Primary Health Care in Venezuela: Old Strategy and New Practice

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• Primary Health Care in Venezuela Old Strategy
  and New Practice
• Sarai Vivas-Martínez1,2, Maria E. Martínez1,2,
  Carlos H. Alvarado1,2, Wolfram G. Metzger3,
• Centro de Estudios de Salud Colectiva y Derecho a
  la Vida, Universidad Bolivariana de Venezuela,
  Caracas, Venezuela
• Dep. de Medicina Preventiva y Social, E. de Med.
  Luis Razetti, Universidad Central de Venezuela,
  Caracas, Venezuela
• Institut für Tropenmedizin, Abteilung
  Humanparasitologie, Eberhard Karls Universität
  Tübingen, Germany

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• 1999 Constitution
• Article 84 ...the State creates...a national
  public health system that is... governed by the
  principles of gratuity.
• Public health assets and services are the
  property of the State and shall not be
  privatized.
• The organized community has the right and duty to
  participate
• Article 85 Financing of the public health system
  is the responsibility of the State...
• Article 86 All persons are entitled to Social
  Security as a nonprofit public service.... The
  lack of ability to contribute shall not be ground
  for excluding persons...

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• 2002 Coup detat
• Strike of private Economy
• 2001-03 Public Health System Go-slow
  Strike of Personnel

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• 2003
• Start of Primary Health Care Programme
• Barrio Adentro

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• 2006 PAHO-Report
• Barrio Adentro The Right to Health and Social
  Inclusion in Venezuela
• Type Retrospective, rapid health impact
  appraisal
• Objectives To delineate Barrio Adentro
• Collaborators PAHO, Health Ministry Venezuela,
  Misión Médica Cubana
• Methods Quantitative and qualitative analysis of
  data collected from key players, in-depth
  interviews, and field visits

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Health Committees
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Access (2009) 14.165 doctors 13.000 (PHC) x 300
families x 5 persons 19.500.000
inhabitants corresponding to 73 Percent of the
Population of Venezuela (26.814.843)
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Medicina Integral Comunitaria New Medical
University Degree 17.000 students from barrio and
rural communities Duration 6 years First
Promotion will be graduated in 2011
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Advertisment at Highway Surgery with your
plastic card
Members of Health Committee and Communal Kitchen
(Casa de Alimentación)
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Die Medicin ist eine sociale Wissenschaft und
die Politik ist weiter nichts als Medicin im
Grossen (Rudolf Virchow)
Medicine is a social science and politics is
nothing but medicine on a larger scale
Medicine is nothing but politics on another
scale
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• References
• Health Impact Assessment, Main Concepts and
  Suggested Approach, European Centre for Health
  Policy, WHO, Gothenburg Consensus Paper, Regional
  Office for Europe, 1999.
• Briggs CL, Mantini-Briggs C. Confronting Health
  Disparities Latin American Social Medicine in
  Venezuela. Am. J. Pub Health 2009, Vol 99, No. 3
• Misión Médica Cubana. Informe Misión Médica
  Cubana febrero 2009. Caracas
• Ministerio del Poder Popular Para la Salud.
  Registro de establecimientos de Barrio Adentro
  2009. Caracas.
• PAHO / WHO, Mission Barrio Adentro The Right to
  Health and Social Inclusion in Venezuela,
  Caracas, 2006