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THE PROCESS OF HEALTH REFORM IN PERU JOSÉ CARLOS DEL CARMEN SARA Translated into English by Isadora Steffens
THE PROCESS OF HEALTH REFORM IN PERU
JOSÉ CARLOS DEL CARMEN SARA
Translated into English
by Isadora Steffens
Why a Health Reform?
We want to eliminate restrictions that
keep people from excercising their
RIGHT TO HEALTH
Establishes the path towards a health system
that is UNIVERSAL, EQUITABLE AND SOLIDARY
The Reform answers to an
ACCUMULATION PROCESS
The Reform PROMOTES
CORRESPONSABILITY
The challenge against inequality
Source: ENDES 1996, 2000 and 2012. INEI.
Child mortality rate in Peru
THE POLICY OF HEALTH INSURANCE IN PERU:
THE RESULT OF AN ACUMULATION PROCESS
2002: National Agreement (13th 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
MORE protected
people
MORE and better care
MORE Rights
protection
MORE stewardship and
governance of the system
Source: ENAHO 2002-2012
Health insurance trend according to the level of poverty. 2002-2012
MORE PROTECTED PEOPLE
MORE PROTECTED PEOPLE
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.
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)
Source: ENAHO 2002-2013
Health insurance trend according to the level of poverty. 2002-2013
MORE PROTECTED PEOPLE
Source: ENAHO 2004-2013
Trend of the health insurance in Peru according to kind of IAFAS. 2004-2013
MORE PROTECTED PEOPLE
MORE PROTECTED PEOPLE
MORE AND BETTER CARE
Where people insured at CHI look for medical attention. 2005-2011
Source: ENAHO 2005-2011
MÁS Y MEJORES CUIDADOS MORE AND BETTER CARE
Source: ENAHO 2005-2011
MORE AND BETTER CARE
Where people insured at ESSALUD go for health problems attention. 2005-2011
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
MORE AND BETTER CARE
(Percentage)
Childbirths in health facilities 2000 - 2013
Urban
Total
Rural
Source: INEI - ENDES 2013
MORE AND BETTER CARE
Urban
National
Rural
Latin America Death of children under one year old for each per thousand live
births Peru 2000-2013
Source: INEI - ENDES 2013
MORE AND BETTER CARE
MORE PROTECTION OF RIGHTS
Manage the operational risk of the institutions
Orient and protect the rights of users
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
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
MORE SUPERVISION AND GOVERNANCE OF THE SYSTEM
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
Make the measures that were designed for the people
possible and sustainable
MORE SUPERVISION AND GOVERNANCE OF THE SYSTEM
MORE SUPERVISION AND GOVERNANCE OF THE SYSTEM
of Coordination: generar acuerdos intergubernamentales;
of Colaboration: Bilateral and reciprocal support;
of Cooperation: In the framework of the respective competences.
In search of eficacy, quality and good orientation of State intervention
Mecanisms for the Process
• Management Agreements with the Regional Governments for compliance with institutional goals, performance indicators and improvements in services, under the DL N°1153.
• Convenios entre el CHI and the regional governments in order to stumulate the prevention activities and improve the heath index..
MORE SUPERVISION AND GOVERNANCE OF THE SYSTEM Multisectoral and Intergovernmental Alliances
Lima - Together against Tuberculosis September 11th, 2011
Agreement MINSA – ESSALUD – Regional Governments Performance Exchange
Plan Integral Peste – Macro Norte Region
La Libertad Representants OPS/OMS
Provincial Mayors
Plan TB Cero
Eco. Victor Salcedo R. Mayor El Agustino
Arq. Alberto Sánchez A. Mayor La Victoria
Colonel® Marco Álvarez Alcalde San Borja
Dra. Carmen Masías President DEVIDA
Preventorium for children a and adolescents
