Dullak Roberto, Rodriguez-Riveros María Isabel, Bursztyn Ivani, Cabral-Bejarano Maria Stella, Ruoti Monica, Paredes Maria Elsa, Wildberger Carmen, Molinas Faustina
Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay.
Cien Saude Colet. 2011 Jun;16(6):2865-75. doi: 10.1590/s1413-81232011000600024.
This paper presents an overview of Primary Health Care (PHC) in Paraguay, as part of a multicentric study, seeking to identify the possibilities of PHC as a factor for reorganizing the health system. The methodology adopts the comprehensive PHC concept, and takes into consideration the system's segmentation, formed by the public sector of the Ministry of Health and Welfare, Social Security, a not-for-profit private sector, a private for-profit sector and a mixed sector. The study analyzes 5 dimensions: stewardship, financing, resources, integration/continuity, intersectorality/participation, through reviewing data from the literature and official documents, and key informant interviews (experts, decision-makers, professionals and civil society). Advances in health policy legislation since the 1990, with gratuity for all age groups, have been observed. Public spending on health is among the lowest in Latin America. PHC is provided through different vertical programs, with poor coordination and articulation, though a recent political shift prioritizes the progressive implementation of Family Health teams. In conclusion, PHC can contribute to improve health, equity and participation.
本文概述了巴拉圭的初级卫生保健(PHC)情况,这是一项多中心研究的一部分,旨在确定初级卫生保健作为重组卫生系统的一个因素的可能性。该方法采用了全面的初级卫生保健概念,并考虑了由卫生和福利部公共部门、社会保障、非营利性私营部门、营利性私营部门和混合部门构成的系统分割情况。该研究通过回顾文献和官方文件数据以及关键信息人访谈(专家、决策者、专业人员和民间社会),分析了5个维度:管理、筹资、资源、整合/连续性、部门间合作/参与。自1990年以来,已观察到卫生政策立法方面的进展,即所有年龄组均可享受免费医疗。卫生方面的公共支出在拉丁美洲处于最低水平。初级卫生保健通过不同的纵向项目提供,协调和衔接较差,不过最近的政治转变优先考虑逐步推行家庭健康团队。总之,初级卫生保健有助于改善健康、公平性和参与度。