IMPLEMENTATION OF THE NATIONAL
HEALTH SYSTEM
OUR GREAT CHALLENGE
FAMILY HEALTH
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MINISTRY OF PUBLIC HEALTH
AND SOCIAL WELFARE
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MINISTRY OF PUBLIC HEALTH
AND SOCIAL WELFARE
5-year Strategic Plan
2004-2009. MSPAS
Strategic Objective:
“Implement a concerted CHANGE in the health
sector that promotes an efficient integrated
decentralized NATIONAL HEALTH SYSTEM TO
ACHIEVE universal coverage, care for all people,
in the entire country.”
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MINISTRY OF PUBLIC HEALTH
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Millennium Development Goals
MDG
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria, and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development
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MINISTRY OF PUBLIC HEALTH
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Primary Health Care
Health care put within reach of all
individuals
and
families
in
the
community, through means that are
acceptable to them, with their full
participation and at a cost that the
community and the country can support.
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MINISTRY OF PUBLIC HEALTH
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NATIONAL
HEALTH
POLICY
Strategic
Objectives
S
N
S
DEVELOPMENT
OF HUMAN
RESOURCES IN
HEALTH
SOCIAL
PARTICIPATION
IN HEALTH
MANAGEMENT MODEL
MSPAS
STEERING
ROLE
Impact
Objectives
UNIVERSAL COVERAGE
BETTER HEALTH
STATUS IN
THE POPULATION
MODEL OF CARE
MODEL OF
DELIVERY
FOCUS ON
FAMILY
HEALTH
COMPLEMENTARY
CONNECTED
NETWORKS
QUALITY OF CARE
AND SERVICES
SATISFACTION
OF CONSUMERS
AND PROVIDERS
EQUAL ACCESS
1. Increase State budget
allocation for public spending in
health.
ADJUSTMENT OF THE
LEGAL FRAMEWORK
FINANCING MODEL
2. Improve the efficiency of
public institutions.
3. New financing sources.
MECHANISM
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MINISTRY OF PUBLIC HEALTH
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PROCESS OF CHANGE IN HEALTH
THE INITIATIVE aimed at creating a National Health
System, in response to the following strategic objectives:

Expand health services coverage for the population within
a framework that gives special importance to family
health.
 Improve quality AND compassion of health-care services
holding as key the model of individual, family and
community health care.
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MINISTRY OF PUBLIC HEALTH
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Family Health Model
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IMPLEMENTING THE
CONCEPTUAL FRAMEWORK
MINISTRY OF PUBLIC HEALTH
AND SOCIAL WELFARE
FAMILY HEALTH
PHC-based model, with emphasis on health
promotion and community work that views as
the unit of analysis the care and intervention of
“the family”, provides intra- and extramural
services, which promote healthy lifestyles,
control of environmental risks and preventive
care with focus on family life and life cycle in
order to promote and preserve health of the
family members and their environment.
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MINISTRY OF PUBLIC HEALTH
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General objective
• Guarantee access to and equity in the supply of
health services, based on the strategy of primary
care, with emphasis on health promotion, to family
members and their environment in order to achieve
satisfaction
and
improve
the
level
of
health;
promoting co-responsibility.
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MINISTRY OF PUBLIC HEALTH
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Objective specific
• Determine geographical and population
areas of responsibility, assigning families to
family health teams and health facilities.
• Organize the network of services connecting
the levels of care and strengthening the
process of referrals and follow-up visits.
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MINISTRY OF PUBLIC HEALTH
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Specific objectives
• Strengthen the promotion
prevention of health risk
impairments.
and
and
• Establish integral management of
service networks.
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MINISTRY OF PUBLIC HEALTH
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Characteristics
• Family and community focus, respecting their culture
and rights.
• Define and guarantee continuous health services,
applying standards, protocols, instruments, as well as
evaluation mechanisms that ensure effectiveness.
• Made up of processes and procedures developed by
interdisciplinary and integrated teams.
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MINISTRY OF PUBLIC HEALTH
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Characteristics
• A flexible, dynamic, and interactive model capable of
predicting and responding on a timely basis to the
current and future health characteristics and needs
of the family.
• Based on social participation and intersectoral
approach.
• Essential: address and resolve the population’s
most common health problems and risks through
family and community participation.
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MINISTRY OF PUBLIC HEALTH
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Essential
Components
Strengthen
first level
Comprehensive
care
Training
FAMILY
HEALTH
MODEL
Family
interventions
Health
Promotion
Multidisciplinary
Teams
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MINISTRY OF PUBLIC HEALTH
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Instruments
Family File
Family Registry, reduces time spent on data collection and
allows longer time devoted to relation with the patients.
Familiograma (“Family Diagram”)
Structural diagram of family composition and of the system
of relationships of several generations in the family,
identifies risk factors and dysfunctions, and its important
role in causing illness, recuperation and rehabilitation.
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MINISTRY OF PUBLIC HEALTH
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What does the Family File contain?
• NAME
• ADDRESS
• LIFE-CYCLE FILES
• CLINICAL HISTORIES
• HEALTH FILE
• INTERVENTION PLAN
• FAMILIOGRAMA
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MINISTRY OF PUBLIC HEALTH
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Value-added to the model
Traditional Model
Community work
Service-oriented culture
Availability of promoters
Culture of volunteer service
Expansion of rural
coverage, Fosalud,
Hospital without walls
Population targeting (poverty)
Prompt care
Greater problem-solving capacity
(physician)
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MINISTRY OF PUBLIC HEALTH
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Phases of Implementation
Preparation
Selection
of Units
Pilot
Gradual implementation
in the public network of
Regional establishments
Extension
Implementation of other
SIBASI Units in the
5 Regions
Expansion
All Units
of all
SIBASIS
Preparation
Inputs
Training
Nov-Dec 06
January-December 07
January-December 08
January 09
interface
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MINISTRY OF PUBLIC HEALTH
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Key Elements of Intervention
FAMILIES
EDUCATIONAL CENTERS
WORK ENVIRONMENTS
HEALTH FACILITIES
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MINISTRY OF PUBLIC HEALTH
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ORGANIZATION FOR
IMPLEMENTING THE FAMILY
HEALTH MODEL
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MINISTRY OF PUBLIC HEALTH
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Family Health Teams (FHT) Composition
The FHT includes preferably:
1 health promoter
1 nurse and
1 physician.
A Health Facility can have more than one family health
team, according to its installed capacity and defined
population.
These teams are supported by other professionals
(dentists, specialists, psychologists, nutritionists, etc.) as
well as technical personnel (laboratory, RX, Pharmacy)
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Family Health Team Area of Intervention
The basic geographical unit is the program area of
the Family Health Promoters and includes homes,
dwellings, blocks, communities, country houses,
grouping of cantons, or parts of these.
Such geographical units include a maximum
group of 250 families, approximately equal to
1,000 - 1,200 people.
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MINISTRY OF PUBLIC HEALTH
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Interventions
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MINISTRY OF PUBLIC HEALTH
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Families Assigned to the Family Health Model
Geographical Area
Progress
Programmed
Families
families
Assigned
Western Region
8,590
3,161
37%
Central Region
2,187
1,197
54%
Metropolitan Region
1,947
862
44%
Paracentral Region
3,633
1,240
34%
Eastern Region
8,162
4,916
53%
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MINISTRY OF PUBLIC HEALTH
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