Objective Peri-borders programs are innovative policies aimed at improving the social and healthcare conditions of the populations living along the borders of two or more neighboring States. The research focuses on the Ecuador-Peru peri-border program and has the following objectives: identifying program’s main strengths, weaknesses and challenges and analyzing the legislative, managerial and organizational arrangements adopted toward the integration of the two health systems in the border area. Materials and Methods A descriptive qualitative case study has been developed through the triangulation among three complementary methods: literature review and analysis of official Peruvian and Ecuadorian national and bi-national documents, 18 semi-structured interviews of key informants, and a survey directed to the entire health workers’ population of the micro network Suyo-Macará. Results The key challenge was the absence of reciprocity, in the sense that just Peruvian citizens were entitled to free healthcare services in Ecuador. A need for improvements in the Human Resources bi-national system emerged, too. On the other hand, the program’s main strength is its organization, based on the implementation of a Bi-National Network and a system of referral and counter-referral of patients and clinical information. Conclusions Notwithstanding considerable challenges, peri-border programs are feasible and replicable. Final success seems to be highly dependent on a number of steps: a) consolidation of the bi-national memorandum into a binding Bi-national Agreement between the two countries, b) achievement of similar standards in the provision and quality of healthcare services, taking action oriented toward complementarity, c) development of an integrated bi-national information system

Peri-border healthcare programs: the Ecuador-Peru experience

MISSONI, EDUARDO;
2014

Abstract

Objective Peri-borders programs are innovative policies aimed at improving the social and healthcare conditions of the populations living along the borders of two or more neighboring States. The research focuses on the Ecuador-Peru peri-border program and has the following objectives: identifying program’s main strengths, weaknesses and challenges and analyzing the legislative, managerial and organizational arrangements adopted toward the integration of the two health systems in the border area. Materials and Methods A descriptive qualitative case study has been developed through the triangulation among three complementary methods: literature review and analysis of official Peruvian and Ecuadorian national and bi-national documents, 18 semi-structured interviews of key informants, and a survey directed to the entire health workers’ population of the micro network Suyo-Macará. Results The key challenge was the absence of reciprocity, in the sense that just Peruvian citizens were entitled to free healthcare services in Ecuador. A need for improvements in the Human Resources bi-national system emerged, too. On the other hand, the program’s main strength is its organization, based on the implementation of a Bi-National Network and a system of referral and counter-referral of patients and clinical information. Conclusions Notwithstanding considerable challenges, peri-border programs are feasible and replicable. Final success seems to be highly dependent on a number of steps: a) consolidation of the bi-national memorandum into a binding Bi-national Agreement between the two countries, b) achievement of similar standards in the provision and quality of healthcare services, taking action oriented toward complementarity, c) development of an integrated bi-national information system
2014
2014
Cafagna, Gianluca; Missoni, Eduardo; Benites de Beingolea, Rosa Luz
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11565/3882121
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