Putting people at the center of care

By Imelda Mercedes Medina, MD, MPH, Founder and Chair of the Rotarian Public Health Fellowship and member of the Rotary Club of Miami Airport, United States 

The Declaration of Alma-Ata made by the World Health Organization in 1978 called world leaders to come together to deliver better health for all.  The vision of the Declaration of Alma-Ata was to change how we think about health, moving away from focusing on diseases and towards recognizing that health is not only about illness and services but more importantly about empowering individuals, caring for the person, and placing people at the center of care.

However, forty years later, that vision has gone largely unfulfilled.  Primary health care is in crisis, and half the world’s population has no access to the most essential health services. According to the United Nations, unclean water and poor sanitation are the leading cause of child mortality; hunger and malnutrition are the number one health risk worldwide. One in ten people in developing regions still lives on less than US$1.90 a day – the internationally agreed poverty line, and around 10 percent of the world population is living in extreme poverty and struggling to fulfill the most basic needs like health and education.

To respond to complex public health issues, the CDC provides valuable guidance through a multi-level model of  factors affecting health.  From macro to micro levels, the four strata of this model are: societal, community, relational and individual levels, with the individual placed at the center of everything.  This broad approach to thinking of health, advanced in the 1947 Constitution of the World Health Organization, includes physical, mental and social well-being.

Because of this, we decided to take action and form the Rotarian Public Health Fellowship to connect with our fellow members, because together we can make a difference.

For example, Rotary International, the World Health Organization, the Centers for Disease Control and Prevention, UNICEF and the Bill and Melinda Gates Foundation have been working together in the Global Polio Eradication Initiative through a people-centered public health initiative.  By focusing on understanding people’s needs and beliefs, and engaging community leaders, the Global Initiative has been able to work with communities to best administer vaccines.  And through this way, we are reaching our goal of eradicating polio from the world.

According to the Health Innovation Network, person-centered care “is a way of thinking and doing things that sees the people using health and social services as equal partners in planning, developing and monitoring care to make sure it meets their needs. This means putting people and their families at the center of decisions and seeing them as experts, working alongside professionals to get the best outcome.”  The International College of Person-Centered Medicine states: “Person-centered medicine is dedicated to the promotion of health as a state of physical, mental, socio-cultural and spiritual wellbeing as well as to the reduction of disease, and founded on mutual respect for the dignity and responsibility of each individual person.”  And at a global level, one way WHO defines people-centered care is as “An approach to care that consciously adopts individuals’, families’, and communities’ perspectives as participants in and beneficiaries of trusted health systems, that respond to their needs and preferences in humane and holistic ways.  People-centered care also requires that people have the education and support they need to make decisions and participate in their own care.  It is organized around the health needs and expectations of people rather than diseases.”  Find more information about person-centered care here.

If you are passionate about service, looking to grow at the professional level, would like to enhance your curriculum, are interested in connecting with worldwide leaders or looking for internship and mentorship opportunities within public health, come join us. Together, we can help address the root causes of problems by contributing to increase protective factors and decrease risk factors of public health issues.

Through our fellowship, we will be participating in conferences and other public health initiatives that focus on person-centered care (person-centered medicine and people-centered public health).  Join our discussion group on My Rotary, read our blog for information about resources available and/or follow our Facebook page for updates.  If you have any questions, please email us!

4 thoughts on “Putting people at the center of care

  1. Great work you people are doing by helping others and providing health services to everyone. There are many health crisis that arise in this era. The most important thing is that people who are cannot reach these health services are being affected the lot. This is going to be very helpful for them.
    Cosmetic dentistry Shoreline WA

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