On March 15th, JSI convened a distinguished panel of guest speakers for a moderated discussion on governing and financing person-centered care (PCC). The Behavior Effect livecast series will be conducting a three-part series on PCC.
The global health community is increasingly supporting PCC— demanding de-medicalization of the health system and shifting the focus of control to the person, not the disease. But how do we do that? Where do we start? Our moderator, Kate Onyejekwe, set the scene by breaking PCC into three areas of changes needed: 1)policies and the way we finance care, 2) the way we develop our workforce and hold systems accountable, and 3) how we design and deliver services.
Representatives from different constituency groups representing different parts of the health system were convened to shed light on where we can start with operationalizing PCC. They included: Dr. Loyd Mulenga, National HIV Program Coordinator and Head of Infectious Disease program at the Ministry of Health in Zambia; Sentayehu Tsegaye, Project Director for Amref-Ethiopia; Andy Seale, HIV/AIDS Advisor with the World Health Organization; and JSI’s Philip Kamutenga, Chief of Party at the Global Health Supply Chain Technical Assistance — Tanzania (GHSC-TA-TZ).
The WHO defines PCC as an approach to care that considers individuals, carers, and communities as participants in their own care. Creating an environment where the recipient of care is a critical component in clinical decision-making requires a cultural shift in public health programming.
These shifts are eased when financial, political and governing structures are aligned. Several key takeaways, illustrated by this event’s panel, are critical in ensuring this alignment:
We must work to create and support health policies that break down vertical or siloed funding in order to provide room for PCC
Integrating person-centered services will require more resources and we work in resource-constrained environments. We must engage communities and data in helping prioritize how those resources are used. While donors are recognizing the need to move away from siloed funding streams (PEPFAR, Global Fund, GAVI as examples), panelists urged attendees to continue to push for a move away from vertical funding silos and consider adjacent or more integrated programs.
“Look for the diagonal approach that will cut across systems and diseases.” — Sentayehu Tsegaye
The panel also emphasized the importance of investing and prioritizing primary health care as foundational to expanding PCC and recognizing that each community and circumstance requires a nuanced and contextualized approach.
Leadership in PCC requires flexibility, curiosity and community grounding
Leaders designing and implementing PCC interventions need the flexibility and time to know communities, engage with community leaders, learn from their providers, and support others to problem solve. Teamwork is essential for the development of person-centered care. Time horizons for results need to be expanded, local and donor priorities must align.
Multiple Stakeholders and multiple sectors need to be part of designing and implementing person-centered care
Conceptual clarity of who each stakeholder is, what they want, and what they will be held accountable for will help the overall process as we move toward PCC. The panelists articulated the roles that government, civil society, local and international NGOS, as well as the private sector play in enabling PCC.
“Community voices guide Zambian health infrastructure. We’ve been able to provide primary health care due to diverse funding sources, but these donors don’t guide the policy framework: they allow the voices of our people to guide policy decisions” — Lloyd Mulenga, Zambia MOH
In closing, all panelists echoed that people who lead policy and make financing decisions need to systematically engage the individuals receiving care, as well as the communities and health providers who support those clients as part of decision-making processes. Collectively, the panelists urged the audience to hold those with decision-making power accountable for making sure funding is available at the right time for the right things, and that leaders prioritize people, and not diseases.
For more information and resources on PCC, please visit: https://www.jsi.com/person-centered-care/. If you missed this first of three livecasts, you can watch it here. Our second in the series will be on accountability of person-centered care — stay tuned for this in May.
