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Advances in Policy ObservatoryChronic non-communicable diseases in Chile
Advances in Policy ObservatoryChronic non-communicable diseases in Chile
Dr. María Cristina Escobar
Non-communicable Diseases DepartmentPrevention & Control of Diseases Division
Undersecretary of Public Health
Montreal, May 12, 2008
CONTENTS
Context
Purpose & Goals
Recommendations
Participants
CONTEXTInternational
Canada & Chile co-founders of the CARMEN network
PAHO´s Regional Strategy and Action Plan for Integrated Prevention & Control of NCDs including Diet, Physical Activity & Health
PAHO/PHAC Policy Observatory for NCDs
CONTEXTNational
National Health Objectives for the decade 2000-2010: Mid-term evaluation
On-going Health Reform New structure & roles within MOH GES: Explicit guarantees regime in health Burden of disease of NCDs in Chile
Opportunities
Political will to strengthen preventive actions: Preventive health examination & preventive interventions within GES conditions.
The proposal would be finished one year before the formulation of the National Health Objectives for the next decade 2010-2020.
Purpose & Goals
Effective integration of NCD prevention & control policies: Health promotion and prevention of NCDs; Treatment & care in the primary health level; Strengthening population/public health policies for
health promotion, health protection and action on social determinants.
“Achieving greater integration in prevention and control of
chronic non-communicable diseases in Chile”
Canada/Chile Policy Observatory Project
Chronic, Non-communicable Diseases
Three stages Stage 1: Canadian/PAHO delegation visit to Chile
(December 2007)Stage 2: Chilean delegation visits Canada (August
2008)Stage 3: NCD policy dialogue
External experts will review observations and recommendations from the first two stages to assist chileans in formulation of a comprehensive approach to NCD policy that will achieve a better balance between health promotion, prevention, treatment & care of NCDs. (to be determined)
RECOMMENDATIONSStage 1
Integrated health plan based on the principles of PAHO Regional Strategy for NCDs, revision of National Health Objectives Need strenghen public health competencies regarding
NCD prevention at national and regional levels in support of population level approaches
Strengthen public health leadership at a regional level Strengthen collaborative work between regional level
& health services Need for a set of indicators representing NCD prevention
for Regional Public Health Plans. Integrated individual and population based approaches &
strategies for care and treatment of diabetes and cancer.
RECOMMENDATIONS (cont.)Stage 1
Improvement of information technology to support gathering, assembling and processing NCD and risk factor data to facilite easier access to health information and services for various users: general population, patients and health professionals. Address NCD information system development through a
phased approach. Prioritize primary health care centres. Standarize and streamline data collection process to meet
requirements for GES, health statistics, program reports. Develop a unified set of indicators that apply across the
health sector that serve to link primary care with secondary and tertiary services (eg. avoidable hospitalizations)
Simplify, automate and disseminate more practical clinical guidelines for health professionals that allow more accurate diagnosis, better treatment and effective self-mangament.
Develop and disseminate patient education and self-management tools.
RECOMMENDATIONS (cont.)
Stage 1Optimize health promotion & health protection
regarding risk factorsExamine tobacco, diet and physical activity in light
of regulatory frameworks of what has been proven to be effective thus far and present multisector best practices.
Broaden the scope of GES to incorporate prevention and early detection measures/interventions.
Reorient human resources toward team work and prevention of risk factorsStrengthen the interdisciplinary team approach
through health human resources training.
RECOMMENDATIONS (cont.)
Stage 1
Strengthen the role of NGOs and civil society.Increase effectiveness of collaboration
between the various levels of MOH and existing NGOs (Juvenile Diabetes Association, Cancer Society) to improve their efforts in public education, patient education and patient self-management.
Activate physicians and medical societies to advocate for health promotion and health protection.
PARTICIPANTS WHO Collaborating Centre on Chronic Disease
Policy, Public Health Agency of Canada (PHAC):
Dr. Sylvie Stachencko Ms. Lise Mathieu Ms. Barbara Lewoski
Health Canada, International Affairs Directorate Ms. Kate Dickson
Pan American Health Organization (PAHO) Dr. Branka Legetic
Ministry of Health of Chile Office of International Affairs: Dr. Osvaldo Salgado Prevention & Control of Diseases Division: Dr. Pedro Crocco
Chronic Non-communicable Diseases Department: Dra. María Cristina Escobar and team
Public Health Policies Division: Dra. Helia MolinaNutrition & Food Department: Dr. Tito Pizarro; Judith Salinas, Health
Promotion Department Primary Health Care Division, Dr. Hugo Sánchez Planning Division, Dra. Ximena Aguilera
Epidemiology Department: Dr. Andrea Guerreo & Clelia Vallebuena