Public health systems across the globe are under increasing pressure to meet growing demands, reduce disparities, and respond to rapidly changing health landscapes. Amid these pressures, traditional models of service delivery—often rigid, centralized, and fragmented—have proven inadequate. Innovation in health service models has therefore emerged as a critical imperative, not just to expand access, but to redesign delivery mechanisms around people, communities, and outcomes. From integrated care pathways to digital health platforms and co-produced models of care, public health systems are evolving. This article explores the rationale, strategies, and evidence behind these innovations, drawing on recent global literature and institutional reports.
The Case for Innovation
Health systems are no longer judged solely by their capacity to provide services, but by the quality, efficiency, and responsiveness of those services. As Kruk et al. (2020) argue, in the era of Sustainable Development Goals (SDGs), the time for incremental improvements is over; a systemic revolution is needed—one that prioritizes high-quality care over sheer coverage. The burden of non-communicable diseases, the rise of complex comorbidities, and growing inequalities have challenged the relevance of conventional delivery models. A growing consensus holds that public health systems must become more integrated, people-centred, and resilient (WHO, 2021).
Frenk, Moon and Holmes (2020) reinforce this by asserting that redesigning health systems requires a fundamental shift in architecture: away from siloed, disease-specific interventions, toward platforms that embed prevention, equity, and adaptability at their core.
People-Centred and Integrated Care
A major trend in service delivery innovation is the transition toward people-centred and integrated care models. These models aim to align services around the needs of individuals rather than institutional boundaries or disease categories. As defined by the World Health Organization (2021), integrated people-centred care involves the coordination of services across the continuum of care—preventive, curative, rehabilitative, and palliative—delivered by multidisciplinary teams in partnership with patients and communities.
This reorientation demands new organizational structures, collaborative decision-making, and digital systems capable of sharing information seamlessly. Levine, Landon and Linder (2021) argue that such transformations in primary care are foundational, especially as it remains the first and most frequent point of contact for many populations. By redesigning primary care as a hub for coordination, innovation becomes not just technological but structural.
Social Determinants and Community-Based Models
Innovative models also increasingly address the social determinants of health—housing, nutrition, education, employment—which shape more than half of health outcomes. Figueroa, Frakt and Jha (2020) highlight new primary care frameworks that integrate social care into clinical practice, either through embedded social workers, community health navigators, or referral systems that link medical settings with community resources. This model reduces the gap between medical services and the socio-economic realities patients face.
Community-based innovations further emphasize this shift. Liu, Liu and Zhang (2020), in a study of urban China, showcase how local service platforms—staffed by multidisciplinary teams and guided by community needs assessments—can dramatically increase utilization, trust, and outcomes. These findings echo broader calls for bottom-up service models that prioritize local agency and contextual relevance.
Read also: Technology And Healthcare Quality By Sylvester Akpan
Digital Health and Co-Production
Technology plays a dual role in service model innovation: as an enabler of efficiency and as a tool for citizen engagement. Digital health platforms, from mobile apps to electronic health records and telemedicine, are helping extend reach, reduce costs, and improve continuity of care. WHO (2021) emphasizes the importance of leveraging digital tools to improve data integration and real-time decision-making in service delivery.
Yet innovation is not only technological—it is also relational. Exworthy and Powell (2022) introduce the concept of co-production in digital health, where service users are not passive recipients but co-designers and co-implementers of care. Through shared decision-making, feedback loops, and participatory planning, public health systems can become more responsive and accountable. Such models redefine service delivery as a partnership rather than a transaction.
Policy and Systemic Considerations
Institutional reform is a prerequisite for sustaining innovative models. Chaitkin et al. (2021) argue that service delivery innovation must be accompanied by governance reform, investment in human resources, and performance accountability. Pilot projects often fail when scaled up due to systemic rigidities and fragmented financing.
WHO (2021) and Ravaghi, Abolhallaje and Hadian (2021) call for learning systems that continuously evaluate and adapt. Innovation is not a one-off intervention, but an ongoing process requiring leadership, policy alignment, and iterative refinement. Health systems must cultivate the institutional agility to evolve with emerging challenges and opportunities.
In conclusion, Innovating service models for public health systems is no longer optional—it is essential. The demands of a complex, interconnected world, the persistent gaps in equity and access, and the lessons of recent global crises all point toward a singular truth: health systems must change not just what they do, but how they do it. Integrated, people-centred models; community-based and socially responsive frameworks; digital and co-produced services—these represent not the future of public health, but its necessary present.
Moving from intention to implementation, however, will require a confluence of vision, investment, and inclusive governance. Innovation in service delivery is not simply a technical challenge, but a political, ethical, and social one—and its success will ultimately depend on how well systems listen, learn, and adapt.
Ms. Cynthia Chinemerem Anyanwu is a distinguished leader in health and social care, celebrated for her visionary impact on nursing management and healthcare innovation. Driven by a passion for patient-centered care, she has shaped transformative policies that advance workforce development, digital integration, and system-wide efficiency. A champion of evidence-based practice, Cynthia bridges clinical excellence with public health priorities to deliver sustainable, high-impact solutions. Her strategic foresight, combined with an unwavering commitment to mentorship and leadership, has inspired a generation of healthcare professionals. Respected for her ability to lead through complexity, she is a catalytic force in modern healthcare transformation.
References
Chaitkin, M., Blanchet, N.J., Su, Y. and de Ferranti, D., 2021. Designing better health systems: The role of service delivery innovation. Center for Global Development Working Paper 577. Available at: https://www.cgdev.org/publication/designing-better-health-systems
Exworthy, M. and Powell, M., 2022. New models of public service delivery: Co-production and digital health. Public Administration Review, 82(2), pp.312–322. https://doi.org/10.1111/puar.13384
Figueroa, J.F., Frakt, A.B. and Jha, A.K., 2020. Addressing social determinants through innovative primary care models. Health Affairs, 39(5), pp.851–856. https://doi.org/10.1377/hlthaff.2019.01594
Frenk, J., Moon, S. and Holmes, J., 2020. Redesigning health systems for universal care. The Lancet, 395(10229), pp.1038–1040. https://doi.org/10.1016/S0140-6736(20)30512-3
Kruk, M.E., Gage, A.D., Arsenault, C., Jordan, K., Leslie, H.H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S.V., English, M., Garcia-Elorrio, E., Guanais, F., Gureje, O., Hirschhorn, L.R., Jiang, L., Kelley, E., Lemango, E.T., Liljestrand, J., Malata, A., Marchant, T., Matsoso, M., Meara, J.G., Mohanan, M., Ndiaye, Y., Norheim, O.F., Reddy, K.S., Rowe, A.K., Salomon, J.A., Thapa, G., Twum-Danso, N.A.Y. and Pate, M., 2020. High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet Global Health, 8(11), pp.e1350–e1356. https://doi.org/10.1016/S2214-109X(20)30340-1
Levine, D.M., Landon, B.E. and Linder, J.A., 2021. Transforming primary care: The emergence of a new model. New England Journal of Medicine, 385(5), pp.431–434. https://doi.org/10.1056/NEJMp2102569
Liu, G., Liu, J. and Zhang, Y., 2020. Community-based service innovations in public health: Evidence from urban China. Health Policy and Planning, 35(9), pp.1153–1161. https://doi.org/10.1093/heapol/czaa094
Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., Chisholm, D., Collins, P.Y., Cooper, J.L., Eaton, J., Herrman, H., Herzallah, M.M., Huang, Y., Jordans, M.J.D., Kleinman, A., Medina-Mora, M.E., Morgan, E., Niaz, U., Omigbodun, O., Prince, M., Rahman, A., Saraceno, B., Sarkar, B.K., De Silva, M., Singh, I., Stein, D.J., Sunkel, C. and UnÜtzer, J., 2020. The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), pp.1553–1598. https://doi.org/10.1016/S0140-6736(18)31612-X
Ravaghi, H., Abolhallaje, M. and Hadian, M., 2021. Innovative models for health service delivery: A global narrative review. BMC Health Services Research, 21(1), p.1243. https://doi.org/10.1186/s12913-021-07242-6
World Health Organization (WHO), 2021. Innovating care delivery: Models for integrated people-centred health services. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789240039782