What is Person-Centered Care?
Person-centered care acknowledges people’s essential human dignity, treats people as individuals, and finds out what is important to them regarding their treatment and care. At JSI, we put people at the center of health programs at all levels—individual, community, health facility, system, policy—because we know that each part of the ecosystem bears a responsibility to enable person-centered care. We use behavioral science to understand people’s motivations and preferences and to learn what system and service delivery changes are needed to transform people’s experiences and improve health outcomes.
Person-centered systems and services provide many benefits
- Improved access to care
- Increased health literacy
- Higher rates of patient satisfaction
- Improved job satisfaction among the health workforce
- More efficient and cost-effective services
- Improved health outcomes
JSI uses the term person-centered care rather than patient-centered care because we believe it is paramount to acknowledge the notion of person, which calls for a more holistic approach to care that incorporates the various dimensions to whole well-being, including a person’s context and individual expression, preferences, and beliefs. Additionally, person-centered care is not limited to only healthcare, but also considers the broader health ecosystem.”
– Jessica Posner, Person-Centered Care Portfolio Lead
Our person-centered care framework uses a human-rights-based approach that focuses on the rights holder (person) and the obligations of duty bearers (e.g., providers, policymakers, caregivers). The five principles that surround the rights holder (at the center) establish a common vision for person-centered care.
The principles can be operationalized and assessed at each socio-ecological level (i.e., policy and environment, health system, facility, community, and individual and family) through interventions within six domains, as labeled on the outside of the framework.
Each dot on the framework highlights where interventions could take place across domains and socio-ecological levels to advance person-centered care. Hover over the dots on the framework to see examples of how JSI has put the principles into action.
The Five Principles of Person-Centered Care
These principles establish a common vision of person-centered care, and they are applicable across all health interventions and settings.
Operations, workforce development, and services are conducted with transparency and with the goal of building and maintaining trust between stakeholders.
- There is a concerted effort to ensure information about health care policies, procedures, decision-making, and costs are accessible to all.
- The roles of rights holders and duty-bearers are clearly articulated and respected and each is accountable for their decisions and actions.
Communications, settings (workplace and care), interactions, and experiences provide a sense of safety, dignity, and respect — primarily defined by the people being served.
- Staff and the people they serve feel physically, emotionally, and psychologically safe.
- Care is evidence-based, delivered in a timely fashion and according to recognized quality standards.
- Health services are free of stigma and discrimination, ensure client privacy, and recognize the shared humanity between the client and provider.
The design of health policies, products, and services take into account people’s culture and identity (e.g., race, ethnicity, sexual orientation, age, religion, gender identity).
- Policies, protocols, and processes are responsive to individuals’ housing and legal status, as well as their individual needs based on their geography, culture, and identity.
- Duty bearer biases that adversely affect care options and experiences are identified and addressed.
Individuals and communities understand and are able to advocate for and make decisions about their goals, service options, and care.
- Individuals and communities are active and meaningful participants in program and/or service design, implementation, and monitoring. They are encouraged to advocate for program and/or service improvements that better meet their needs.
- Duty bearers actively listen to, consult, seek consent, and openly communicate with people throughout their care journey.
- People have control over their services, including the amount, duration, and scope of services, as well as their choice of providers
Staff and providers account for the fact that the individuals they treat are connected to other people, broader communities, and specific contexts that influence their lives and their healthcare decisions.
- The different stages of each individual’s life course are taken into account, focusing on what stage clients are at in their lives. For children, this includes considering developmental readiness versus chronological age.
- Empathy and communication are considered essential to providing person-centered care.
- All duty bearers are treated with empathy and work in a collaborative environment that provides them with the support and systems to deliver person-centered care.
Operationalizing Person-Centered Care
Developing a person-centered approach to care requires change at multiple levels — individual, family, community, facility, and system. The five principles of person-centered care can be operationalized through interventions within the following six domains.
Leadership & Governance
Leadership and governance support and invest in implementing and sustaining person-centered care. This includes engaging meaningfully with community stakeholders, including through multiple, active communication and feedback mechanisms.
Workforce Environment Support & Development
Leadership invests in a culture, environment, and incentives that support staff safety, wellness, and development — strengthening their motivation and ability to provide person-centered care. Human resource systems incorporate person-centered principles in hiring, supervision, and performance evaluations.
Monitoring, Learning & Accountability
Monitoring metrics reflect person-centered care principles and evaluation practices favor strengths-based and participatory approaches that prioritize rights holders’ voices and priorities. Monitoring and evaluation practices balance accountability with adaptation and learning— prioritizing feedback loops, generating actionable data, and using data to make decisions and hold leadership to account for improving person-centered care.
Policy & Financing
Policies, protocols, resource allocations, and financing structures establish and support person-centered care at every level of the socio-ecological model. Person-centered care is embedded into practice.
Service Design, Integration & Delivery
The design and range of services and how they are delivered are informed by people’s lived experiences, reflect their whole health needs, and take into consideration a life course perspective. Supplies and information are available and accessible when and how people want it.
Point of Care Access and Experience
Care settings and experiences — both physical and digital — are inviting, accessible, user-friendly, and promote a sense of physical and psychological safety for all – rights holders and duty bearers alike.
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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