14 October 2011
Reorienting public health programmes in Chile
Chile has recently embarked on a reorientation of its public health programmes to reduce health inequities. In 2008, equity assessments using a Tanahashi-based framework were initiated for six major public health programmes: Child Health, Reproductive Health, Cardiovascular Health, Oral Health, Health of Workers, and Red Tide (algal blooms). The aims of these assessments were to identify differential barriers and facilitators to prevention, case detection, and treatment success and to provide guidelines to reorient each programme so as to improve equity in access to care. Multidisciplinary teams undertook the assessments, with participation of health workers from all levels of the health system, communities, health bureaucrats, and decision-makers from other sectors.
In 2010, all programmes applied the resulting recommendations, using intersectoral and participatory strategies. For example, the cardiovascular Health programme implemented 67 good-practice interventions identified by its assessment and assisted all regional health teams in developing specific action plans to put these interventions into practice. In the Red Tide programme, strategies were developed for improved handling of the issue, with reduction of negative effects on fishermen through temporary diversification and restructuring of working conditions. This process resulted in the development of a set of indicators and methodologies for assessing equity of access to public health programmes. More information on the Chilean experience can be found at http://www.equidad.cl/.