Advances in Policy Observatory Chronic non-communicable diseases in Chile

1. Advances in Policy Observatory Chronic non-communicable diseases in Chile Dr. María Cristina Escobar Non-communicable Diseases Department Prevention & Control of Diseases Division Undersecretary of Public Health Montreal, May 12, 2008

2. CONTENTS • Context • Purpose & Goals • Recommendations • Participants

3. CONTEXTInternational • Canada & Chile co-founders of the CARMEN network • PAHO´s Regional Strategy and Action Plan for Integrated Prevention & Control of NCDs including Diet, Physical Activity & Health • PAHO/PHAC Policy Observatory for NCDs

4. CONTEXTNational • National Health Objectives for the decade 2000-2010: Mid-term evaluation • On-going Health Reform • New structure & roles within MOH • GES: Explicit guarantees regime in health • Burden of disease of NCDs in Chile

5. Opportunities • Political will to strengthen preventive actions: Preventive health examination & preventive interventions within GES conditions. • The proposal would be finished one year before the formulation of the National Health Objectives for the next decade 2010-2020.

6. Purpose & Goals • Effective integration of NCD prevention & control policies: • Health promotion and prevention of NCDs; • Treatment & care in the primary health level; • Strengthening population/public health policies for health promotion, health protection and action on social determinants. “Achieving greater integration in prevention and control of chronic non-communicable diseases in Chile”

7. Canada/Chile Policy Observatory ProjectChronic, Non-communicable Diseases • Three stages • Stage 1: Canadian/PAHO delegation visit to Chile (December 2007) • Stage 2: Chilean delegation visits Canada (August 2008) • Stage 3: NCD policy dialogue External experts will review observations and recommendations from the first two stages to assist chileans in formulation of a comprehensive approach to NCD policy that will achieve a better balance between health promotion, prevention, treatment & care of NCDs. (to be determined)

8. RECOMMENDATIONSStage 1 • Integrated health plan based on the principles of PAHO Regional Strategy for NCDs, revision of National Health Objectives • Need strenghen public health competencies regarding NCD prevention at national and regional levels in support of population level approaches • Strengthen public health leadership at a regional level • Strengthen collaborative work between regional level & health services • Need for a set of indicators representing NCD prevention for Regional Public Health Plans. • Integrated individual and population based approaches & strategies for care and treatment of diabetes and cancer.

9. RECOMMENDATIONS (cont.)Stage 1 • Improvement of information technology to support gathering, assembling and processing NCD and risk factor data to facilite easier access to health information and services for various users: general population, patients and health professionals. • Address NCD information system development through a phased approach. • Prioritize primary health care centres. • Standarize and streamline data collection process to meet requirements for GES, health statistics, program reports. • Develop a unified set of indicators that apply across the health sector that serve to link primary care with secondary and tertiary services (eg. avoidable hospitalizations) • Simplify, automate and disseminate more practical clinical guidelines for health professionals that allow more accurate diagnosis, better treatment and effective self-mangament. • Develop and disseminate patient education and self-management tools.

10. RECOMMENDATIONS(cont.)Stage 1 • Optimize health promotion & health protection regarding risk factors • Examine tobacco, diet and physical activity in light of regulatory frameworks of what has been proven to be effective thus far and present multisector best practices. • Broaden the scope of GES to incorporate prevention and early detection measures/interventions. • Reorient human resources toward team work and prevention of risk factors • Strengthen the interdisciplinary teamapproach through health human resources training.

11. RECOMMENDATIONS(cont.)Stage 1 • Strengthen the role of NGOs and civil society. • Increase effectiveness of collaboration between the various levels of MOH and existing NGOs (Juvenile Diabetes Association, Cancer Society) to improve their efforts in public education, patient education and patient self-management. • Activate physicians and medical societies to advocate for health promotion and health protection.

12. PARTICIPANTS • WHO Collaborating Centre on Chronic Disease Policy, Public Health Agency of Canada (PHAC): • Dr. Sylvie Stachencko • Ms. Lise Mathieu • Ms. Barbara Lewoski • Health Canada, International Affairs Directorate • Ms. Kate Dickson • Pan American Health Organization (PAHO) • Dr. Branka Legetic • Ministry of Health of Chile • Office of International Affairs: Dr. Osvaldo Salgado • Prevention & Control of Diseases Division: Dr. Pedro Crocco • Chronic Non-communicable Diseases Department: Dra. María Cristina Escobar and team • Public Health Policies Division: Dra. Helia Molina • Nutrition & Food Department: Dr. Tito Pizarro; Judith Salinas, Health Promotion Department • Primary Health Care Division, Dr. Hugo Sánchez • Planning Division, Dra. Ximena Aguilera • Epidemiology Department: Dr. Andrea Guerreo & Clelia Vallebuena