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