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CORE Global Health Practitioner Conference, Fall 2014
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Dr. Amalia Del Riego Unit Chief, HS, PAHO/WHO
Where is the C in HSS Framework? PAHO/WHO Perspective
2
0
50,000
100,000
150,000
200,000
250,000
300,000
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11
0
20
40
60
80
100
Cases Coverage
Catch-up campaigns
*1333 confirmed cases in 2011; data as of 31 August 2012.
Follow-up campaigns
Ro
utin
e in
fan
t vaccin
atio
n c
ov
era
ge
(%)
Co
nfi
rmed
cases (
tho
us
an
ds
)
0
20000
40000
60000
80000
100000
120000
140000
78 80 82 84 86 88 90 92 94 96 98 00 02 04 06 08 10
0
20
40
60
80
100
Pertussis Diphtheria Coverage
Co
vera
ge
(%) N
um
be
r o
f C
ases
Measles elimination*
0
1000
2000
3000
4000
5000
6000
7000
70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 00 02 04 06 08 10
0
10
20
30
40
50
60
70
80
90
100
Cases Coverage
Nu
mb
er
of
cases
Co
vera
ge
(%)
Type 1 vaccine derived virus in 2000 and 2001: 21 cases
Polio Eradication
Diphtheria and
Pertussis
Achievements in the Americas
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11
0
20
40
60
80
100
Cases Routine coverage
Rubella Elimination* Acceleration Campaign
Nu
mb
er
of
cases
Co
vera
ge
(%)
*9 confirmed cases in 2011; data as of 31 August 2012.
Health situation in the region
0
50
100
150
200
250
300
350
1990 1995 2000 2005 2013 2015
Canada Caribbean Latin America United States of America
Mat
ern
al M
ort
aity
Rat
io x
100
.000
lb
Source: Maternal Mortality Estimation Inter-agency Group
(MMEIG)
Regional Inequities in Health– Maternal Mortality
The proportion of municipalities with less than
80% DPT3 coverage varies significantly between
countries.
Between populations
Important differences in population health indicators exist
between Indigenous and non Indigenous populations
Health situation in the region
Inequities in Health Care Access & Use
Within Countries
Current Challenges in Public Health for the Americas
WHO Building Blocks
•Governance
•Service delivery
•Human Resources
•Medicines and Technologies
•Information
•Financing
PAHO Strategy for Universal Access to Health and Universal Health Coverage
C: people and communities at the center
Mean that all people and communities can use the services they need, when they need them, with quality, throughout the life course, without financial hardship.
Universal Access to Health and Universal Health Coverage
Values Right to Health
Equity
Solidarity
Four Simultaneous and Interdependent
Strategic Lines
Strategic line 1: Expanding equitable access to comprehensive, quality, people- and community-centered health services. Empowerment of people
Strategic line 2: Strengthening stewardship and governance. Social participation and social dialogue, accountability
Strategic line 3: Increasing and improving financing, with equity and efficiency, and advancing toward the elimination of direct payment that becomes a barrier. Solidarity
Strategic line 4: Strengthening intersectoral action to address the social determinants of health. Empowerment of communities
How these frameworks can be used?
• Advocacy and mobilization of resources
• Collaboration with countries
• Innovative approaches: HSS and Global Health Initiatives – how to find the right balance?
• Sharing of experiences
• People and community engagement