Ministry of Health, Mexico
Objective
The MOH is the national-level
government agency responsible for the provision of health services to
the population with no access to social welfare and the coordination of
the National Health System (regulations, advice and evaluation, etc).
This agency has two programmatic components for the provision of primary
health services: (1) institutions and (2) community. The former is composed
of hospitals and medical units while the latter basically refers to the
Coverage Extension Strategy (CES).
Scope
Mexico's national health
system was created as the governmental response to the coordination
of health programmes and services offered by various governmental agencies
such as the Ministry of Health (MOH)', the Mexican Institute of Social
Welfare' and the Institute of Social Welfare and Services for Government
Employees.
Background
The MOH is responsible for
the provision of medical services to the population with no access to
social welfare, mostly in rural areas, in localities of less than 2,500
inhabitants, usually scattered in geographical zones of difficult access.
Since the late seventies
the MOH has developed a programme called Coverae Extension Strategy
(CES) to deliver basic health services, including family planning, to
this segment of the population and improve their social wellbeing.
Evaluation Findings.
The Evaluation-Supervision
Model is implemented over ten working days. At the end of this period
there is a work session with the state officials to discuss the results
and propose appropriate solutions. At each additional implementation
of the model, recommended on an annual basis, helps to assert the changes
which have occurred since the previous findings.
The ESM is a set of instrument
and procedures aimed at finding out the extent to which the CES objectives
are being fulfilled and how fast appropriate corrective actions can
be applied
Ten days are needed for
the ESM to provide an evaluation of the CES which includes:
- 1) a
report on the historical development of the programme;
- 2) a follow-up of the
programme activities; and
- 3) reports in tables
and graphics depicting the evaluation results.
This evaluation helps to start
discussions, in the place where the model was applied, on the detection
of problematic situations and possible solutions as well as to strengthen
and promote the goals of the programme.
Periodic application of
the ESM helps to ascertain the decree of development of the CES and
assess the impact of different activities. This model is designed mainly
for use in the state and districts and a means to strengthen the planning
activities of the communities' health systems.
It has been a successful
management planning tool and its main contribution has been to
improve state and district-level management capabilities.
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Management Features
Strategy:
The MOH's General Directorate
of Reproductive Health (formerly the General Directorate of Family Planning)
designed the Evaluation-Supervision Model (ESM) in order to identify strategies
to improve the quality of the services provided in rural areas. It allows
the collection of quantitative and qualitative information on the development
of CES activities.
Human Resource Management:
The CES purpose is to provide
basic health services to localities of 2,500 or less inhabitants through
voluntary personnel from those communities (of 500-2,500 inhabitants)..
Voluntary health auxiliaries throughout the country are trained and
supervised by institutional personnel.Today the programme has 13,089.
The community personnel are called the "health auxiliaries" and are
supervised by a nurse called "health auxiliaries: supervisor" (HAS)
The HAs are from and live in the respective communities, visits them
on a regular basis to provide technical support.
The CES consists of health
auxiliaries, health auxiliares' supervisors and district medical coordinators.
The operational scheme consists of the interaction between a DMC that
coordinates the activities of four HASs who, in turn, coordinate and
give support to the work of ten HAs.
The HAS is a nurse,
experienced in rural community work, mainly in training and supervision
activities. She is a liaison between rural communities and the health
district office. The success of the health programmes under the CES
depends on her work.
Mobilizing resources:
The objectives of the EMS
for the rural primary health care programme of the CES are:
- to obtain an evaluation
of the coverage and quality of services in a fast and overall manner,
that could help in the making process.
- to strengthen the routine
supervision and counselling services in order to make these activities
more selective and efficient.
- to provide the states
and districts with easy-to-apply skills which could promote the evaluation
activities.
Using the EMS, computer software
to process information on the various components interventions in the
programme, from the institutional and from the community perspectives.
Its application at the state level makes the results useful at this
administrative unit.
Leadership:
The CES purpose is to provide
basic health services to localities of 2,500 or less inhabitants through
voluntary personnel from those communities (of 500-2,500 inhabitants)..
Voluntary health auxiliaries throughout the country are trained and
supervised by institutional personnel.Today the programme has 13,089.
The community personnel are called the "health auxiliaries" and are
supervised by a nurse called "health auxiliaries: supervisor" (HAS)
The HAs are from and live in the respective communities, visits them
on a regular basis to provide technical support
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