The issue of protection of the achievements in the health sector comes from the guidelines of the Pan American Health Organization when it established a common framework of technical cooperation for the Americas for an institutional transformation process started in 2003 . This was reaffirmed in the second term of Dr. Mirta Roses, who in his speech office said the courses of the agenda and strategic plan for the Region of the Americas, led in three dimensions: "Completing the unfinished agenda, protect the achievements and respond to new challenges ..." (1) .
The meaning of these guidelines is to close the unfinished agenda against the reduction or elimination of diseases such as rabies, HIV / AIDS and the problems of maternal and infant mortality (Health in MDGs); protect achievements, as in the Expanded Programme on Immunization, the eradication of poliomyelitis, elimination Measles and rubella, the maintenance of surveillance systems and health information, among others. And new challenges concerning the problems of social epidemiology under the new conditions of health, being able to anticipate them, such as outbreaks [SARS, Influenza A (H1N1/09), cholera (Haiti 2010)], psychosocial disorders of humanitarian emergencies, including (2) .
is imperative, almost a mandate, especially in the context of global economic crisis, inequality and climate change, this three-fold the agenda of PAHO / WHO for the period 2008-2017. There are three basic but interrelated circles. If we close the unfinished agenda and not tied to achievement protection strategies run the risk of disastrous setback in the short term real.
How to protect your achievements is the big question. Hardly been spoken of economic resources, which is true, then reduce or cancel items or new items are not creating the biggest mistake in public health (3) . But this is not the only variable on which we must work to protect health achievements. Other variables must be identified to construct indicators of protection of achievements which should be included in all projects specifically formulated to achieve those accomplishments.
try detailing at least three of these variables.
try detailing at least three of these variables.
Political : What is political? I think that is the backbone on which projects should be built for investment in health. The political will is not only the desire of approval that one expects to hear from a health authority or a local or national representative. The must be measured by the presence of four powerful components:
- Public Policy: If there is no public health policies face a problem no solution. Political will is measured to the extent that such authorities identify and issue orders directed to the formulation of relevant administrative acts for the adoption of a strategy or program.
- Programs: There must be a minimum structure, properly organized, through which establishes the base line of the public health problem, the likely scenarios without intervention, and objectives goals, strategies, activities and indicators which are going to fight this problem. This program must have a responsible, technically and administratively appropriate and permanently satisfied and excited about her subject.
- Human Talent: Something very difficult in modern times. Have the human resources necessary to carry out the objectives set, in accordance with the guidelines established in the Program. Be understood by not only the quantity but the quality of the human resource. Provides quality, in addition to its technical and scientific knowledge, the full full of satisfactions of being, ie, a well-paid human resources, with access to the benefits of social protection, rest and recreation. With these characteristics, it is difficult for a team only work by complying with terms of reference or a function provided for a fee. Must be a team that finds satisfaction in what he does. Also, if you are succeeding, give them continuity. Excessive staff turnover diminishes the quality of products.
- Resources: Ensure logistics and sustainability of a program or project is the fourth variable denoting the political will face a public health problem. These resources must be well identified and in addition, must show growth over time within a software process improvement.
Another variable to consider for building protection indicators of achievement could be that the medium-term monitoring . Regularly made and executed without software projects even without political will, perhaps for lack of governance. Especially in these cases it is pertinent to include some resources remaining projects to monitor project activities in two or three points in time post, either at 6 and 12 months or at 6, 12 and 18 months after completion of the project. This monitoring will enable a second wind to a process that the authorities and / or communities have already taken on their own. Or would resume or reformulate a new project to prevent a backflow of achievements against government disability or community organizations. Or help to identify new needs facing new challenges and threats in public health (thus closing the three basic circles linked).
A third variable is geared towards knowledge management . To the extent that a project or program is working and broadcast communities subjectively their complacency in the improvement of health conditions due to the actions of the program or project, we must find the technical support those findings or objective. For example, linking academia in the development of research in front of the achievements, the establishment and maintenance of health indicators to the problems intervene, which demonstrate tangible impacts.
I expose here only three variables which must be built protection indicators of achievement to be included in the draft protection intervention and improving the health of communities. But are not the only ... there are threats such as disasters, internal armed conflict, social disruption, security, among others, should also be included depending on the context, and which would also develop indicators that allow us to launch the alert to act in the interests of protecting the achievements.
(1) Inaugural Address by Dr. Mirta Roses as Director of the Pan American Health Organization, February 1, 2008 , available at http://www.paho.org/English/D/D_InaugSpeech_F08_spa.htm , accessed 15/12/2010
(2) Epidemiological Bulletin Pan American Health Organization , Vol 26, No. 1, March, 2005, available at http://www.paho.org/spanish/dd/ais/EB_v26n1.pdf , accessed 15/12/2010
(3) Roses, M.: investing in health to protect the gains, Blog of the Director of PAHO / WHO, Washington, March, 2009, available at http://66.101.212.220/mirtaroses/index.php?id=79 , accessed 15/12/2010
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