PHRplus in Peru
To make governmental policy and programs more responsive to the local needs, PHRplus provides technical assistance on health sector decentralization and reform and promotes strategic alliances among key actors of the state and civil society. This assistance contributes to raising the health status and welfare of Peruvians at high risk.
PHRplus has established cooperative agreements with four regions in the country: La Libertad, Lambayeque, San Martín, and Ucayali. Through on-going cross-fertilization and dissemination events, successes in each region are shared with other regions and institutions.
The main components of the work are:
- Health sector decentralization: In accordance with new decentralization legislation in Peru, PHRplus assists regional and provincial governments to understand their increasing responsibilities and functions as well as to strengthen their capacity to effectively carry out these new functions. After ample deliberation amongst key stakeholders, PHRplus has developed a Health Decentralization Map that clarifies roles and responsibilities at each level of government. PHRplus has developed APTO Salud, a software application that when used with the Health Decentralization Map, allows each level of government to identify and plan for the transfer of previously centralized responsibilities and adapt decentralization to local institutional and social conditions.
- Participatory health planning: To strengthen health planning capabilities, PHRplus provides technical assistance for the development and functioning of regional and provincial health councils, which serve as consultative bodies for regional and provincial governments regarding health policies and programs. PHRplus has developed a Health Needs Assessment methodology, which combines information on epidemiological data, demand and supply of health services, perceived health needs, and regional health finances utilizing Regional Health Accounts. PHRplus supports the creation of Regional and Provincial Participatory Health Plans that, through participation of civil society, allow the definition of health priorities, strategies, policies, and action plans at regional and provincial levels.
- Capacity building in health management: Together with the Catalyst Consortium and the Policy Project, PHRplus has designed and is implementing a health management training program, PROGRESA. This program, implemented by a consortium of four regional universities, trains three levels of managers: senior management comprised of management teams from the regional level; mid-level management that includes hospital and health network management teams; and front-line managers including facility level managers. PROGRESA will train 400 people in six regions.
- Integration of the health services network: In order to contribute to increased utilization, quality, and efficiency of public health services, PHRplus provides technical assistance for the design and implementation of an Integrated Network of Health Services that includes a hospital system and primary care facilities in the city of Trujillo, La Libertad province. PHRplus assisted in the description of services provided by network members and in the development and implementation of a Referral and Return Referral System. PHRplus has also supported the development of a Management Agreement to guide the Health Network Board in Trujillo as they work to strengthen strategic management and performance oversight in the network. Based on this experience, PHRplus will formulate a legal proposal for the modernization of public hospitals.
- Targeting health and other subsidies: In order to increase resource availability for the most needy and reduce leakage of health subsidies to the middle class, PHRplus developed a Standardized Instrument for the Identification of Beneficiaries of Social Programs based on household/individual socio-economic data. This methodology has been officially incorporated into the Peruvian national targeting strategy for social programs, and will be implemented with PHRplus assistance in the 30 principal cities of Peru.
- Operational guidelines financing for emergency services: PHRplus has developed the Operational Guidelines for the Mandatory Insurance of Traffic Accidents (SOAT) in public facilities and the SOAT Tariff Schedule, both officially approved by the Ministry of Health. PHRplus also provides training for health personnel in public hospitals on the use of these guidelines to standardize the provision and billing of emergency care.
- Hospital management information system: Acknowledging the importance to hospital management of timely and accurate information, PHRplus has developed GalenHos an information system comprised of modules on clinical records and appointment management, outpatient and inpatient services, bed management, and billing. The project provides assistance and training for the implementation of the system.
Key personnel – Peru
Midori de Habich, Senior Technical Advisor
Ada Pastor, Technical Advisor in Health Reform
Oscar Ugarte, Technical Advisor in Health Decentralization
Miguel Madueño, Technical Advisor in Monitoring and Evaluation
Key personnel – Bethesda
Kathleen Novak, Team Leader
Mary Diehl, Task Manager
Antequera 777 Piso 8
Tel: 422 3185 / 440 5002 / 440 5544