Putting people at the center of health and health research: A paradigm shift for a holistic healthcare and healthcare system
“Health technology often missed out the consideration of human and human differences in conceptualizing healthcare and healthcare systems,” said Dr. Alberto Romualdez Jr., former Secretary of Health and first Philippine Council for Health Research and Development (PCHRD) Executive Director in his keynote speech during the 31st PCHRD anniversary held at the Sofitel Philippine Plaza, CCP Complex, Roxas Boulevard, Pasay City on 18 March 2013.
His claim is being backed-up by the World Health Organization (WHO) publication People at the Center of Health Care: Harmonizing Mind and Body, People and Systems, which mentioned that failure to consider people in any aspect of health and health technologies, may lead to unsuccessful healthcare and health systems.
According to WHO, despite biomedical, scientific and technological advances to eliminate and control diseases, people are continue to suffer from poor health, while healthcare systems continue to grapple with issues of health care access, safety, quality, affordability, and satisfaction. In fact, fifty percent of all patients in the world received unsafe and poor quality health care, and often suffer as a result of medical errors, leading to dissatisfaction and disappointments.
The WHO also stated that the health community relied heavily on biomedical sciences and focus almost exclusively on the physical aspects of health. “There must be harmonization between people and systems, within the health sectors,” said Dr. Samlee Plianbangchang, WHO Regional Director for South-East Asia.
The WHO now recognized that health is being influenced by a complex interplay of physical, social, economic, cultural and environmental factors. It must be viewed in a broader context, involving all the stakeholders, multidisciplinary and multisectoral partnerships, enabling people to achieve optimal health and well being.
“To transform the current healthcare systems toward a people-centered orientation, there must be comprehensive and positive changes spanning to key policies and action domains including, individuals, families, and communities; health practitioners; healthcare organizations; and healthcare systems,” explained Dr. Romualdez.
In the context of the Philippine healthcare, Dr. Romualdez mentioned that the Universal Health Care (UHC) study group applied the WHO framework to come up with the proposal for the UHC advocacy program. The group plotted and analyzed the healthcare systems against the four stakeholder domains (individuals, families, and communities; health practitioners; healthcare organizations; and healthcare systems). The analysis revealed that the bottom domains – the individuals, families and communities were least involved and considered. “Indeed the country needed much attention to enhance the empowerment of individuals, families and communities,” said Dr. Romualdez.
He also cited the example of tuberculosis (TB) control to illustrate how the perspective of individuals and families may contribute to health research prioritization.
Sputum microscopy and chest x-ray are the gold standards for diagnosis and case findings of TB patients. These methods are still being used in the country. However since TB is highly contagious, there is a need for faster methods especially in areas where TB is rampant, to lower the risks of infection between the untreated household to individuals, families and communities.
Although there is a new technology for more sensitive and faster TB diagnosis in the form of a polymerase chain reaction (PCR) method. It is not being used because it is too expensive, the existing technologies needed to be upgraded to match up with the requirement of the new technology and the need for expertise to operate the new machines is also an added burden. “However, if the good of individuals, families and communities were of the highest consideration, all of these obstacles should be addressed,” concluded Dr. Romualdez.