8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

1/34

` varsd ad t

Ngvardca d`l tma

Vosa ge Nmrg`onLosadsa;

D Idto` Dbarond`

Tuast

Eaionod Bdroa H`dui

4:tm oMAD Sgril Ng`crass

Maditm Ang`gbons o` tmaDca ge Ig`cavoty;

Kuiy 41, 6:4. Baxong d`l ^acurg Zgpuidr

Fradst Nd`nar d`l QMN

Zdo` ng`trgi d`l pdiiodtova ndra

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

3/34

Muca staps tg raegrb maditm systabs o` tma

quast egr QMN o` bd`y ngu`troas

Axdbpias;

Frdzoi

Ngigbfod

NmoiaLgbo`ond` Vapufion

Ai divdlgr

Zaru

Baxong; ^acurg Zgpuidr la ^diul

^gutm De r ond

Nmo`d

(Q^D- Deegrldfia Ndra Dnt)

_atgeta` o` tmang`taxt ge rdpol,

prgegu`l,

pgidrozal d`lngbpiax

apolabogigcondi

trd`sotog` grfdttio`cerdcba`tal maditm

systabs

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

4/34

Idto` Dbarond` `dtog`s, bunm ge adstar`

Aurgpa d`l na`trdi Dsod, Nmo`d, O`lod, bd`y gtmarpdrts ge sgutm Dsod, d`l ava` ngu`troas o` Derond,

XdraR edno`c d pdo`eui lgufia furla` ge losadsa

`gt g`iy tma parsosta`na ge o`eantogus tmradts,

nmoil d`l bdtar`di bgrtdioty, d`l u`lar`utrotog`,

fut disg tma abarca`na ge `aw ld`cars, `gtdfiylodfatas, gfasoty, ndrlogvdsnuidr losadsa, strgha,

nd`nar, ba`tdi oii-maditm, d`l o`kuroas. \mos lgufia

furla` raquoras d lgufia raspg`sa, d

pralondba`t tmdt pidnas muca raspg`sofoiotoas g`tma stawdrls ge `dtog`di maditm systabs.

KQIOG EVA@H & VONMDVL MGV\G@

MADI\M VAEGVB O@ BA]ONG ^AVOA^8 \MA ID@NA\, 6::5

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

5/34

^gurna; Napdi, 6:46. \ma apolabogigcon prgeoia ge Idto` Dbarond d`l tam Ndroffad`; nmdiia`cas, iobots, d`l dntog`s.

4?=: 6:4:

55%

61%

?%

3:%

4=%

46%

Ngbbu`ondfia

@g`-

Ngbbu`ondfia

O`kuroas

O` kust gvar :+

o` 4?6:, tg 31+tgldyO` d vary smgrt tobaparogl, tma ndusasge ladtm mdvaravarsal

O` Idto` Dbarond d`l tma Ndroffad`,labgcrdpmon d`l apolabogigcon trd`sotog`s

mdva faa` rdpol d`l prgegu`l

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

6/34

LDI_s (%) fy ndusa-crgup d`l

wgril racog`, CFL-OMBA, 6:4:

34

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

7/34

\ma Lodcg`di Dpprgdnm tg

Maditm ^ystab ^tra`ctma`o`cVdtmar tmd` egnuso`c g` aotmar losadsa-spanoeon vartondi gr

mgrozg`tdi-systabon prgcrdbs mdr`ass sy`arcoas tmdt

prgvola gppgrtu`otoas tg tdnhia losadsa-spanoeon progrotoas

wmoia dllrasso`c systabon cdps d`l gptoboza dvdoidfiarasgurnas

Lodcg`di strdtacoas mdva bdkgr fa`aeots;] 2 0 pdrts

Frolca losadsa lovolas uso`c d ioea nynia raspg`sa

dvgols tma edisa loiabbds fatwaa` losadsa soigs -

NL/@NL- tmdt ng`to`ua tg pidcua cigfdi maditm

Ca`ardta pgsotova axtar`diotoas; a.c. wgba`s nd`nar

prgcrdbs eocmt ca`lar losnrobo`dtog`8 pdo` ng`trgi

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

8/34

Losadsa d`l maditm systab eu`ntog`s,

Fy o`tacrdtog`Lodcg`di,

sy`arcoston;

vartondid`l

mgrozg`tdi

o`tacrdtog`

Losadsa

^panoeon;

vartondio`tacrdtog`,

mgrozg`tdi

sacba`tdtog`

Ca`ardiozal;

vartondi

sacba`tdtog`,mgrozg`tdi

o`tacrdtog`

Dtgbozal;

vartondi

d`lmgrozg`tdi

sacba`tdtog`

^tawdrlsmop

Eo`d`no`c

Vava`ua ngiiantog`

Eu`l Zggio`c

Zurnmdso`c

Zrgvosog`

Vava`ua

ca`ardtog`

EQN\OG@^

Dldptal ergb Burrdy d`l Era`h8 SMG Fuiiato` 6:::

Losadsa 4

Losadsa 6Losadsa >

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

9/34

Edisa lonmgtgboas nmdiia`ca

Q`ovarsdi Maditm Ngvardca (QMN)

Ngbbu`ondfia gr o`eantog`-

dssgnodtal @NL

Nmrg`on MOU/DOLs (H^) Fradst nd`nar

Dnuta Lodrrmad

Vaspordtgry o`eantog`

Dnuta bygndrlodi o`edrntog`

Dnuta IybpmgfidstonIauhabod

Losadsas o`dnnurdtaiy idfaial nmrg`on gr o`eantogus

Narvondi Nd`nar (MZU)

Ig`c tarb losdfo i o ty pgst o`eantog` (pgiog)

Nmrg`on w dnutaaposglas; Dsbd, ba`tdi

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

10/34

Gutio`a

4. QMN d`l tma nmdiia`ca ge nmrg`on ng`lotog`s

6. Aeeantova Q`ovarsdi Maditm

Ngvardca>. Baxong d`l ^acurg Zgpuidr

Fradst Nd`nar d`l QMN

Zdo` ng`trgi d`l pdiiodtova ndra

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

11/34

Aeeantova Q`ovarsdi Ngvardca

Q`ovarsdi Ngvardca; quast wotm > stdcas

Iacdi; deeoiodtog`/a`rgiiba`t

Dnnass tg d ngbprama`sova pdnhdca ge axpionot

a`totiaba`ts wotm eo`d`nodi prgtantog`

Aeeantova ngvardca & aeeantova eo`d`nodi

prgtantog`

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

12/34

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

13/34

Q`ovarsdi Maditm Ngvardca;

Zgpuidtog`, Losadsas, d`l O`tarva`tog`s

Zgpuidtog`

(Mgrozg`tdi)

Zdnhdca-Losadsas

& O`tarva`tog`s

(Uartondi)

d`l^nmraygcc, at di., 6::1.

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

14/34

D` aeeantovaQMN raspg`sa tg nmrg`on oii`ass

bust o`tacrdta o`tarva`tog`s dig`c tma

Ng`to`uub ge losadsa;4. Zrobdry prava`tog`6. Adriy latantog`

>. Lodc`gsos

.Laiovary

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

15/34

Maditm ^ystab

Eu`ntog`s

^tdca ge Nmrg`on Losadsa Ioea Nynia /ngbpg`a`ts NNN

Zrobdry

Zrava`tog`

^ang`ldry

prava`tog`Lodc`gsos \radtba`t

^urvovgrsmop/

Vamdfoiotdtog`

Zdiiodtog`/

A`l-ge-ioea ndra

^tawdrlsmop

Eo`d`no`c

Laiovary

Vasgurna

Ca`ardtog`

aQMNraquoras d` o`tacrdtal raspg`sa dig`c tmang`to`uub ge ndra d`l wotmo` adnm

ngra maditm systab eu`ntog`

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

16/34

Gutio`a

4. QMN d`l tma nmdiia`ca ge nmrg`on ng`lotog`s

6. Aeeantova Q`ovarsdi Maditm Ngvardca

>. Baxong d`l ^acurg Zgpuidr Fradst Nd`nar d`l QMN Zdo` ng`trgi d`l pdiiodtova ndra

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

17/34

Baxong, 6::>; Maditm Vaegrb

Dibgst mdie ge Baxond` mgusamgils

idnhal maditm o`surd`na, wmonm

iobotal dnnass tg ndra, ralunalgppgrtu`otoas egr rosh pggio`c, d`l

ca`ardtal ndtdstrgpmon axpa`loturas.

Iacosidtova raegrb o`trgluntal^acurg Zgpuidr d`l tma ^ystab egr

^gnodi Zrgtantog` o` Maditm

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

18/34

^acurg Zgpuidr, Vasuits

Id`nat 6:46

O`nradsal ngvardca;

iacdi, fdson d`l aeeantova

Eo`d`nodi prgtantog` obprgval

\ma eo`d`nodi losaquoiofroub fatwaa`

tma o`sural d`l tma u`o`sural`gwngvaral fy ^acurg pgpuidr- mds nigsal

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

19/34

Axpd`sog` ge Ngvardca;

^acurg Zgpuidr

Mgrozg`tdi Ngvardca;

Fa`aeonodroas

UartondiNgvardca

Losadsasd

`lO`tarva`t

og`s;

Fa`aeotsZdnhdc

a

Deeoiodtog`; 6::

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

20/34

NDQ^A^ 6= 51 51 51 51 51 51 51 51 51

5 5 = 5 46 46 46 46 4> 4>66

=>

435 4= e t eo o i

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

23/34

\ma 6::> raegrb nradtas d `aw eo`d`nodi

bglai;Eu`ls ge tma ^ystab ge ^gnodi Zrgtantog` o` Maditm

* ^o`na Lan 6::5.

** ^o`na 6:4>

^gurna; Dldptal ergb; Era`h K, Cg`ziaz-Zoar A, Cbaz-Ld`ts G, Iazd`d BD, H`dui EB. Ngbprama`sova raegrb tg obprgva maditm systabparegrbd`na o` Baxong. Id`nat 6::58 >5=; 416

4

4 y 6

4 y 6

>

Ngbbu`ondtog`fatwaa` eu`lsd`l iavais os

prgfiabdton, futtma pgpuidtog`

bgvas fatwaa`tmab

L io l eo o i o m ii

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

24/34

Fa`aeot

s;ngvaralo`

tarva`tog`s

Laiovary d`l eo`d`nodi prgtantog` nmdiia`cas;

^acurg Zgpuidr o` Baxong

DNNAIAVD\AL UAV\ONDI NGUAVDCA egr Ndtdstrgpmon

Oii`assas o`niulal o` tma Eu`l; fradst nd`nar, DOL^

Ngbbu`oty d`l Zufion Maditm ^arvonas

Zggr Vonm

NMOILVA@; Maditm o`surd`na egr d @aw Ca`ardtog` / ]]O Na`tury Bal O`s.

Zdnhdca ge assa`todi parsg`di

sarvonas

Fa`aeonodroas

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

25/34

Aeeantova eo`d`nodi ngvardca ge d

nmrg`on losadsa; fradst nd`nar

Baxong; Idrca d`l axabpidry o`vastba`t o` eo`d`nodiprgtantog` egr fradst nd`nar prava`tog` d`l tradtba`t,

yat..d igw survovdi rdta.

^tra`ctma` adriy latantog`, survovgrsmop d`l pdiiodtog`

Nd`nar Ng`trgi-Ndra ng`to`uub

Zrobdry

Zrava`tog`

Adriy

Latantog` Lodc`gsos \radtba`t ^urvovgrsmop Zdiiodtog`

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

26/34

^tdca ge Nmrg`on Losadsa Ioea Nynia /ngbpg`a`ts NNN

Eo`d`todi

prgtantog`

Zrobdry

Zrava`tog`

^ang`ldry

prava`tog`Lodc`gsos \radtba`t

^urvovgrsmop/

Vamdfoiotdtog`

Zdiiodtog`/

A`l-ge-ioea

ndra

Ngstd Vond

Bxong Zdrtodiiy Zdrtodiiy

Ngigbfod Zdrtodiiy Zdrtodiiy Zdrtodiiy

Lgbo`ond`

Vap.Zdrtodiiy

Zaru

Ngvardca ge fradst nd`nar o` saiant IDN

ngu`troas fy ng`trgi-ndra ng`to`uub

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

27/34

Gutio`a

4. QMN d`l tma nmdiia`ca ge nmrg`on ng`lotog`s

6. Aeeantova Q`ovarsdi Maditm Ngvardca

>. Baxong d`l ^acurg Zgpuidr Fradst Nd`nar d`l QMN

Zdo` ng`trgi d`l pdiiodtova ndra

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

28/34

Zdo`; d cigfdi o`kustona

Avary yadr, boiiog`s ge pagpia sueear u``anassdroiy ergb

bglardta d`l savara pdo`, o`niulo`c 1.1 boiiog` nd`nar pdtoa`ts

=>% ge tma wgrils pgpuidtog` iovas o` ngu`troas wotm eaw gr `g

dnnass tg pdo` balono`as Mocm-o`ngba ngu`troas raprasa`t iass tmd` 41% ge tma wgrils

pgpuidtog` fut bgra tmd` ?

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

29/34

\ma bgst o`sologus o`kustona;

\ma pdo` lovola

636,::: bc

6,>:: bc

653,::: bc

5,5:: bc

>3,::: bc

^gurna; Fdsal g` ldtd ergb; \radt tma pdo`(mttp;//www.tradttmapdo`.ngb)

@g`-batmdlg`a, Bgrpmo`a

Aquovdia`t gpogol ng`subptog` parladtm ergb MOU gr nd`nar o` pdo`;

Zggrast 4:%; 1< bc

Vonmast 4:%; ?3,

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

30/34

Vana`t bdkgr cigfdi

prgcrass 6:4

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

31/34

O` Baxong

Iacosidtova o``gvdtova fa`nmbdrh dt d cigfdiiavai;

6::?; bgloe ondtog` ge tma Ca`ardi Maditm Idw

d`l Idw g` Zdii odtova Ndra

6:4>; Axpd`sog` ge tma Ca`ardi Maditm Idw g`

pdii odtova ndra bdttar

Mgwavar..

Gut ge tma =>,334 ladtms ergb nd`nar gr

MOU/DOL^ o` 6:4:, 51,

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

32/34

Fdrroars tg dnnass pdiiodtova ndra fy

maditm systab eu`ntog`Maditm

^ystabEu`ntog`s

Ngbpg`a`ts ge tma ng`to`uub ge losadsa d`l ioea nynia

Zrava`tog`^urvovgrsmo

p

Zdiiodtog`, pdo` ng`trgi d`l

a`l-ge-ioea ndra

^tawdrlsmop

Q`oeyo`c @dtog`di Zrgcrdb/Zid` idnho`c

Sadh, rastrontova, d`l pggriy laeo`al racuidtgry

erdbawgrhs

Dfsa`na ge d` o`stotutog`di systab egr bg`otgro`c d`lavdiudtog`

Eo`d`no`cNDQ^A^ d`l EZNMA; tmaras g axpionot ngvardca8

O` ^gnodi ^anuroty, d wmgia

LaiovaryIdnho`c sarvona u`ots

^uppiy d`l lostrofutog` nmdo`s o`ngbpiata cagcrdpmondiiy

Vasgurna

Ca`ardtog`

^ndrnoty ge qudioeoal parsg``ai

Eadr o` tma prasnroptog`

O`ngrpgrdtog` ge raiavd`t nidssas o` u`ovarsoty nurronuid os bosso`c

Dfsa`na ge pufiosmal o`vastocdtog`s

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

33/34

D crgwo`c cigfdi bgvaba`t egr u`ovarsdi

ngvardca os dlvgndto`c egr tma trd`segrbdtog`ge maditm ndra o`tg d u`ovarsdi rocmt, wmonm

a`tdois d trd`sotog` ergb trdlotog`di sgnodi

o`surd`na ds d` abpigyba`t fa`aeot tgu`ovarsdi sgnodi prgtantog` ge maditm, d rocmt ge

notoza`smop. \rd`sidtog` ge tmos sgnodi rocmt o`tg

prdntona os d quast - ot obpioas d ng`to`ugusstra`ctma`o`c ge maditm systabs tg a`dfia tmab

tg geear aeeantova u`ovarsdi ngvardca o` tma edna

ge nmrg`on oii`ass.

` varsd ad t

8/12/2019 Universal Health Coverage and the Rise of Chronic Disease: A Latin American Quest

34/34

` varsd ad tNgvardca d`l tma

Vosa ge Nmrg`on

Losadsa;

D Idto` Dbarond`

Tuast

Eaionod Bdroa H`dui

4:tm oMAD Sgril Ng`crass

Maditm Ang`gbons o` tmaDca ge Ig`cavoty;

Kuiy 41, 6:4