurposing buildings in Bulambuli District into six health facilities that provided immunization and other primary health care services to 53,000 people. Other districts passed bylaws to supplement funding for immunization, held leadership forums to discuss human resources, and worked with community savings banks to provide transport for health workers. While the collaboration focused on immunization, it benefited the health system more broadly and promoted shared ownership of outcomes and commitment to community well-being.
Person-centered care moves us closer to building “effective, accountable, and inclusive institutions at all levels.”
Accountability is multi-directional, and as we prioritize rights holders’ voices, we must be transparent and hold leaders accountable, but also make sure all actors are aware of their responsibilities when implementing person-centered care. For example, the USAID Ethiopia Transform: Primary Health Care Activity supported 31 districts to implement a community scorecard to manage performance. The intervention improved primary health care unit performance, health system responsiveness to community needs, and maternal and child health service availability and use.
Person-centered care can facilitate positive norm changes and improve service access, reducing inequality within and among countries.
Delivering person-centered care means providing experiences that are identity-affirming and respond to individual needs and aspirations. It also means taking action beyond health facilities to end stigma, discrimination, and social norms that perpetuate inequality so that people can get care when and where it is convenient. For example, in the Kyrgyz Republic, the USAID Cure Tuberculosis project works with health promotion units, village health committees, and community and religious leaders to dispel myths and stop stigma and discrimination against people living with TB to increase access to TB care and social services. The USAID-funded Strengthening Egypt’s Family Planning (FP) Program engages local youth groups and FP champions to increase access to sexual and reproductive health information and services. Through initiatives like Ma’ana Fe Al-Dawar, youth use storytelling and art to spark conversations that challenge traditional social and gender norms related to FP. With guidance from youth leaders, this approach expanded to other health and social topics that advance local health and gender equality goals.
As the UNGA continues this month, I ask my colleagues in all sectors of international development to consider how person-centered care can help us achieve the 2030 Agenda and ensure that all people can achieve their full potential. Let us work together to see that everyone is treated with dignity and equality and that we as a global community continue on the path to better health, social, economic, and educational outcomes for all.