Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2018

Open Access 01-12-2018 | Research

Using concept mapping to identify policy options and interventions towards people-centred health care services: a multi stakeholders perspective

Authors: Christine Cécile Leyns, Jan De Maeseneer, Sara Willems

Published in: International Journal for Equity in Health | Issue 1/2018

Login to get access

Abstract

Background

People-centred health care (PCC) services are identified by the WHO as important building blocks towards universal health coverage. In 2016 the WHO formulated a comprehensive framework on integrated PCC services based on an international expert consultation. Yet, expert opinions may fail to recognize the needs of all health system stakeholders. Therefore, a consultation method that includes the health workforce and laypersons, can be instrumental to elaborate this framework more in-depth. This research sought to identify participants’ perspectives on policy options and interventions to achieve people-centred health care services from a multi stakeholder perspective.

Methods

Study participants, both laypersons and health professionals, were recruited in Belgium. A total of 53 participants engaged in one of the seven concept mapping workshops. In this workshop the concept mapping methodology developed by Trochim, a highly structured qualitative group method for brainstorming and idea sharing, was used to generate and structure participants´ perspectives on what is needed to achieve PCC services. The method was validated using the WHO framework.

Results

The seven workshops together resulted in 452 different statements that were structured in a framework forming 35 clusters and four overarching domains. The four domains with their most prominent clusters were: (1) governance & policy with intersectoral health policies and affordable health for all; (2) health workforce with excellent communication skills, appreciation of health literacy challenges and respectful attitude based on cultural self-awareness; (3) integrated health services with a greater emphasis on prevention, health promotion and the availability of health education and (4) patient, person and community empowerment and participation with support for informal care, promotion of a healthy lifestyle and contextualised health education. Additionally, this study generated ideas that fitted into every single approach described in the WHO framework.

Discussion and conclusion

This study shows that in order to achieve PCC a participative approach involving all stakeholders at all levels is needed. The concept mapping process is one of these approaches that brings together diverse stakeholders and foments their egalitarian and respectful participation. The framework that resulted from this study can inform future debate regarding planning, implementation and monitoring of PCC.
Literature
1.
WHO. World Health Report : Primary Health Care, now more than ever. Geneva: World Health Organization; 2008.
2.
Mead N, Bower P. Patient-centeredness: a conceptual framework and review of the emperical literature. Soc Sci Med. 2000;51(7):1087–110.CrossRefPubMed
3.
Rogers CR. The foundations of the person-Centred approach. Education. 1979;100(2):98–107.
4.
WHO. Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: World Health Organization; 2008.
5.
WHO. Declaration of Alma Ata. Alma Ata: International Conference on Primary Health Care; 1978.
6.
WHO. WHO global strategy on people-centred and integrated health services 2015 (interim report). Geneva: World Health Organization; 2015.
7.
8.
Borgermans L, Marchal Y, Busetto L, et al. How to Improve Integrated Care for people with Chronic Conditions: Key findings from UE FP7 Project INTEGRATE and beyond. Int J Integr Care. 2017;17(4):7.CrossRefPubMedPubMedCentral
9.
Montenegro H, Ramagem C, Kawar R, et al. Making progress in people-centered care: country experiences and lessons learnt. Int J Pers Cent Med. 2012;2(1):64–72.
10.
WHO. People at the centre of health care: harmonizing mind and body, people and systems. Geneva: World Health Organization; 2007.
11.
WHO. Framework on integrated, people-centred health services. Geneva: World Health Organization; 2016. p. A69/39.
12.
Nasiru S, Aliyu GG, Gasasira A, et al. Breaking community barriers to polio vaccination in northern Nigeria: the impact of a grass roots mobilization campaign (Majigi). Pathog Glob Health. 2012;106(3):166–71.CrossRefPubMedPubMedCentral
13.
Larson H, Jarrett C, Eckersberger E, DMD S, Paterson P. Review: Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine. 2014;32:2150–9.CrossRefPubMed
14.
APS F, AVM B, ACSL S, ACB N, Cerqueira ES, SJFE G. The effects of a people-centred model on longitudinality of care and utilization pattern of healthcare services—Brazilian evidence. Health Policy Plan. 2014;29(Suppl 2):107–13.CrossRef
15.
WHO. People Centred Care in Low- and Middle - Income Countries - meeting report. Geneva: World Health Organization; 2010.
16.
MKS M. A people-centered approach to primary health care implementation in Mvumi, Tanzania. Soc Sci Med. 1989;28(10):1031–7.CrossRef
17.
Srivastava A, Singh D, Montagu D, Bhattacharyya S. Putting women at the center: a review of Indian policy to address person-centered care in maternal and newborn health, family planning and abortion. BMC Public Health. 2017;18(1):20.CrossRefPubMedPubMedCentral
18.
19.
WHO-Europe. Lessons from transforming health serrvice delivery: compendium of initiatives in the WHO European Region. Copenhagen: World Health Organization; 2016.
20.
21.
Namakula J, Witter S. Living through conflict and post-conflict: experiences of health workers in northern Uganda and lessons for people-centred health systems. Health Policy Plan. 2014;29:ii6–ii14.CrossRefPubMedPubMedCentral
22.
Trochim W. An Introduction to Concept Mapping for Planning and Evaluation. Eval Program Plann. 1989;12:1–16.CrossRef
23.
Rachlis B, Ahmad F, van Lettow M, Muula AS, Semba M, Cole DC. Using concept mapping to explore why patients become lost to follow up from an antiretroviral therapy program in the Zomba District of Malawi. BMC Health Serv Res. 2013;13(1):210.CrossRefPubMedPubMedCentral
24.
Reis RS, Kelly CM, Parra DC, et al. Developing a research agenda for promoting physical activity in Brazil through environmental and policy change. Rev Panam Salud Publica. 2012;32(2):93–100.CrossRefPubMed
25.
Mpofu E, Lawrence F, Ngoma MS, Siziya S, Malungo JR. Mapping an HIV/STD prevention curriculum for Zambian in-school settings. Int J Psychol. 2008;43(2):97–106.CrossRefPubMed
26.
Ruple JA, Frazer GH, Bake W. Commonalities of the EMS education workforce (2004) in the United States. Prehosp Emerg care. 2006;10(2):229–38.CrossRefPubMed
27.
Kornet-van der Aa DA, van Randeraad-van der Zee CH, Mayer J, Borys JM, Chinapaw MJM. Recommendations for obesity prevention among adolescents from disadvantaged backgrounds: a concept mapping study among scientific and professional experts. Int J of pediatr obes. 2017;13(6):389–92.CrossRef
28.
Trezona A, Dodson S, Osborne RH. Development of the organisational health literacy responsiveness (Org-HLR) framework in collaboration with health and social services professionals. BMC health serv res. 2017;17(1):513.CrossRefPubMedPubMedCentral
29.
De Maeseneer J, Van Weel C, Daeren L, et al. From "patient" to "person" to "people": the need for integrated, people-centered healthcare. Int J Pers Cent Med. 2012;2(1):601–14.
30.
Harvey N, Holmes C. Nominal group technique: an effective method for obtaining group consensus. Int J Nurs Pract. 2012;18:188–94.CrossRefPubMed
31.
32.
33.
Jaworska N, Chupetlovska-Anastasova A. A review of multidimensional scaling (MDS) and its utility in various psychological domains. Tutor Quant Methods Psychol. 2009;5(1):1–10.CrossRef
34.
Murtagh F, Legendre P. Ward’s hierarchical agglomerative clustering method: which algorithms implement Ward’s criterion? J Classif. 2014;31(3):274–95.CrossRef
35.
de Leeuw E. Engagement of Sectors Other than Health in Integrated Health Governance, Policy and Action. Annu Rev Public Health. 2017;38:329–49.CrossRefPubMed
36.
Art B, De Roo L, De Maeseneer J. Towards unity for health utilising community-oriented primary care in education and practice. Educ Health. 2007;20(2):74.
37.
38.
39.
Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923–58.CrossRefPubMed
40.
Sheridan NF, Kenealy TW, Kidd JD, Schmidt-Busby JI, Hand JE, Raphael DL. Patients’ engagement in primary care: powerlessness and compounding jeopardy. A qualitative study. Health Expect. 2015;18(1):32–43.CrossRefPubMed
41.
Batterham RW, Hawkins M, Collins PA, Buchbinder R, Osborne RH. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health. 2016;132:3–12.CrossRefPubMed
42.
De Maeseneer J, Zurmati A. Populatiegerichte eerstelijnszorg als voorwaarde voor het terugdringen van (sociale) gezondheidsverschillen. Bijblijven. 2018;34:275–85.CrossRef
43.
Hamui-Sutton A, Varela-Ruiz M, Ortiz-Montalvo A, Torruco-García U. Educational model to develop trustworthy professional activities. Rev Med Inst Mex Seguro Soc. 2015;53(5):616–29.PubMed
44.
45.
De Maeseneer J. Strengthening the model of primary health care in Estonia. Copenhagen: WHO regional office for Europe; 2016.
46.
Landon B, Grumbach K, Wallace P. Integrating public health and primary care systems: potential strategies from an IOM report. JAMA. 2012;308(5):461–2.CrossRefPubMed
47.
Martin-Misener R, Valaitis R, Wong ST, et al. A scoping literature review of collaboration between primary care and public health. Prim Health Care Res Dev. 2012;13:327–46.CrossRefPubMed
48.
IOM. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington: The National Academies Press; 2012.
49.
De Maeseneer J. Chapter 8: Policy Change: from Care for Individuals and Families towards Accountability for a Population. In: Family Medicine and Primary Care. At the Crossroads of Societal Change. 1st ed. Tielt, Belgium: Lannoo Campus; 2017.
50.
51.
Stenberg U, Haaland-Øverby M, Fredriksen K, Westermann KF, Kvisvik T. A scoping review of the literature on benefits and challenges of participating in patient education programs aimed at promoting self-management for people living with chronic illness. Patient Educ Couns. 2016;99(11):1759–71.CrossRefPubMed
52.
Mold J, Blake G, Becker L. Goal-oriented medical care. Fam Med. 1991;23(1):46–51.PubMed
53.
54.
Ters A, Yima T. Power imbalance prevents shared decision making. BMJ. 2014;348:17.CrossRef
55.
McCormack L, Thomas V, Lewis MA, Rudd R. Improving low health literacy and patient engagement: a social ecological approach. Patient Educ Couns. 2017;100(1):8–13.CrossRefPubMed
56.
De Vos P, Malaise G, De Ceukelaire W, Perez D, Lefèvre P, Van der Stuyft P. Participation and empowerment in primary health care: from Alma Ata to the era of globalization. Soc Med. 2009;4(2):121–7.
57.
Wallerstein N. Empowerment to reduce health disparities. Scand J Public Health. 2002;30:72–7.CrossRef
58.
59.
Rifkin S. Examining the links between community participation and health outcomes: a review of the literature. Health Policy Plan. 2014;29:ii98–ii106.CrossRefPubMedPubMedCentral
60.
61.
Browne A, Varcoe C, Wong S, et al. Closing the health equity gap: evidence-based strategies for primary health care organizations. Int J Equity Health. 2012;11(1):59.CrossRefPubMedPubMedCentral
62.
Marmot M, Allen J, Goldblatt P, et al. Fair Society, Healthy Lives: The Marmot Review. England: The Marmot Review; 2010.
63.
Starfield B. Primary Care - Balancing Health Needs, Services and Technology. New York: Oxford University Press; 1998.
64.
Tange H, Nagykaldi Z, De Maeseneer J. Towards an overarching model for electronic medical-record systems, including problem-oriented, goal-oriented, and other approaches. Eur J Gen Pract. 2017;23(1):257–60.CrossRefPubMedPubMedCentral
Metadata
Title
Using concept mapping to identify policy options and interventions towards people-centred health care services: a multi stakeholders perspective
Authors
Christine Cécile Leyns
Jan De Maeseneer
Sara Willems
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2018
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-018-0895-9

Other articles of this Issue 1/2018

International Journal for Equity in Health 1/2018 Go to the issue

Research

Can community action improve equity for maternal health and how does it do so? Research findings from Gujarat, India

Research

“I feel more comfortable speaking to a male”: Aboriginal and Torres Strait Islander men’s discourse on utilizing primary health care services

Research

Accrediting private providers with National Health Insurance to better serve low-income populations in Kenya and Ghana: a qualitative study

Research

On the unraveling of ‘revitalization of local health traditions’ in India: an ethnographic inquiry

Commentary

What have the social sciences ever done for equity in health policy and health systems?

Annotated bibliography

Social vulnerability and its possible relation to the principal causes of morbidity and mortality in the Mexican state of Oaxaca