THE PROCESS OF HEALTH REFORM IN PERU. JOSÉ CARLOS DEL CARMEN SARA Translated into English by Isadora Steffens

Transcription

1 THE PROCESS OF HEALTH REFORM IN PERU JOSÉ CARLOS DEL CARMEN SARA Translated into English by Isadora Steffens

2 Why a Health Reform? We want to eliminate restrictions that keep people from excercising their RIGHT TO HEALTH The Reform PROMOTES CORRESPONSABILITY Establishes the path towards a health system that is UNIVERSAL, EQUITABLE AND SOLIDARY The Reform answers to an ACCUMULATION PROCESS

3 The challenge against inequality Child mortality rate in Peru Source: ENDES 1996, 2000 and INEI.

4 THE POLICY OF HEALTH INSURANCE IN PERU: THE RESULT OF AN ACUMULATION PROCESS 2002: National Agreement (13 th Policy) 2005: Political Parties Agreement Maternal and child health Infectious diseases Health sector decentralization Universal health insurance Financing and targeting Social participation 2007: Concerted National Plan 2009: AUS Framework Law 2011: AUS Financing Law

5 MORE protected people MORE and better care MORE Rights protection MORE stewardship and governance of the system

6 MORE PROTECTED PEOPLE Health insurance trend according to the level of poverty Source: ENAHO

7 MORE PROTECTED PEOPLE In the intention of establishing a Social Protection model of Social in universal Health, we are increasing the insurance coverage of the Comprehensive Health Insurance (CHI) Afiliation to CHI for poor people without coverage (inhabitants of remote areas, undocumented populations, people with precarious living conditions, etc). Afilliation to CHI for priority populations that do not have health protection: pregnant women, children from 0 to 5 years old, students of the initial and primary level in public schools. Afilliation free of charge to the CHI for small independent contributors without health insurance.

8 MORE PROTECTED PEOPLE Health insurance trend according to the level of poverty Source: ENAHO

9 MORE PROTECTED PEOPLE Trend of the health insurance in Peru according to kind of IAFAS Source: ENAHO

10 MORE PROTECTED PEOPLE

11 MORE AND BETTER CARE

12 MÁS MORE Y MEJORES AND BETTER CUIDADOS CARE Where people insured at CHI look for medical attention Source: ENAHO

13 MORE AND BETTER CARE Where people insured at ESSALUD go for health problems attention Source: ENAHO

14 MORE AND BETTER CARE Bring closer the health interventions and services through integrated nets of primary health attention, including specialized attention Establish a remunerative policy that encourages the primary health attention, the specialized attention, the work in remote areas, the responsibilities of leadership and adequate performance Expand the use of the existing public offer through exchange and provision of complementary services Reduce pocket spending on medication through improvement of access to generics for people insured by the CHI Strengthen the public offer of health services, modernizing the management of investments and complementing it with APP

15 MORE AND BETTER CARE Childbirths in health facilities (Percentage) Urban Total Rural Source: INEI - ENDES 2013

16 MORE AND BETTER CARE Latin America Death of children under one year old for each per thousand live births Peru Rural National Urban Source: INEI - ENDES 2013

17 MORE PROTECTION OF RIGHTS The National Health Superintendence is the institution that, through its actions, pretends to aggregate value to the operations of the health system in benefit of users Orient and protect the rights of users Manage the operational risk of the institutions Propose appropriate models of provider certification Monitor the adequacy of the categorization and of accreditation of providers Monitor the fulfilment of standards in the provision of health services

18 MORE SUPERVISION AND GOVERNANCE OF THE SYSTEM Make the measures that were designed for the people possible and sustainable Reorganize the ministry with emphasis on public health and multisectoral actions related to the social determinants of health Strengthen the intergovernmental articulation on health Strengthen the capacity of Regulation and Control of the health related markets Develop the Sectoral System of Health Information and connect it to the monitoring and evaluation system of the health and reform objectives Guarantee the public service in emergency situations

19 MORE SUPERVISION AND GOVERNANCE OF THE SYSTEM

20 MORE SUPERVISION AND GOVERNANCE OF THE SYSTEM In search of eficacy, quality and good orientation of State intervention Mecanisms for the Process of Coordination: generar acuerdos intergubernamentales; of Colaboration: Bilateral and reciprocal support; of Cooperation: In the framework of the respective competences. Management Agreements with the Regional Governments for compliance with institutional goals, performance indicators and improvements in services, under the DL N Convenios entre el CHI and the regional governments in order to stumulate the prevention activities and improve the heath index..

21 MORE SUPERVISION AND GOVERNANCE OF THE SYSTEM Multisectoral and Intergovernmental Alliances Plan TB Cero Plan Integral Peste Macro Norte Region Lima - Together against Tuberculosis September 11 th, 2011 Arq. Alberto Sánchez A. Mayor La Victoria Eco. Victor Salcedo R. Mayor El Agustino Agreement MINSA ESSALUD Regional Governments Performance Exchange Preventorium for children a and adolescents Representants OPS/OMS La Libertad Provincial Mayors Colonel Marco Álvarez Alcalde San Borja Dra. Carmen Masías President DEVIDA

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