Traditional PHC Proposed PHC-R Universality– free (removal of user fees) Inclusion of all family members Integration (Life cycle) Family Health Units Increased Health budget PHC as a gateway and coordinator (To-do) PHC is not cheap, requires important investments • Health posts for the rural poor • Maternal and Infant Health • Focus on infectious and acute diseases • Voluntary Health Workers • Management of increasingly scarce resources • Primary care as the antithesis of hospitals • PHC is cheap and requires only a small investment World Health Report 2008: Primary Health Care, Now More than Ever
Maternal mortality decreased almost 40% in ten years. Maternal mortality reduced from 164 deaths per 100,000 live births in 2000 to 100.8 per 100,000 live births in 2010. 2010 is the largest change within this indicator as well as dates preliminary to 2011, coincidentally with the implementation of the majority of the FHU. Biostatistics, Ministry of Public Health and Social Wellbeing. 2012.
Infant mortality decreased from17.8 deaths for each thousand live births in 2005 to 16.3 deaths in 20102. • User satisfaction.More than 70% of FHU users say they are satisified with the care received. • 73% of indigenous communities (450 of 620) are currently under the responsabilty of a family health unit (FHU). Diagnostic study of the health sector. Preliminary results. ICA, JICA 2012.
Increased access.Increase from 48,000 people to 2,950,000 people. Representing 60 times more people cared for. • Of all persons seen by the health services network in 2001, 42% consulted with a FHU. • The assigned budget for the PHC strategy has increased five times, compared to the years 2009 and 2012. • Over 90% of FHU staff report that they have medicines to administer care; however 73% of these note that the supply is insufficient. PHC Program Monitoring. Technical Planning Secretary, 2012
Universal Coverage and Equal Access • Workforce competencies for primary health care • Methodologies to eliminate fragmentation within health services—integration of the health services delivery networks (IDN) • Compilation of PHC best practices in the Americas • Accreditation and systems evaluation of unemployment for primary care • Integration of PHC in all programs • Health in All Policies Pending
Consulted sources • World Health Report 2008: Primary Health Care, Now More than Ever • Renewing Primary Health Care in the Americas: A Position Paper of the Pan American Health Organization/World Health Organization (PAHO/WHO). 2007. • Renewing Primary Health Care in the Americas. Reynaldo Holder, March 31, 2011. • Integrated Health Service Delivery Networks PAHO 2010 • Approaching Topics from an International Health Perspective and the Development of a Conceptual Model. PAHO, 2010. • Accountability. Ministry of Public Health and Social Wellbeing, December 2011. • Department of Statistics and Census. 2012. • http://www.dgeec.gov.py/ • PHC Program Monitoring. Technical Planning Secretary, 2012 • Diagnostic study of the health sector. Preliminary results. ICA, JICA 2012. • Biostatistics. Ministry of Public Health and Social Wellbeing. 2012. • Thank you