Subject(s)
Guidelines as Topic , Health Care Reform , Health Services/standards , National Health Programs/standards , Primary Health Care/standards , Brazil , Costa Rica , Expert Testimony , National Health Programs/organization & administration , Nicaragua , Pan American Health Organization , Primary Health Care/organization & administration , Program Evaluation , Social Security/organization & administrationABSTRACT
Given that the lack of qualified human resources devoted to primary health care (PHC) is one of the reasons why Alma Ata goals are as yet unattained, PAHO/WHO sponsored the design and implementation of a virtual course for training health care professionals at this level. The course was designed around competencies identified as being necessary for renewing primary care, founded on the premise that providing quality, sustainable services amenable to the public must emanate from professionals who lead the change process at all levels in the system. In this first phase, instruction is aimed at PHC leaders, managers, and other decision makers. The course is offered through the Virtual Public Health Campus and is 27 weeks long.
Subject(s)
Humans , Clinical Competence , Primary Health Care , World Health OrganizationABSTRACT
OBJETIVOS: Identificar los componentes relacionales de una red internacional de organizaciones de cooperación técnica y financiera que promueva el desarrollo de sistemas de salud basados en la atención primaria de salud (APS) en los países de la Región; analizar los vínculos de acción social para la cooperación en salud entre los socios colaboradores de la Organización Panamericana de la Salud (OPS); y determinar los elementos teóricos básicos que pueden contribuir a desarrollar estrategias de acción que respalden la abogacía en red. MÉTODOS: Estudio transversal cualitativo y cuantitativo basado en la identificación de informantes clave y el análisis de redes sociales. Se colectó información etnográfica y relacional de 46 organizaciones internacionales mediante un cuestionario semiestructurado autoaplicado. Participaron 29 tomadores de decisión pertenecientes a 29 organizaciones de cooperación internacional en salud (tasa de respuesta: 63,0 por ciento). La estructura y solidez de la red se evaluó mediante la densidad, la distancia, la transitividad y la centralización de los nodos. El análisis estadístico se realizó mediante los programas informáticos UCINET, PAJEK y MS Access, entre otros. RESULTADOS: Se identificó una red teórica estructuralmente centralizada, cuyos nodos aglutinados en cuatro subgrupos centrales se vincularon en una visión compartida. El liderazgo, la influencia y los intereses políticos reflejaron los vínculos cooperativos de tipo formal y técnico y el apoyo formal a favor de la propuesta, con el predominio del flujo de recursos técnicos sobre los financieros. CONCLUSIONES: Los componentes relacionales interorganizacionales y los vínculos de acción social identificados pueden influir positivamente en la conformación y consolidación de una red temática de abogacía y gestión para la cooperación técnica y financiera en apoyo a la APS en la Región de las Américas. Los vínculos de acción identificados pueden favorecer...
OBJECTIVES: To identify the relational components of an international network of organizations that provide technical and financial assistance to promote the development of health systems based on primary health care in the countries of the Region of the Americas; to analyze the linkages that would allow the collaborating partners of the Pan American Health Organization (PAHO) to work together on health issues; and to determine the basic theoretical elements that can help to develop action strategies that support advocacy efforts by a network. METHODS: This was a qualitative and quantitative cross-sectional study based on identifying key informants and on analyzing social networks. Ethnographic and relational information from 46 international organizations was collected through a self-administered semistructured questionnaire. From 46 international health cooperation organizations, 29 decisionmakers from 29 organizations participated (63.0 percent response rate). The structure and the strength of the network was evaluated in terms of density, closeness, clustering, and centralization. The statistical analysis was done using computer programs that included UCINET, Pajek, and Microsoft Access. RESULTS: We found a structurally centralized theoretical network, whose nodes were clustered into four central subgroups linked by a shared vision. The leadership, influence, and political interests reflected the formal and technical-cooperation linkages, the formal support for health systems based on primary health care, and the flow of resources being more often technical ones than financial ones. CONCLUSIONS: The interorganizational relational components and the social-action ties that were identified could help in the development and consolidation of a thematic network for advocacy and for the management of technical and financial assistance that supports primary health care in the Americas. The linkages for joint action that were identified could...
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Health Promotion/methods , Primary Health Care , Americas , Community Networks , Cross-Sectional Studies , Social SupportABSTRACT
El documento "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO" es fruto del mandato de los Estados Miembros de la Organización Panamericana de la Salud (OPS) para el fortalecimiento de la APS, definido por la resolución CD44.R6 del Consejo Directivo en 2003. Dicho mandato culminó con la Declaración de Montevideo, un compromiso de todos los gobiernos de las Américas para renovar la APS, entendida como la base de los sistemas de salud de la Región. Los resultados científicos demuestran que la APS es un componente clave para alcanzar la efectividad de los sistemas de salud y puede adaptarse a los diversos contextos sociales, culturales y económicos de los diferentes países. El nuevo contexto mundial hace que cambien las necesidades en salud de la población, por lo que es necesario adaptar los servicios y sistemas de salud para que puedan dar una respuesta adecuada a esas nuevas necesidades. Rescatando el legado de la Conferencia Internacional sobre Atención Primaria de Salud, celebrada en Alma-Ata (Kazajstán, antigua Unión Soviética) en 1978, la OPS propone un conjunto de líneas estratégicas esenciales para adoptar sistemas de salud basados en la APS, construidos sobre los valores de la equidad, la solidaridad y el derecho a gozar del grado máximo de salud posible. El objetivo principal de las líneas estratégicas propuestas es desarrollar o fortalecer los sistemas de salud basados en la APS en toda la Región de las Américas. Esto requerirá un esfuerzo considerable de los profesionales de la salud, los ciudadanos, los gobiernos, la sociedad civil y las agencias de cooperación. Se exponen las líneas estratégicas que deben establecerse a nivel nacional, subregional, regional y mundial.
At the 2003 meeting of the Directing Council of the Pan American Health Organization (PAHO), the PAHO Member States issued a mandate to strengthen primary health care (Resolution CD44.R6). The mandate led in 2005 to the document "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO [World Health Organization]," and it culminated in the Declaration of Montevideo, an agreement among the governments of the Region of the Americas to renew their commitment to primary health care (PHC). Scientific data have shown that PHC, regarded as the basis of all the health systems in the Region, is a key component of effective health systems and can be adapted to the range of diverse social, cultural, and economic conditions that exist. The new, global health paradigm has given rise to changes in the population's health care needs. Health services and systems must adapt to address these changes. Building on the legacy of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (Kazakhstan, Union of Soviet Socialist Republics), PAHO proposes a group of strategies critical to adopting PHC-based health care systems based on the principles of equity, solidarity, and the right to the highest possible standard of health. The main objective of the strategies is to develop and/or strengthen PHC-based health systems in the entire Region of the Americas. A substantial effort will be required on the part of health professionals, citizens, governments, associations, and agencies. This document explains the strategies that must be employed at the national, subregional, Regional, and global levels.