People empowerment in the healthcare system: A conceptual model and roadmap

Public Health. 2025 Jun:243:105720. doi: 10.1016/j.puhe.2025.03.032. Epub 2025 Apr 14.

Abstract

Objectives: People empowerment is the process of assisting individuals in representing their activities with responsibility and self-determination, and acting on their own authority. While most studies have focused on training and informing patients, other aspects of empowerment are often overlooked. Therefore, the main objective of this paper is to present a conceptual model that empowers not only patients but all people.

Study design: Public health policy.

Methods: The conceptual model is developed based on strategies outlined in 2009 World Bank report and is extended through a two-stage field interview. In the first stage, 15 healthcare policymakers were interviewed and in the second stage, a workshop was held with one hundred healthcare experts.

Results: The first stage interviews confirmed the effectiveness of the five empowerment strategies provided by World Bank report. Additionally, a new group of strategies was recommended, particularly for countries with less accountable healthcare systems. These strategy groups are Information and education, accountability, advocacy, financial empowerment, local organizational capacity, and participation. The second stage of interviews confirmed the results and provids valuable insights. To operationalize this model for the country a roadmap consisting of several projects is also developed.

Conclusions: From an implementation perspective, not all strategies are equally important; Some are prerequisites for others. Certain strategies can be considered as fundamental strategies. Some are functional, while others could be considered as the outcomes.

Keywords: Conceptual model; Empowerment roadmap; Healthcare policy; Participation; People empowerment.

MeSH terms

  • Delivery of Health Care* / organization & administration
  • Empowerment*
  • Health Policy*
  • Humans
  • Interviews as Topic
  • Models, Theoretical*