BUILDING INTEGRATED HEALTH SERVICE DELIVERY NETWORKS NETWORK CONFIGURATION

BUILDING INTEGRATED HEALTH SERVICE DELIVERY NETWORKS NETWORK CONFIGURATION (IHSDNs Attribute # 1 and 2) July 28 - 30, 2015 Belize REYNALDO HOLDER Health Services and Access Unit Department of Health Systems and Services

Overview • Definitions: – Population/Territory – Extensive network of healthcare facilities • Attribute # 1: – Responsibility for population and territory – Mapping the territory – Public Health responsibilities • Attribute # 2: – Creating and Deciding on Sector size – Comprehensive health services – Broad range of health facilities

Integrated Health Services Delivery Networks

Population/Territory Attribute 1 Clear definition of the population/territory covered and extensive knowledge of the health needs and preferences of this population, which determine the supply of health services.

Extensive network of healthcare facilities Attribute 2 An extensive network of health care facilities that offers health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation and palliative care, and that integrates programs targeting specific diseases, risk and population, as well as personal and Public Health services

Responsibility for population and territory Attribute 1 • Clear identification of the populations and geographic areas • Implementing Public Health activities • Promoting intersectoral action • Intervening on social determinants at the local level.

Mapping the territory and sectors • Regional maps disaggregated by: – Population centers – Rural areas – Minority population groups if conglomerated (Equity mapping) – Sectors (once defined) – Location of health services and other social services (schools, churches, etc. ) – Risk factors • Geographical • Occupational • Social, etc.

Mapping the territory and sectors • HEALTH STATUS PROFILES: – Baseline database on the community – Facilitates current and future health services planning – Capacity to make projections (needs, demands and future supply.

Mapping the territory and sectors • PUBLIC HEALTH: – The IHSDNs has responsibility for Public Health activities and interventions in the assigned territory – Ensures planning, implementation and evaluation of Public Health activities (Immunization, Public Health surveillance of water quality, sewage disposal, food safety, etc. ) in the respective territory.

Extensive network of healthcare facilities Attribute 2 An extensive network of health care facilities that offers health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation and palliative care, and that integrates programs targeting specific diseases, risk and population, as well as personal and Public Health services

Extensive network of healthcare facilities Attribute 2: • The primary focus is to keep people healthy. • The aim is to ensure equitable distribution of operating units and geographic proximity to the population served. • Optimal population sizes • Guarantee quality standards • Maximize economies of scale

Extensive network of healthcare facilities • Range of health facilities: – First and second level ambulatory services – Specialist ambulatory services – Hospitals – Diagnostic services – Nursing centers, – Home-based care – Rehabilitation centers

Extensive network of healthcare facilities • Comprehensive Services: – Health promotion – Prevention – Diagnosis and treatment – Rehabilitation – Palliative care – Social care

Extensive network of healthcare facilities • PUBLIC HEALTH: – The IHSDNs has responsibility for Public Health activities and interventions in the assigned territory – Ensures planning, implementation and evaluation of Public Health activities (Immunization, Public Health surveillance of water quality, sewage disposal, food safety, etc. )

Moving Forward: The How? 1. Local health needs assessment and priorities 2. Local response capacity assessment 3. Design of comprehensive, quality services a. b. Guidelines for network health care and protocols Health technologies based on needs and services design 4. Re-organization of service delivery a. b. c. Plan of action for strengthening first level of care Organization and empowerment of FLC Teams Empowerment of people/users and communities 5. Systematic monitoring and evaluation of each implementation step.

Thank you! 16