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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/4308/13/2019 Politicas de Educacion 2013
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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.
14.31
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
m o r t a l
i d a
d m a
t e r n a
( t a s a p o r
1 0 0
, 0 0 0 n . v . )
HA I
BOL
P ER
BRA
GUT
NIC
LAC
P AR
P AN
TR T
DOR
ELS
COL
ECU
HON
VEN
B A R
JA M
M EX
A RG B AH
CORCUB
CH I
URU
CA N
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