New implementation package to support countries’ efforts to transform health services delivery

In the WHO European Region, millions of people do not have access to the right health care services at the right time and in the right place. Health systems looking to meet this challenge are strained by the growing burden of noncommunicable diseases, the re-emergence of several communicable diseases and the fact that people are living longer and with chronic conditions. In this environment, there is a clear need for health services delivery that is proactive rather than reactive; comprehensive and continuous rather than episodic and disease-specific; and founded on lasting patient–provider relationships rather than incidental, provider-led care.

At the 66th session of the WHO Regional Committee for Europe, countries of the Region took an important step towards transforming health services delivery and strengthening people-centred health systems – one of 4 priorities of the Health 2020 policy framework – by unanimously endorsing the European Framework for Action on Integrated Health Services Delivery (EFFA IHSD).

To support countries in their efforts to put the EFFA IHSD into action, the WHO European Centre for Primary Health Care in Almaty, Kazakhstan, launched a new implementation package designed for a range of audiences. The implementation package is the first of a series of resources that will be developed and available from a website devoted to the EFFA IHSD. The package consists of policy documents, background briefs, a catalogue of tools, examples of applications and lessons learned, as well as a glossary of key terms in both English and Russian. Its intended users include patients, health professionals, facilities managers, officials and associations.

This implementation package will be key in strategically and effectively shaping the political narratives required to move integrated health services delivery forward across the Region and to support decision-makers, managers and officials with evidence, experiences and tools in this area.

The Centre in Almaty provides technical support to countries for strengthening the delivery of health services based on a primary-health-care approach. It focuses on hands-on country work that will move the transformation of health services delivery forward in real terms.


The EFFA IHSD was developed over 3 years of collaboration and with the involvement of European Member States. The consultation process engaged patient organizations, practitioners, researchers, experts and policy-makers. The EFFA IHSD contributes to the Region’s vision of Health 2020, which focuses on efforts across government and society and underpins a primary-health-care approach for people-centred health systems.

In its endorsement, Denmark praised the EFFA IHSD as “relevant and inspirational”. Estonia emphasized that the alignment of the EFFA IHSD with the primary-health-care approach and the Tallinn Charter on health systems will guide countries in implementing integrated care, no matter their starting point.

The EFFA IHSD calls for actions across 4 domains:

  • working to identify people’s multidimensional health needs and to partner with populations and individuals;
  • ensuring that services-delivery processes are responsive to the needs identified;
  • aligning to other health-system functions to support services delivery to perform optimally; and
  • facilitating the strategic management of transformations.

It is closely aligned with the values, principles and strategies developed in the global Framework on integrated, people-centred health services and the Global strategy on human resources for health: workforce 2030, adopted at the Sixty-ninth World Health Assembly in May 2016. The EFFA IHSD is also fundamental to Sustainable Development Goal 3: ensure healthy lives and promote well-being for all at all ages.