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Novel health systems service design checklist to improve healthcare access for marginalised, underserved communities in Europe
- Source :
- BMJ Open, Dipòsit Digital de la UB, Universidad de Barcelona
- Publication Year :
- 2020
- Publisher :
- BMJ Publishing Group, 2020.
-
Abstract
- BackgroundMarginalised communities such as homeless people, people who use drugs (PWUD), lesbian, gay, bisexual, transgender and intersex people (LGBTI), prisoners, sex workers and undocumented migrants are at high risk of poor health and yet face substantial barriers in accessing health and support services. The Nobody Left Outside (NLO) Service Design Checklist aims to promote a collaborative, evidence-based approach to service design and monitoring based on equity, non-discrimination and community engagement.MethodsThe Checklist was a collaborative project involving nine community advocacy organisations, with a focus on homeless people, PWUD, LGBTI people, prisoners, sex workers, and undocumented migrants. The Checklist was devised via a literature review; two NLO platform meetings; a multistakeholder policy workshop and an associated published concept paper; two conference presentations; and stakeholder consultation via a European Commission-led Thematic Network (including webinar).ResultsThe NLO Checklist has six sections in line with the WHO Health Systems Framework. These are: (1) service delivery, comprising design stage (6 items), services provided (2 items), accessibility and adaptation (16 items), peer support (2 items); (2) health workforce (12 items); (3) health information systems (7 items); (4) medical products and technologies (1 item); (5) financing (3 items); and (6) leadership and governance (7 items). It promotes the implementation of integrated (colocated or linked) healthcare services that are community based and people centred. These should provide a continuum of needs-based health promotion, disease prevention, diagnosis, treatment and management, together with housing, legal and social support services, in alignment with the goals of universal health coverage and the WHO frameworks on integrated, people-centred healthcare.ConclusionsThe Checklist is offered as a practical tool to help overcome inequalities in access to health and support services. Policymakers, public health bodies, healthcare authorities, practitioner bodies, peer support workers and non-governmental organisations can use it when developing, updating or monitoring services for target groups. It may also assist civil society in wider advocacy efforts to improve access for underserved communities.
- Subjects :
- medicine.medical_specialty
Service delivery framework
Peer support
organisation of health services
Health Services Accessibility
quality in health care
Sexual and Gender Minorities
Health care
medicine
Humans
Child
Health policy
Marginality, Social
Transients and Migrants
Public health
Community engagement
business.industry
Service design
public health
health policy
General Medicine
Public relations
Salut pública
Checklist
Europe
Health promotion
Marginació social
Health Services Research
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- BMJ Open, Dipòsit Digital de la UB, Universidad de Barcelona
- Accession number :
- edsair.doi.dedup.....db996a5ccb0677a745773ebfdc9f44cd