Health systems should ultimately seek to serve people and society. and

Health systems should ultimately seek to serve people and society. and are central to their existence and functioning. People make all the most important decisions in health systemseither by accessing services as patients, setting rules and allocating resources as policymakers, or enacting, coping with and subverting those rules, as implementers, managers, providers and service users. Communities and citizens influence these systems by shaping the social norms and contexts in which they operate. Community norms and behaviour drive health market forces and practices, influence how individuals 144143-96-4 and families access services, and can help hold systems accountable. Citizens may also influence system development through their electoral voting power, exercising the long route to accountability. People centredness embraces this essentially human character of health systems. Yet, the term is surprisingly new in health system debate and the common response to its use is what does that mean? This supplement advances the conversation by exploring varied perspectives on the concept of people centred health systems (PCHS). PCHS emerges as a multi-faceted concept, with ideological power and also carrying huge potential for practical thinking and change in health systems. While Universal Health Coverage has become emblematic globally for health systems change for better health care access and quality, and social protection, PCHS offers opportunities to elaborate and deepen our understanding of what such change should entail in the operational practices of health systems. The initial 11 articles in this collection, published as a printed supplement, begin to illustrate different aspects of the PCHS concept (further articles on the theme will be released in an online collection, 144143-96-4 and will be scattered through subsequent print editions of the journal). Four overarching themes that define and represent different aspects of PCHS emerge from this set of articles, and from other existing writing on PCHS and related themes. These aspects are summarized in Box 1, and also provide a framework for the subsequent discussions in this editorial. Box 1. Aspects of people centred health systems (PCHS) Putting peoples voices and needs first PCHS are ultimately shaped by community voices and needs. Participatory governance mechanisms can channel the power of communities to mould health systems in the public interest, and hold them accountable. People-centred governance can also confront entrenched power imbalances within health systems, and address their broader social determinants. People centredness in service delivery PCHS put peoples needs first in the design and delivery of health care and services. Important principles of this approach are quality, safety, longitudinality (duration and depth of contact), closeness to communities and responsiveness to changing requirements. Capacity building in PCHS focuses, foremost, on creating capabilities to respond to peoples health care needs. Relationships matter: health systems as social institutions PCHS are social institutions, which operate through chains of relationships between different health systems actorsincluding administrators, health care providers, service users and researcherseach acting in their respective contexts. As such, systems thrive on mutual trust, dialogue and reciprocity, and their effectiveness correlates to the quality of these human relationships. Values drive people centred health systems In PCHS, decision making is informed by people centred values around justice, rights, respect and equality, and the principles of 144143-96-4 primary health care. Values drive peoples decisions within the health system contributing to change, and conversely, system reforms can have effects on peoples ideals within the system. This supplement is definitely a joint production of and the organizers of the Third Global Symposium on Health Systems Study, Cape Town, 2014. Its launch is definitely timed to coincide with the Symposium, that requires as its theme, the presents a systematic review of study seeking to link community participation with improved health outcomes. She finds that the majority of studies fail to establish a link for lack of a standard definition of community and participation. Although she identifies two evaluations that link community health worker programmes with improved health services delivery, concrete causal lines remain 144143-96-4 hard to establish. The author recommends a platform that views the process of community participation as a process rather than as an input into a linear, causal pathway. Community health workers (CHWs) have been recognized as important actors in improving broader sociable determinants, ensuring areas health rights and combating sociable exclusion. examine the tasks of CHWs, in influencing sociable determinants of health in central India. They trace how these volunteer CHWs helped combat malnutrition and violence against women in the areas in which they worked, through prolonged advocacy on the issues within the community, and mobilization of ladies to understand and claim their entitlements and seek redress. Citing Poteete (2010), propose that the governance of common house resources such as PHC solutions in Nigeria is GIII-SPLA2 definitely a joint business of areas and governments, and hence that individuals and areas can potentially mitigate the.