Chile's Neoliberal Health Reform: An Assessment and a Critique

In spite of serious under-financing during the Pinochet years, Chile's public health system remains the backbone of health provision, responsible for the impressive public health status

Implementación de la política pública para el cuidado de la primera infancia en el contexto chileno: una mirada desde salud al “Chile Crece Contigo”

En el campo del cuidado de la infancia Chile posee una larga historia de intervenciones que han apuntado hacia la disminución de la mortalidad infantil, la mayoría de ellas, con un fuerte enfoque biomédico. Estas han intentado dar respuesta a las demandas de la época en que han sido formuladas, reflejando la evolución de la historia socio-sanitaria del estado chileno y logrando un cometido exitoso durante el transcurso del pasado siglo. En este contexto emerge la política pública “Chile Crece Contigo”, la cual ha apostado al abordaje biopsicosocial de la primera infancia mediante una serie de acciones tendientes a la protección y acompañamiento del desarrollo de los niños/as, con un especial énfasis en el apoyo a las familias más vulnerables. Este ensayo plantea antecedentes de la política pública para la protección de la primera infancia en el contexto chileno mirada desde el sector salud y presenta brevemente algunos aspectos relevantes del proceso de implementación de una de sus políticas más significativas.In the field of childhood care, Chile has a long history of interventions which have pointed to reduce infant mortality, most of them with a strong biomedical approach. These interventions have attempted to respond to the demands of the period when they were established, reflecting the evolution of social and health history of the Chilean State and achieving good results during the past century. In this context the Chile Crece Contigo (Chile grows with you) public policy was created to bet on a biopsychosocial approach to early childhood through a serie of actions aimed at protecting and accompanying children throughout their development, with special emphasis on support to the most vulnerable families. This essay presents the background of the public policy for early childhood protection in the Chilean context, from a health perspective, and also presents briefly some important aspects of the implementation process of one of its most significant policies

Análisis de los procesos que han generado transformaciones en la ocupación del suelo de la “Quebrada Guachucal”, período 1990 – 2010, sector comprendido entre los barrios Chambú y la Minga, municipio de Pasto

El presente trabajo tiene como objetivo, analizar los procesos que han generado transformaciones en la ocupación del suelo de la “Quebrada Guachucal”, sector Chambú – La Minga, en el período comprendido entre los años 1990 a 2010. Se realiza un estudio a través del análisis de la información primaria y secundaria con el fin de determinar, cuáles han sido los procesos de transformación y ocupación del suelo y se elabora una matriz que permite vincular las actividades que han sucedido, con los conflictos e impactos que han generado, y el grado de afectación que alcanzaron. Se identifican también los distintos tipos de intervención y los actores implicados; estas herramientas condujeron a apreciar la actual situación. Además, la investigación permitió identificar diversos aspectos de contaminación en altos índices, debidos a la introducción de animales, al depósito de basura y a la presión sobre la ronda hídrica y su vegetación; se identificaron aspectos que han contribuido de una u otra forma a enfrentar estas situaciones mediante mecanismos de participación comunitaria, buscando solución a dichos problemas con el apoyo de las autoridades municipales. El presente estudio presenta unas acciones estratégicas a desarrollar que proveen de información fundamental para una gestión y planificación futura; las recomendaciones están basadas en estudios técnicos, necesidades de la comunidad y en el espacio disponible para el manejo y ocupación adecuados de este sector

Implementación de la política pública para el cuidado de la primera infancia en el contexto chileno: una mirada desde salud al “Chile Crece Contigo”

En el campo del cuidado de la infancia Chile posee una larga historia de intervenciones que han apuntado hacia la disminución de la mortalidad infantil, la mayoría de ellas, con un fuerte enfoque biomédico. Estas han intentado dar respuesta a las demandas de la época en que han sido formuladas, reflejando la evolución de la historia socio-sanitaria del estado chileno y logrando un cometido exitoso durante el transcurso del pasado siglo. En este contexto emerge la política pública “Chile Crece Contigo”, la cual ha apostado al abordaje biopsicosocial de la primera infancia mediante una serie de acciones tendientes a la protección y acompañamiento del desarrollo de los niños/as, con un especial énfasis en el apoyo a las familias más vulnerables. Este ensayo plantea antecedentes de la política pública para la protección de la primera infancia en el contexto chileno mirada desde el sector salud y presenta brevemente algunos aspectos relevantes del proceso de implementación de una de sus políticas más significativas.In the field of childhood care, Chile has a long history of interventions which have pointed to reduce infant mortality, most of them with a strong biomedical approach. These interventions have attempted to respond to the demands of the period when they were established, reflecting the evolution of social and health history of the Chilean State and achieving good results during the past century. In this context the Chile Crece Contigo (Chile grows with you) public policy was created to bet on a biopsychosocial approach to early childhood through a serie of actions aimed at protecting and accompanying children throughout their development, with special emphasis on support to the most vulnerable families. This essay presents the background of the public policy for early childhood protection in the Chilean context, from a health perspective, and also presents briefly some important aspects of the implementation process of one of its most significant policies

Implementación de la política pública para el cuidado de la primera infancia en el contexto chileno: Una mirada desde salud al “Chile Crece Contigo” Implementation of a policy for early childhood care in the Chilean context: A view from health to “Chile C

© 2017, Universidad Nacional de Colombia. All rights reserved. In the field of childhood care, Chile has a long history of interventions which have pointed to reduce infant mortality, most of them with a strong biomedical approach. These interventions have attempted to respond to the demands of the period when they were established, reflecting the evolution of social and health history of the Chilean State and achieving good results during the past century. In this context the Chile Crece Contigo (Chile grows with you) public policy was created to bet on a biopsychosocial approach to early childhood through a serie of actions aimed at protecting and accompanying children throughout their development, with special emphasis on support to the most vulnerable families. This essay presents the background of the public policy for early childhood protection in the Chilean context, from a health perspective, and also presents briefly some important aspects of the implementation process of on

Governance of health care networks: Assessment of the health care integrating councils in the context of the health sector reform in Chile Gobierno de redes asistenciales: Evaluación de los consejos integradores de la red asistencial (CIRA) en el contexto

Objective. This paper aims at assessing the contribution of Chile's Health Care Integrating Councils (CIRA, Spanish acronym) to strengthening governance in health. Materials and methods. A literature review on the official documents related to the process of creation and development of CIRA was carried out; an ad hoc questionnaire was applied to all 29 health services of the country; finally, 35 semi-structure in-depth interviews were carried on a sample of six CIRA. Results. The CIRAs have become a tool for functional integration and a valuable space for dialogue, cooperation and learning for all of the actors of the Chilean public health network. Conclusions. In this study, we conclude that there is room for improvements of CIRA's role regarding governance of the health care network as long as CIRA is authorized to deal with strategic topics, such as investment in infrastructure, technology and human resources, and budgeting

Governance of health care networks: Assessment of the health care integrating councils in the context of the health sector reform in Chile.

Objective. This paper aims at assessing the contribution of Chile’s Health Care Integrating Councils (CIRA, Spanish acronym) to strengthening governance in health. Materials and methods. A literature review on the official documents related to the process of creation and development of CIRA was carried out; an ad hoc questionnaire was applied to all 29 health services of the country; finally, 35 semi-structure in-depth interviews were carried on a sample of six CIRA. Results. The CIRAs have become a tool for functional integration and a valuable space for dialogue, cooperation and learning for all of the actors of the Chilean public health network. Conclusions. In this study, we conclude that there is room for improvements of CIRA’s role regarding governance of the health care network as long as CIRA is authorized to deal with strategic topics, such as investment in infrastructure, technology and human resources, and budgeting

Public Expenditure on Health in Chile, 1970–2000 (Pesos 2000)

<p>As the graph shows, there was a sharp increase in public health expenditure (in 2000 Chilean pesos) in Chile after 1990, with social democratic governments. A short spike can be observed during the socialist Allende government. The lower darker line represents public expenditure, the upper lighter one public expenditure per person. From [<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050079#pmed-0050079-b013" target="_blank">13</a>].</p

Health Expenditure in Chile, 1970–2004, as a Percentage of Gross Domestic Product

<p>As a percentage of gross domestic product, public health expenditure rose under the Allende government, then decreased sharply under the Pinochet neoliberal experiment, and is now stable at around 3%. From [<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050079#pmed-0050079-b013" target="_blank">13</a>].</p

Expenditure per Member, FONASA and ISAPRES, 1984–2002

<p>The graph shows that per capita expenditure was always much higher in ISAPRES than in FONASA, and the difference has expanded in the past years. From [<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050079#pmed-0050079-b013" target="_blank">13</a>].</p