We noted the term people-centred care was used - this incorporates person-centred care in terms of ‘clinical encounters’, but broadens the focus to include the health of people in their communities and ‘their crucial role in shaping health policy and services’ (World Health Organization, 2016)

• There appeared to be an emphasis on trust, respect and dignity, supporting communities and strengthening the health system.

For example Jaramillo and colleagues detail evidence of individual people with TB experiencing pejorative attitudes from some health workers and a ‘blame game’ for ‘non-adherence’ to treatment and argue top-down approaches to disease management and weak community engagement have contributed to individuals’ alienation from services. The authors suggest people can be supported to reclaim their health and dignity through person-centred approaches, which will in turn strengthen communities.

Writing on Ebola, Martineau notes that effective clinical care is essential, but it is not the only component of a trusted health system and its workers. He suggests that efforts to strengthen a health system must work with the local context to ‘build mutual trust, respect and dignity between health actors and the communities they serve alongside initiatives to improve the quality of care’.

Colleagues from the People-led care portfolio and the Transformational Redesign Unit have recently blogged about taking community-led support to the next level and highlighted the role of communities in strengthening community partnerships.

For example, Martineau suggested that a community surveillance initiative could be set up in an inclusive way and engage with a range of ‘actors’ in the system to identify potential cases of Ebola as a global priority, but if priorities which were equally important to local people were not considered, the local perception of the programme could be damaged, and this could prevent working with the community on other determinants of health.

Similarly, Parker and colleagues’ anthropological study in Sierra Leone, exploring how a village responded to public authority in an Ebola outbreak, found that in practice relatives of people with Ebola chose to care for them themselves rather than take their relatives to the authorised treatment centres. The authors suggest medical and scientific interventions and impact of resources will be affected if there is a lack of understanding or respect of the local ‘norms, social values, practical capacities and public authority of affected populations’. They argue greater engagement of social scientists and anthropologists could help to improve health and social outcomes in times of crisis and in the ‘everyday functioning of the system’. In a separate letter to the Lancet, they cite the idea that everyone pays ‘lip service’ to community engagement but the ‘how and who’ are often not well defined.