181105_collectivity_blog_post_titleCommunity Health Centres (CHCs) are community-oriented primary care (COPC) organizations that deliver health and social services through interprofessional teams, addressing the specific health and social needs of individuals, families and local communities. CHCs involve members of the community in planning and programming, and they employ a multi-sector approach to address social determinants of health. CHCs currently exist in dozens of countries around the world but there remains limited comparative information nor policy/planning guidance across jurisdictions for use by stakeholders wishing to implement and support CHCs. Insights from CHCs in numerous countries help increase understanding of the comprehensive CHC approach and how CHCs provide countries and non-governmental organizations a model to operationalize primary health care as articulated in the Declaration of Astana on Primary Health Care and to achieve sustainable developments goals…..more

I was interested to see this new report from Jan De Maeseneer and colleagues at the International Centre for Family Medicine and Primary Health Care, published by the International Federation of Community Health Centres (May 2019).

Below are the citation, abstract and table of ‘cross-cutting characteristics of community health centres’. I note that the concept of ‘community health centres’ and their desired characteristcs are not mentioned as such in the WHO Guideline on CHWs, and, conversely, that this new report does not acknowledge the WHO Guideline. Is there a disconnect here?

The WHO Guideline includes recommendations that relate indirectly to health centres (eg Recommendation 15: Availability of supplies) but I wonder if more could be done to promote the concept of enabling, Positive Practice Environments? (This concept was championed by the International Council of Nurses several years ago, and HIFA contributed directly with guidance on the availability and use of information at the point of care.)

Full text: http://www.ifchc.org/wp-content/uploads/2019/05/Community-Health-Centres-Operationalizing-the-Declaration-of-Astana-on-Primary-Health-Care.pdf

CITATION: Community Health Centres: Operationalizing the Declaration of Astana on Primary Health Care
Jan De Maeseneer MD PhD1; Antonija Poplas Susič MD PhD2; Scott A Wolfe MA3; Meng Qingyue MD PhD4; Shabir Moosa MFamMed MBA PhD5; Lynne Raskin RN6; Tom Symondson BSc7; Daniel R Hawkins BA8
Corresponding author: Dr. Jan De Maeseneer (jan.demaeseneer@ugent.be)

ABSTRACT: Community Health Centres (CHCs) are community-oriented primary care (COPC) organizations that deliver health and social services through interprofessional teams, addressing the specific health and social needs of individuals, families and local communities. CHCs involve members of the community in planning and programming, and they employ a multi-sector approach to address social determinants of health. CHCs currently exist in dozens of countries around the world but there remains limited comparative information nor policy/planning guidance across jurisdictions for use by stakeholders wishing to implement and support CHCs. Insights from CHCs in numerous countries help increase understanding of the comprehensive CHC approach and how CHCs provide countries and non-governmental organizations a model to operationalize primary health care as articulated in the Declaration of Astana on Primary Health Care and to achieve sustainable developments goals.

METHODS: Incremental purposive sampling based on the domain-experience of the authors, supplemented by descriptive information, and practice- and policy-relevant information.

TABLE 1: CROSS-CUTTING CHARACTERISTICS OF COMMUNITY HEALTH CENTRES
• Historical background in societal and health care transitions;
• Focus on accessibility with special attention for vulnerable and marginalized groups;
• Accountability for services to a defined population, usually based on a geographical catchment area;
• A comprehensive person-centered approach, integrating primary care with: chronic care and other forms of frontline care (dental, vision, mental health, etc); health promotion and community participation; and various social services;
• An inter-professional team with available providers including family physicians, nurses, social workers, nutritionists, health promotors, dentists, physiotherapists, community health workers, community pharmacists, and others;
• Focus on upstream causes of ill-health, addressing social and environmental determinants of health, through intersectoral action involving housing, education, migration, and other sectors;
• Demonstrated positive results in terms of quality, outcomes, cost-effectiveness and sustainability;
• Often a front-runner in introduction of innovation and involved as role-model in health professional education with emphasis on collaborative care;
• Contributing to social cohesion and solidarity in communities.

Best wishes, Neil

Coordinator, HIFA Project on Community Health Workers
http://www.hifa.org/projects/community-health-workers