The 5 challenges of health systems in Latin America

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According to a report published by INCAE, the greatest challenges in health are not only in the use of technologies but also in administrative practices

According to the report published by INCAE, an educational institution founded by Harvard, and entitled "The Future Challenges for Health Systems in Latin America," presents that beyond the implementation of technologies that help in the health sector, there is the largest gap in administrative practices.

Leer en español: Los 5 retos de los sistemas de salud en América Latina

This is how, through a survey of 1,281 health system professionals in 18 Latin American countries, they identified several common elements presented by the region in terms of public health. The study also makes certain recommendations to address the difficulties.

1. Drug shortage

Of the respondents, 58.8% affirm that it is one of the main problems. "In eight of the thirteen countries with the most answers, it was classified as the problem with the greatest impact. In three others it was considered the second most important problem, "the study highlights. This way, it is proposed that this shortage occurs due to the delay in the purchase of medicines, which includes fraud and corruption processes.

Also, according to the study, "part of the shortage is caused by the logistical problems and perverse incentives found through the distribution chain of medicines and other supplies." Referring to unfair competition for drugs, which may be scarce in a hospital, but have excess in others. In the same way, a shortage can be generated due to the remoteness of the rural populations, which for cost, do not have access to medicines.

On the other hand, and according to the Commission on Human Rights (CIDH), access is denied by the pharmaceutical companies, "which prevent the distribution of generics," according to RCN. The same means adds that "according to the complainants, the lack of medicines is because pharmaceutical companies focus their research and distribution where it is most profitable." Which implies a manipulation of the monopoly, which in the long run affects buyers because of its high prices.

2. System capacity

In second place is the capacity of the system with 38.5%. Its capacity is proportional to the long lines that have to be done to obtain medication, an appointment, an exam, among others. "Prolonged rows are a result of the difference in the pace of demand growth and the rate at which installed capacity increases."

To face the above, it is essential to observe the flow of patients and identify the nodes in which there are problems within the hospital system, to help decongest waiting times. Likewise, it is ideal for forming a long-term approach, in which the hospital's capacity and performance in all areas are also evaluated.

In Costa Rica, for example, "the San Juan de Dios Hospital has significantly reduced wait times using simulation tools, improving the sequence with which patients are treated, improving information about patients in the line (.. .) ".

This is how countries such as Chile and Cuba are usually recognized as the best in health issues because they precisely have the factors described. "What cannot be missing are efficient institutions, which set long-term objectives and are rigorous in their fulfillment. Where anomie, disorder and improvisation rule, unhealthiness is guaranteed, "according to Infobae.

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3. Decentralization

As a way to counteract the above, it is essential that the public health process be well structured from the start. "Health systems should emphasize community medicine and prevention. The systems must increase the resolutive power of the primary care centers ".

Also, and according to the World Health Organization (WHO) "health systems with strong primary care are necessary to achieve universal coverage." Likewise, the report exemplifies the situation in Costa Rica, where specialists from Tony Facio Hospital developed a model called "non-conventional modalities", in which "it combines five models of care (scheduled discharge, day hospital, home care and hospitalization, differentiated attention in the first level of health, and attention
specialized remote) which allowed to apply it in efficient ways within the system ".

4. Analytical and artificial intelligence

With the implementation of artificial intelligence in public health, you can generate analytical solutions to the problems, because "it showed that it is possible to improve the efficiency, planning, and programming of hospital processes and that through the use of analytics can reach a solution (…) ".

This is how, for example, through artificial intelligence, it can "deal with the problem of waiting lists (…)" as well as "make a daily reading of all digital reports of the country in 12 hours, create risk boards according to pathologies for the detection in 24 hours of the most serious cases and generate automatic notifications of control according to diagnosis for follow-up ".

5. Appointments of officials influenced by politics or by family ties

For the report, the minister of health should be "A brilliant doctor who assumes that being a good doctor will be a good administrator," however it seldom happens. "This is perhaps why the main problems detected in the survey are all related to administration," the document said.

LatinAmericn Post | Laura Viviana Guevara Muñoz

Traslated from "Los 5 retos de los sistemas de salud en América Latina"