Presentaci

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Advances in Policy Observatory Chronic
non-communicable diseases in Chile
Dr. María Cristina Escobar Non-communicable
Diseases Department Prevention Control of
Diseases Division Undersecretary of Public
Health Montreal, May 12, 2008
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• CONTENTS
• Context
• Purpose Goals
• Recommendations
• Participants

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CONTEXTInternational

• Canada Chile co-founders of the CARMEN
  network
• PAHOs Regional Strategy and Action Plan for
  Integrated Prevention Control of NCDs including
  Diet, Physical Activity Health
• PAHO/PHAC Policy Observatory for NCDs

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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

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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.

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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

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Canada/Chile Policy Observatory ProjectChronic,
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)

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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.

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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.

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RECOMMENDATIONS (cont.)Stage 1

• Optimize health promotion health protection
  regarding risk factors
• Examine 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/interventi
  ons.
• Reorient human resources toward team work and
  prevention of risk factors
• Strengthen the interdisciplinary team approach
  through health human resources training.

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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.

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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
  Molina
• Nutrition 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