JSI’s Global Leadership in Person-Centered Care
JSI’s Person-Centered Care Framework integrates the human-rights-based approach by focusing on the Rights Holder (person) and the obligations of the Duty Bearers (providers, policymakers, etc). The five principles that surround the Rights Holder establish a common vision of person-centered care that is inclusive across different health technical areas and settings. Implementing person-centered care requires multi-level changes. The principles can be operationalized and assessed at each socio-ecological level (policy+environment, health system, facility, community, family, and individual) through interventions within six domains, as labeled on the outside of the Framework. Each dot within the Framework represents the intersection of how the principles can be operationalized in each domain at different, oftentimes overlapping, levels.
JSI is shifting the global paradigm of health systems and service delivery. We are disrupting medical paternalistic norms that expect people and their circumstances to change to enable changing access to health services. Instead, we are putting the person at the center and focusing on how systems and services can be shaped to meet the person where they are. We use behavioral science to understand the preferences and motivations of the individual and examine each level of the system and service delivery context to transform each person’s experiences and enhance outcomes.
Our Behavior Initiative harnesses JSI’s collective global experience and thought leadership on person-centered care to share cutting-edge practices with our donors, partners, and across our global and domestic divisions, projects and staff. Through coalescing our resources and examining the evidence base, we have developed a common framework through which person-centered care is operationalized.
Person-centered care acknowledges people’s essential human dignity, treating people as individuals and finding out what is important to them, relevant to their treatment and care. Person-centered care is collaborative, localized, and rights-based healthcare designed and delivered with the individual at the center. It purposefully engages all stakeholders across the socio-ecological framework as active contributors to health systems, services, products, supply chains, and experiences. This ensures responsiveness to the individual’s needs and preferences.
Person-centered care represents a transformational change in service delivery which traditionally has been shaped for the convenience of providers and the health system. Instead, person-centered care prioritizes the individual and considers how services can be shaped to meet their needs and expectations.
Person-centeredness is an important function for improving system performance. Person-centered systems contribute to a variety of benefits for both the user and the system including improved access to care and health outcomes, increased health literacy, higher rates of patient satisfaction, improved job satisfaction among the health workforce, and more efficient and cost-effective services in addition to improved health outcomes and a meaningful quality of life.
These principles establish a common vision of person-centered care, describing key characteristics that are generalizable across different health interventions and settings.
Developing a person-centered approach requires change at multiple levels — individual, family, community, organization, and system. The principles that describe a person-centered approach are operationalized and assessed through the domains described below.
Examples of Our Work
In Ethiopia, JSI’s USAID DHA improves digitization and data use for service providers to strengthen the quality of care delivered to the person. By using data to inform and improve how services are delivered, and through ensuring accountability and transparency, the DHA project supports the Ministry of Health (MOH) of Ethiopia in its goal to deliver person-centered care (PCC).
In Ethiopia, JSI supported community engagement in the immunization micro planning process, enabling HCWs to design and adapt service delivery through systematically integrating community voices and participatory approaches. This ensured that services were designed and delivered in the right place at the right time by trusted providers.
In the Kyrgyz Republic, JSI developed an algorithm for a community-based subgrantee that works with TB patients from high-priority groups who are at risk of treatment interruption. The algorithm, guided by USAID’s PCC strategy, describes how to support different types of patients at different stages of their treatment process through a psychosocial support program. This approach honors each person’s unique needs and circumstances while maximizing time and resources of the community group.
In Ghana, JSI brings HIV treatment services closer to people by caring for them at multiple points of care (in facilities, communities, and homes based on each person’s needs and preferences). Our innovative approaches support adherence, overcome access challenges and build trust through providing home-based ART refills, and offering community- and facility-based services, or any combination in between.
In Nigeria, JSI is increasing awareness, and optimizing distribution and use of HIV-prevention commodities among key populations. TMA involves multi-level stakeholders at the policy and financial space/domain taking into account the religious, cultural, and ethnic diversity to help improve access to points of care such as discrete walk-in clinics for men and one-stop shops for adolescents.
JSI and PATH are supporting > 20 countries to introduce and scale-up subcutaneous DMPA (marketed as Pfizer’s Sayana® Press). The project supports governments to create policy for the full introduction of DMPA-SC, ensuring that a person-centered care framework is in place to roll-out DMPA-SC. By focusing on going beyond a single product to informed-choice programming more broadly, JSI is moving beyond systems to empower individuals and to support self-care.
In Kenya, JSI’s affiliate inSupply has developed cStock. This supply chain strengthening approach combines simple resupply procedures with mobile technology and user-centered dashboards. The inSupply team used human-centered design to customize the product to work for resource constrained settings and accommodates both android application and unstructured supplementary service data (USSD) solution to support community health volunteers (CHVs) with feature phones and is integrated with DHIS2. This helps accommodate community volunteers with low literacy levels who serve nomadic populations in remote areas where network coverage is scarce. cStock connects CHVs to their facilities and promotes demand-based resupply, ensuring greater product availability at the community level.
In India, under the Gavi Health System Strengthening Phase 2 Grant, JSI developed an interactive, continuous, and adaptable knowledge-building system for different levels of health personnel to implement the recent guidelines in the Universal Immunization Program and provide five comprehensive modules on different immunization topics. Initially piloted in five districts of five states, the platform has scaled to 36 districts and catered to almost 14,000 learners. Officials can monitor staff’s learning progress and performance and offer individualized mentoring and coaching. The on-demand learning system enables person-centered care by ensuring that providers are continually available at their point of care and engaged.
USAID Advancing Nutrition helps countries around the world address the multiple causes of malnutrition. Together with an external technical advisory group, the project developed the Responsive Care and Early Learning (RCEL) Addendum package which aims to integrate these important components for child development with nutrition counseling to improve childhood outcomes. The package helps HCWs better understand a child’s development and support caregivers in providing loving care, play, and stimulation for their child. The materials address core principles such as trust, safety, and identity–nearly every principle of the PCC framework. They help HCW put a caregiver’s concerns front and center during counseling and actively listen to understand how they can support caregivers in a way that is responsive to their needs and understanding of their context.
The Last 10 Kilometers 2020 Project supported Ethiopia’s efforts to strengthen a responsive and resilient primary health care system that improves the health status of families and communities. L10K supported birth preparedness and emergency readiness by creating a tool for health extension workers to develop individualized birth preparedness and postpartum planning. The project also supported Ethiopia to implement and participate in conferences that strengthen the ability of health extension workers to guide discussions with pregnant women and their families to discuss pregnancy freely. These conferences also helped to create a support system, and reinforce home and community level planning.
Immunization service experience plays an important role in ensuring that immunization programs are valued by and accessible to everyone. JSI designed an Immunization Service Experience (SE) Toolkit to introduce the concept of SE at country level for immunization staff and implementing partners. The five toolkit products are meant to spark discussion around how country immunization programs may address and improve the delivery and experience of immunization.
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