1. IMPLEMENTATION OF THE NATIONAL HEALTH SYSTEM
OUR GREAT CHALLENGE
FAMILY HEALTH

2. EL SALVADOR

3. 5-year Strategic Plan 2004-2009. MSPAS
Strategic Objective:
“Implement a concerted CHANGE in the health sector that promotes an efficient integrated decentralized NATIONAL HEALTH SYSTEM TO ACHIEVE universal coverage, care for all people, in the entire country.”

4. Millennium Development Goals MDG
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria, and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development

5. Primary Health Care
Health care put within reach of all individuals and families in the community, through means that are acceptable to them, with their full participation and at a cost that the community and the country can support.

6. NATIONAL HEALTH POLICYS N
Strategic
Objectives
Impact
Objectives
UNIVERSAL COVERAGE
MANAGEMENT MODEL
DEVELOPMENT
OF HUMAN
RESOURCES IN
HEALTH
MSPAS
STEERING
ROLE
BETTER HEALTH
STATUS IN
THE POPULATION
MODEL OF CARE
QUALITY OF CARE
AND SERVICES
FOCUS ON
FAMILY
HEALTH
SOCIAL
PARTICIPATION
IN HEALTH
SATISFACTION
OF CONSUMERS
AND PROVIDERS
MODEL OF
DELIVERY
EQUAL ACCESS
COMPLEMENTARY
CONNECTED
NETWORKS
1. Increase State budget allocation for public spending in health.
2. Improve the efficiency of public institutions.
3. New financing sources.
ADJUSTMENT OF THE
LEGAL FRAMEWORK
FINANCING MODEL
MECHANISM

7. PROCESS OF CHANGE IN HEALTH
THE INITIATIVE aimed at creating a National Health System, in response to the following strategic objectives:
Expand health services coverage for the population within a framework that gives special importance to family health.
Improve quality AND compassion of health-care services holding as key the model of individual, family and community health care.

8. IMPLEMENTING THE CONCEPTUAL FRAMEWORK
Family Health Model
IMPLEMENTING THE CONCEPTUAL FRAMEWORK 8

9. FAMILY HEALTH
PHC-based model, with emphasis on health promotion and community work that views as the unit of analysis the care and intervention of “the family”, provides intra- and extramural services, which promote healthy lifestyles, control of environmental risks and preventive care with focus on family life and life cycle in order to promote and preserve health of the family members and their environment.

10. General objective
Guarantee access to and equity in the supply of health services, based on the strategy of primary care, with emphasis on health promotion, to family members and their environment in order to achieve satisfaction and improve the level of health; promoting co-responsibility.

11. Objective specific
Determine geographical and population areas of responsibility, assigning families to family health teams and health facilities.
Organize the network of services connecting the levels of care and strengthening the process of referrals and follow-up visits.

12. Specific objectives
Strengthen the promotion and prevention of health risk and impairments.
Establish integral management of service networks.

13. Characteristics
Family and community focus, respecting their culture and rights.
Define and guarantee continuous health services, applying standards, protocols, instruments, as well as evaluation mechanisms that ensure effectiveness.
Made up of processes and procedures developed by interdisciplinary and integrated teams. 13

14. Characteristics
A flexible, dynamic, and interactive model capable of predicting and responding on a timely basis to the current and future health characteristics and needs of the family.
Based on social participation and intersectoral approach.
Essential: address and resolve the population’s most common health problems and risks through family and community participation.

15. Essential Components 15

16. Instruments Family File Familiograma (“Family Diagram”)
Family Registry, reduces time spent on data collection and allows longer time devoted to relation with the patients.
Familiograma (“Family Diagram”)
Structural diagram of family composition and of the system of relationships of several generations in the family, identifies risk factors and dysfunctions, and its important role in causing illness, recuperation and rehabilitation. 16

17. What does the Family File contain?
NAME
ADDRESS
LIFE-CYCLE FILES
CLINICAL HISTORIES
HEALTH FILE
INTERVENTION PLAN
FAMILIOGRAMA

18. Value-added to the model
Traditional Model
Expansion of rural coverage, Fosalud, Hospital without walls
Community work
Service-oriented culture
Availability of promoters
Culture of volunteer service
Population targeting (poverty)
Prompt care
Greater problem-solving capacity (physician) 18

19. Phases of Implementation Implementation of other
Preparation
Pilot
Gradual implementation
in the public network of
Regional establishments
Extension
Expansion
Selection
of Units
Preparation
Inputs
Training
Implementation of other
SIBASI Units in the
5 Regions
All Units
of all
SIBASIS
Nov-Dec 06
January-December 07
January-December 08
January 09
interface

20. Key Elements of Intervention
FAMILIES
EDUCATIONAL CENTERS
WORK ENVIRONMENTS
HEALTH FACILITIES

21. ORGANIZATION FOR IMPLEMENTING THE FAMILY HEALTH MODEL

22. Family Health Teams (FHT) Composition
The FHT includes preferably:
1 health promoter
1 nurse and
1 physician.
A Health Facility can have more than one family health team, according to its installed capacity and defined population.
These teams are supported by other professionals (dentists, specialists, psychologists, nutritionists, etc.) as well as technical personnel (laboratory, RX, Pharmacy)

23. Family Health Team Area of Intervention
The basic geographical unit is the program area of the Family Health Promoters and includes homes, dwellings, blocks, communities, country houses, grouping of cantons, or parts of these.
Such geographical units include a maximum group of 250 families, approximately equal to 1, ,200 people.

24. Interventions

25. Families Assigned to the Family Health Model
Geographical Area
Programmed families
Families Assigned
Progress
Western Region
8,590
3,161
37%
Central Region
2,187
1,197
54%
Metropolitan Region
1,947
862
44%
Paracentral Region
3,633
1,240
34%
Eastern Region
8,162
4,916
53% 25

26. THANK YOU 26 26