Recommendations for Effective Intersectoral Collaboration ...
Thematic Session: Intersectoral Action and Health – Global Learnings CPHA Conference
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Transcript of Thematic Session: Intersectoral Action and Health – Global Learnings CPHA Conference
Integrated action for social equity:
Chile Barrio Chile Solidario
Chile EmprendeChile Crece Contigo
Thematic Session: Intersectoral Action and Health – Global Learnings
CPHA Conference Halifax, Nova Scotia
June 2, 2008
Dr. Patricia Frenz
Poverty and Indigence Indicators: A policy driver
45,1
17,4
38,6
12,9
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7,6
23,3
5,6
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13,7
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1987 1990 1992 1994 1996 1998 2000 2003 2006
Poverty Indigence
Source: MIDEPLAN, CASEN Surveys
Stagnationin extreme
poverty reduction
Chile Barrio
Chile Solidario
Chile Emprende
Chile CreceContigo
Infant Development Gap % of children with deficits,
comparing I and V SE quintiles
Source: Infant Module, National Health and Quality of Life Survey 2006
Policy Timeline
President Patricio Alywin
Eduardo Frei RicardoLagos
MichelleBachelet
SocialEmphasis
Social debt Eradicate poverty
Equality and rights
Social protection
Reform EducationJustice
Health Pension
Program Chile Barrio Chile Solidario+ Chile Emprende
Chile Crece Contigo
Objective Eradicate precarious settlements
Social capital and inclusión: families and territories
Achieve maximum develop-ment potential
Health sector role
Occasional , community demands
Key in CSMarginal in CE
Leading strategic role
Exreme Poverty Reduction
-5,3% -2,1% -2,4%
IncomeGini Index
0,57 0,58 0,54
1990 2000 2006 20101994
World Health Organization
Ref : Policy integration: what does it mean and how can it be achieved? A multi-disciplinary review Evert Meijers, Dominic Stead Delft University of Technology OTB Research Institute for Housing, Urban and Mobility Studies PO Box 5030 2600 GA Delft The
Netherlands
Integrated policy-making
Coordination
Cooperation
Joint new policy
Adjusted + more efficient sectoral
policies
More efficient sectoral policies
Interaction
Interdependence
Formality
Resources needed
Loss of autonomy
Comprehensiveness
Accessibility
Compatibility
( between sectors)
Integrated policy- making, policy co-ordination and co-operation.
Moving towards an Integrated Policy System for Social Welfare
SOCIAL PROTECTION SYSTEM 2006 -2010SOCIAL PROTECCION CARD
INTEGRATED SOCIAL INFO. SYSTEMCASEN: NATIONAL S.E. SURVEY
Work and Income Protection
Job
Intermediation
Basic Solidarity
Pension
Chile SolidarioChile Crece
Contigo
Monetary Benefits
Programatic
Benefits
Families Homeless
People
SeniorsChildren from
the poorest
homes
Children from
gestation to
pre-kinder
(0-4)
All citizens
Source: MIDEPLAN, adapted by the author based on conversation with the Executive Secretary of Chile Solidario.
Biopsicosocial Support
From dispersion to integration
Sectoral Efforts =
Fragmented Services
Sectoral Efforts =
Fragmented Services
Integrated Intersectoral
Action
Integrated Intersectoral
Action
Strategy: organize benefits and accompany families
Longitudinal Accompaniment Scheme during the child’s development
Universal Benefits (Biopsychosocial Support Program)
Differenciated benefits, according to the needs of the child
To the health institution
To the basic municipal network
To the extended network
What is ChCC
Health control
Risk Checklist
Gestation Guide
Primary Care Center
Registry
Examples
1° PrenatalControl
Enters
ChCC 2° Prenatal
Control
Vulnerabilityscore
1. Late start to prenatal controls
Local ChCC Network
Home visits
Entry into Chile Solidario (Bridge
Program)Apply social protection scorecard
Receives Family subsidy
Employment program
Health institution
Basic municipal network
Extended network
2. Low income family with unemployed adult and no
social protection scorecard
Vulnerability
Score
Enters
ChCC
4 yearsLeavesChCC
4 yearsLeavesChCC
MINISTERS COMMITTEE ON INFANCY
Intersectoral Technical Committee(Social Protection Executive Secretary– MINISTRIES – HEALTH – EDUCATION
PRESCHOOL – LABOR – YOUTH – HOUSING – WOMEN – BUDGET OFFICE -PRESIDENCY– REGIONES (INTERIOR)
MIDEPLANMINSAL MINEDUC
PlanningSecretary
Health Authority
EducationSecretary
Health Services
ChCC Managers
Governors Preschool Institutions
Social Protection Coordinator
Local Network ChCCLoMunicipality
Health Educatiob
EncRegional
ChCC
Municipal levelMunicipal level
Provincial level Provincial level
Regional level Regional level
National level National level
Decentralized implementación
articulated especially by three central Ministries:
Operational Network
Intendentes
Model of Integrated IA
MINISTRY
MINISTRY 1
MINISTRY 2
MINISTRY
GOVERNOR
SERVICE 2
SERVICE 1
BUDGET OFFICE
MINISTRY
MINISTRY 1
MINISTRY 2
MINISTRY
GOVERNOR
SERVICE 2
SERVICE 1
BUDGET OFFICE
PRIMARY CARE
FAMILY UNIT
PRIVATE SECTOR
EDUCATION MAYOR
LABOR
SERVICE 1
NGO
FAMILY UNIT
PRIMARY CARE
PRIVATE SECTOR
EDUCATION
MAYOR
LABOR
SERVICE 1
NGO
1
2 Municipal Network Community Network
National Coordination National Network
NGO
NGO
Multidimensional Management Model
Shared Outcome Targets
Network management
Systemic management
Knowledge management
Information management
Budget management
Values management
Electronic Platform
Monitoring and evaluating outcomes
Independent evaluation mechanisms
Insights on IA from the Chilean experiences
Monitoring and evidence as a driver
Political will is crucial but not enough
Common outcome targets, not just shared objectives (strategic policy framework)
The management model and tools determine the results
Santiago’s great expectations depend on local capacity and needs
Expertise for IA: social policy managers
A new culture of respect and dialogue
Institutional social capital
Strengthening the community: participation and social cohesion
Monitoring and measuring success
Persist, working together is not easy
Effective IA
Effective IA