Politicas de Educacion 2013

8/13/2019 Politicas de Educacion 2013

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Education Policies in National Health

SystemsMnica Padilla Daz

OPS/OMSEl Salvador

9 Enero 2013


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http://www.youtube.com/watch?feature=player_embedded&v=atcA76wykWk

http://www.observatoriorh.org/?q=node/430

Art Kaufman - Health Extension: Learning fromFarmers How to Improve Community Health
http://www.observatoriorh.org/?q=node/430http://www.observatoriorh.org/?q=node/430http://www.observatoriorh.org/?q=node/430http://www.observatoriorh.org/?q=node/430http://www.observatoriorh.org/?q=node/430http://www.observatoriorh.org/?q=node/430http://www.observatoriorh.org/?q=node/430


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CONTENTS

Human Resources and Health Systems HR Field

Education Challenges Towards Primary Health Care and Integrated

Health Networks


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Health System

Stock

Needs

Resources

Maintain andimprove health

Access Quality- Efficiency

Protect fromfinancial risks

Satisfaction ofexpectations

Participation- Equity

Inputs processes products

Stewardship

Securingfunding

Provision


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The Health Systems demands

Universal coverage Attention model based on

Primary Healthcare Organization model in

Integrated Network inHealth

Centred around theindividual, family and thecommunitys health.

Interventions from thehealth determinants

perspective. Guarantee warmth and

quality. Efficiency and effectiveness


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Link the education, labour and healthservices markets

Source: WHO (2006). The World Health Report 2006 Working Together for Health. Geneva, World Health Organization


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HumanResources

Health

Education

Scienceand

TechnologyWork

Finances

The Intersections of Human Resources and

Health


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High quality performance

4. Dignified work conditions

3. Links betweenschools, needs and

health services.

Appropriate competencies

Adequate distribution and composition

2. The right people at theright places

5. Managementof Migration

Migration

Enough quantity

1.Plans and Policies

All countries must have a Human Resources National Policy


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Quality, respect& dignity

Efficiency &Effectiveness

Universal andEquitableaccess

Numerical adequacyGeographical distributionSocial compatibility

Coverage:Social-

Geographical

Adequate and competitiveremuneration and incentives

Adequate labor relationsInfrastructure

Motivation:Systems with a

supportinginfrastructure

Education for capacitiesTrianing and learningLeadership and iniciative

Competencies:Capacitation/

Learning

Human ResourcesConditions

Workforcesobjectives

Healthy Systemsperformance

Improvement ofthe

populationshealth

SanitaryResults

Human Resources conditions for the Health System


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AXES OF ANALYSIS

DEPLOYMENT & DISTRIBUTION

EDUCATION /COMPETENCIES

WORKING CONDITIONS


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DEPLOYMENT &

DISTRIBUTION


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There are shortages of health workersworldwide

Distribution of the global health workforce

Source: WHO (2006). The World Health Report 2006 Working Together for Health. Geneva, World Health Organization


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42.7

29.9

22.0 21.3 20.8

11.09.7

8.1 8.0 7.87.0

5.84.9 4.8 4.2

0

5

10

15

20

25

30

35

40

45

S A N S A L V A D O R

L A L I B E R T A D

P A

S

S A N M I G U E L

S A N T A A N A

U S U L U T A N

S O N S O N A T E

C H A L A T E N A N G O

S A N V I C E N T E

A H U A C H A P A N

C U S C A T L A N

L A P A Z

C A B A

A S

L A U N I O N

M O R A Z A N

Density of Human ResourcesPhysicians and Nurses per 10,000 inhabitants

El Salvador


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Rural-Urban DistributionDensity of physicians in Latinamerican countries.

15

5.3

17.7 14.7

105

19.5

0.61.3 3.3

6.0310.4

1.2

0

20

40

60

80

100

120

N ICARAGUA BOLIVIA PERU COLOMBIA ARGENTINA PARAGUAY

DENSIDAD RURAL DENSIDAD URBANA


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Fuente : Observatorio Nacional de Recursos Humanos en Salud. serie Bibliogrfica Recursos Humanos en Salud No 1. Informe al pas: Situacin yDesafos de los Recursos Humanos en Salud. Gobernabilidad y desempeo con desarrollo humano. MINSA y IDREH. Lima-Per-2005.

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7.85

3.94

2.45

0.84

18.81

10.24

6.09

4.323.39

17.57

10.23

5.714.66 4.8

0

5

10

15

20

Estrato IDISTRITOS NO POBRES Estrato II

Estrato III Estrato IV Estrato VDISTRITOS MAS POBRES

1992 1996 2004

Physicians according to Poverty Levels:

An Inequality IssuePer: Sensus 92, 96, 2004

The increase of humanresources

DOES NOT MEAN

DISTRIBUTION ANDEQUITABLE ACCESS.

Attention !


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29

30

31

32

33

34

35

36

37

Sumatoria 19,070

Sumatoria 6,230

Sumatoria 2,596

-500

0

500

1,000

1,500

2,000

2,500

3,000

3,500

19911992

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

Poblacin de 0 a 15aos1

(millones)Poblacin de 0 a 15 aos CONAPO

Demanda de inscripcin al ENARMTend enc ia en la dem and a de insc ripc in a l ENARMOferta de becas pa ra la espec ialida d d e pediatraTendencia d e la oferta de bec as pa ra la espec ialida d d e ped iatraOferta Lab oral pa ra Md icos Ped iatrasTend enc ia de la oferta Lab oral para Md icos Ped iatras

Fuente: Comisi n Interinstitucional para la Formaci n de Recursos Humanos en Salud. Bolet n de Informaci n Estad stica Recursos y Servicios) de laDGEI. Proyecciones de poblaci n CONAPO Censo 2000.

Correlaci n 1991-1999-2001) proyecci n 2010

Especialidad de pediatr a y oferta laboral depediatras.

29

30

31

32

33

34

35

36

37

Sumatoria 19,070

Sumatoria 6,230

Sumatoria 2,596

-500

0

500

1,000

1,500

2,000

2,500

3,000

3,500

19911992

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

Poblacin de 0 a 15aos1

(millones)Poblacin de 0 a 15 aos CONAPO

Demanda de inscripcin al ENARMTend enc ia en la dem and a de insc ripc in a l ENARMOferta de becas pa ra la espec ialida d d e pediatraTendencia d e la oferta de bec as pa ra la espec ialida d d e ped iatraOferta Lab oral pa ra Md icos Ped iatrasTend enc ia de la oferta Lab oral para Md icos Ped iatrasPoblacin de 0 a 15 aos CONAPO

Demanda de inscripcin al ENARMTend enc ia en la dem and a de insc ripc in a l ENARMOferta de becas pa ra la espec ialida d d e pediatraTendencia d e la oferta de bec as pa ra la espec ialida d d e ped iatraOferta Lab oral pa ra Md icos Ped iatrasTend enc ia de la oferta Lab oral para Md icos Ped iatras

Fuente: Comisi n Interinstitucional para la Formaci n de Recursos Humanos en Salud. Bolet n de Informaci n Estad stica Recursos y Servicios) de laDGEI. Proyecciones de poblaci n CONAPO Censo 2000.

Correlaci n 1991-1999-2001) proyecci n 2010

Especialidad de pediatr a y oferta laboral depediatras.

Subsec retara de Innovacin y alidadDireccin General de alidad y Educacin en Salud

Direccin de Polticas y Desarrollos Educativos en Salud


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Fuente: http://www.worldmapper.org/images/largepng/216.png

Proportional distribution / medical doctors


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Fuente: http://www.worldmapper.org/images/largepng/216.png

Proportional distrubution / nurses


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Education ChallengesCompetencies


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Evolucin del Nmero de Universidades (1960-2000)

Per 2010

Estudiantes de Medicina y Enfermera

Per 1990-2002

14400

16800

1140012100

14000

12800

9600

7500

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

1990 1995 2000 2002

EST.MED. EST.ENF.

GROWS WITHOUTH QUALITY CONTROL


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When compare profesional performance and health tasksinclude in the curricula vs. Working functions there are

inconsistencies NO PERTINENCEEx: Medicine

Fuente: Clculo CENDEX

1.66 1.60

0.07 0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

1.80

Clnical Teoretical Practical Context

Colombia


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Longlife learning !!!A big responsability

Medical information doubles every five years, much of which isunstructured. 81% of physicians say they spent five hours or less permonth reading medical journals.

It is estimated that 1 in 5 diagnoses are inaccurate or incomplete 1.5 million errors in the way drugs are prescribed, delivered and taken into

the United States each year. Between 44,000 and 98,000 Americans die each year from medical errors

preventable only in hospitals.

Source: Paul Grundy, director of the project to transform health systems, IBM introduced a veryinnovative conference entitled "Beyond Flexer: Death of the Master Builder Patient CenteredMedical Home.


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REGULATORY PROCECESSLEGAL FRAMEWORK FOR EDUCATION AND

PROFESIONAL PRACTICE

Accreditation of universities Professional certification Enabling practice Recertification


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Discuss innovative methods to further the social mission usingthe modalities developed from the Beyond Flexner Study:

School Mission Pipeline Cultivation Admissions Curriculum Location of Clinical Experience Mentoring Tuition Management Post Graduate Engagementhttp://www.medicaleducationfutures.org/projects/beyond-flexner


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Lessons Learned Increasing the commitment of medical schools to the social mission

of medicine will be essential to achieve a fair and affordable healthcare system

Diversity is a means to excellence in education and practice Geography matters. Medical schools need to identify communities

(cities, regions, states) where they commit to educational andhealth care improvement Community engagement of medical schools remains an essential

instrument of population health improvement Information technologies are an important tools for furthering the

social mission in education Team based training is an essential precursor to interprofessional

practice Core principles of public health should be incorporated into medical

education


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Where should HR policy target

Francisco Campos SEGETES, Brasil

Mainly inHospitalas

Ambulatory CareCentersLearning

Hospitals

Family healthComunity

In their context

METODOLOGY

Teacher centeredLectures

PedagogicalInnovations

ABP

Student centeredCritical Thinking(Constructivism)

LEARNING ENVIROMENT

POLICIES

INCENTIVES

SCENARI

OS

LERNING OBJECTHEALTH CONCEPT

Healingdisease

Preventionand detectionof commondiseases risk

HealthDeterminants


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A donde debe dirigirse la Poltica de Educacin de RHUSFrancisco Campos

BRASIL

PrincipalmenteHospitalario

Hospitalesuniversitarios

Centros de atencinambulatoria

Salud de la familia Y la comunidadEn su contexto

METODOLOGIA

Centradoen el docente

Clasesmagistrales

Innovacionespedaggicas

ABP

Centrado en elestudiante

pensamientocrtico

AMBIENTE DE ENSEANZA

POLITICA

INCENTIVOS

ESCENARIO

S

OBJETO DE APRENDIZAJECONCEPTO DE SALUD

Curacin deLa enfermedad

Prevencin deenfermedadescomunes ydeteccin de

Riesgo

Determinantesde la Salud

O h l h f (i l di HR)


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Our health system performance (including HR)determines our national health levels

Centers for Disease Control & Prevention. Achievements in Public Health 1900-1999: HealthierMothers and Babies; 48(38):849-58; Atlanta, 1999.

WHO Maternal Mortality in 2000: estimates developed by WHO, UNICEF & UNFPA; Geneva, 2002

0

100

200

300

400

500

600

700

800

900

1000

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000

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B A R

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tendenciaUSA


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DOCUMENTO RESUMEN OPS

Beyond Flexner Conference http://www.medicaleducationfutures.org/proj

ects/beyond-flexner PAHO ON LINE DIALOGUES Human ResourcesObservatory : educationhttp://www.observatoriorh.org/?q=node/437

WHO: http://www.who.int/hrh/en/
http://www.medicaleducationfutures.org/projects/beyond-flexnerhttp://www.medicaleducationfutures.org/projects/beyond-flexnerhttp://www.observatoriorh.org/?q=node/437http://www.who.int/hrh/en/http://www.who.int/hrh/en/http://www.observatoriorh.org/?q=node/437http://www.medicaleducationfutures.org/projects/beyond-flexnerhttp://www.medicaleducationfutures.org/projects/beyond-flexnerhttp://www.medicaleducationfutures.org/projects/beyond-flexnerhttp://www.medicaleducationfutures.org/projects/beyond-flexnerhttp://www.medicaleducationfutures.org/projects/beyond-flexner

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