The theme of the Third Global Health Systems Research Symposium was the science and practice of people-centered health systems. But what do we mean when we say “people-centered”? What seems straightforward can actually be quite complex. The people at the center of the health system represent everyone from the clients receiving services to the policy makers driving budget and strategy at the national level. Key questions: who do we focus on and how do we strengthen systems so that they are more people-centered?
So, in JSI we set out to understand what our fellow participants were thinking about people-centered health systems. The Symposium seemed like the perfect place to connect with and learn from researchers and implementers from around the world and ask them to raise their voices about what it means to be people-centered in health.
Our approach: In the Marketplace at the JSI exhibit, we welcomed participants to post their ideas on a sticky wall of ideas. Participants could complete one of three prompts:
- People-centered health systems can…
- People-centered health systems will…
- We can strengthen people-centered health systems by…
Over the course of four days, we gathered 133 different responses, creating a map of thinking about people-centered health systems.
What we learned:
Involving communities in the decision making processes ensures that we strengthen systems by listening to the voices of the most marginalized within a population. “Making patients and communities feel they matter” by developing empathy, showing respect for their unique needs, and increasing the equitable provision of services is at the heart of strengthening systems to be people-centered. Numerous contributors noted the importance of strengthening the relationship between people and providers of health services, for networking and building relationships are core to growing a truly people-centered system.
The focus cannot only be with communities though and must look across the system. Collaboration and partnership, particularly involving new partners like traditional healers and religious organizations, will be key to successful efforts to strengthen people-centered health systems . Efforts should take “both a top down and bottom up approach,” bringing together ideas from both dimensions of the system. We should focus, as researchers, on how to “improve and integrate multiple disciplines to serve and meet the needs of people through research policies and implementation.”
Responses also focused on how we measure success as we build people-centered health systems and ensure research contributes to improved health. Increasing accountability and “promoting systems that are measured by the quality of care provided to the most marginalized” should be our priority, rather than measurement through broad, sweeping metrics. Health systems research is critical to providing the knowledge and information we need to strengthen people-centered health systems, but shouldn’t be conducted as research as the end goal in itself. As a District Medical Officer said in the second plenary, we must find ways to make sure the people at the district level who are managing the system don’t “feel like a punching bag” for researchers. Rather, health systems research must be designed and carried out in a way that is used to achieve and influence health outcomes by investigating questions and sharing findings in an actionable format.
Ultimately, the aspirations for what people-centered health systems can achieve were high. “Eliminate poverty.” “Increase equity in health.” “Create universal health care.” The optimism for the potential of truly people-centered systems was striking: now we must find the most meaningful, effective ways to enable systems to achieve those goals.
**This article was originally published on October 20, 2014 on HSG Connect.