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									       <u>Big Health achievements in 2004. Balance.</u>

    Health for a Dignified Life



       Today the district counts with 57 “Health to your Home” teams and
        a total of 43,000 subscribed and beneficiary families.



       During the actual administration 284,493 health subsidies were
        given, almost the total of the goal planted in the District’s
        Development Plan “Bogota without Indifference”.



       34 ERA rooms are functioning to the date. They are located in
        different health centers and a calculation of 2,500 patients have
        been attended.


”2004 was as definitive year in health care for Bogota,” affirmed Roman Vega,
secretary of health. Within the results of his first year as front-man of this health
institution he mentions the program, “Health to your Home” that reached 43,000
families from the poorest areas in the city with 57 teams and the establishment
of the ERA rooms that attend especially to children affected by acute respiratory
problems.

In the following passage an outline of the projects developed by this institution
is offered. This institution is committed the generation of a health culture in the
citizens of this city.


<b>Health to Your Home, to materialize health as a right</b>


The District’s Secretary of Health formulated and began to develop this social
politic within the frame of the Development Plan geared towards the guarantee
to health rights. To reach this, the strategy of Primary Health Attention (APS in
its original Spanish initials) was adopted. The APS has a family and community
focus, modeled after the successful experiences of countries such as Canada,
Brazil, Costa Rica and Chile. These countries have adopted this health strategy
and present today better health results at a lower cost. This is the program we
call “Health to your Home,” which represents a bigger closeness between health
services and homes with an active family life hoping to offer integral attention.


This integral attention is given through a family and community health team,
conformed by a doctor, a nurse, a nurse’s aid and two or three health
promoters. The team is responsible for a group of families (ranging form 800-
1000) that live in a well defined territory which is characterized and attended to.
The program has already been installed in 14 hospitals subscribed to the SDS
web in the zones of poverty levels 1 and 2 (1 being the poorest level) in 17
areas of the District , in the most vulnerable territories and with an increasing
area coverage within the next three years. The District accounts for 57 teams
and a total of 43,000 families subscribed and *benefited to this date.

<b>Depuration Database</b>

This administration has made efficient and agile measures to depure and
actualize the subsidized regiment database, which has presented for the past
years many structural problems from information sources that consequently
bring up the registered presence of deceased persons or those that are not
entitled to receiving health benefits. The depuration of the database that the
information system team of the Insurance Direction and the National University
have allowed the development and merges with entities such as the National
Registrar of conjugal status and take new security measures to avoid the
manipulation of this information. This shows the interest of this entity to
guarantee the protection of public resources and facilitate the insuring of the
most vulnerable population in the city.

<b>ERA WINGS</b>

One of the most important strategies put forth by the actual administration within
the frame of the politic of “Love Me Well, Love Me Today,” has been the
establishment of the ERA Wings. These are units of therapeutic management
for acute respiratory diseases, that with the timely and mobile attention of the
respiratory crisis of children bellow five years of age have accomplished the
reduction of hospitalization due to this cause in an 85%. To the date there are
34 wings located in different health centers (UBAS, UPAS, CAMIS or hospitals
of level 1) within the 20 location areas of the city. A number of approximately
2,500 patients attended is calculated.

</b>Delivery of health benefits<b>

An important achievement in the effort to improve the access to services and
broaden the coverage in Bogota’s healthcare was the delivery of 284,493
subsidies to the least favored population. The novelty in 2004, according to
Bogota’s health department, has been the delivery of partial subsidies, 87,246
total, to the people in poverty level three in the <i>Sisben</i> survey, which till
the moment were unable to affiliate themselves to any administration of
subsidized regiment, with which the number of benefited increases to
1,530.017.

<b>Merging for the conjoined acquisition of medications</b>

The Health department of the district of Bogota and the managers of 22 public
hospitals in Bogota signed a merging inter-administrative contract for the
conjoined negotiation and buying of medications for both surgery related use
and pharmaceutical use. The purpose of this merge is to unite efforts with the
end of improving the negotiation process, the buying of medications and to
optimize the district’s resources destined to health services. This negotiation
strategy of medications has effected in important accomplishments for the
public hospitals of the city, such as the estimated savings of more than 3,750
million pesos that the hospitals reported in the first semester of 2004, in a
conjoined acquisition exercise and in the reduction of 14.1% as an estimated
price in 379 medications negotiated in the 2003-2004 period.

<b>Nutri-Combo program</b>

The Nutri-Combos are offers in delis, supermarkets and street fairs that allow
the citizens of Bogota to obtain balanced, nutritious and low-priced products
within the frame of the “Bogota Without Hunger” program. Thanks to the union
of the private and public sector of the city, more than 5,000 neighborhood
delis,18 street fairs and five supermarket chains will be offering nutri-combos,
(which will be previously marked off as such) so that the citizens of Bogota can
buy these products which promote adequate eating habits with a lower cost in
relation to the individual prices of the total of each itemized product.

<b>Fray Bartolomé Opening</b>

Thanks to the district’s administration’s measures, since April 15 the Fray
Bartolomé de las Casas clinic reopened its services to the citizens, through a
renting contract, after many failed tries and one last paralysis of 8 months. In
this clinic there is an emergency, internal medicine, pediatrics and oral health
unit, clinical laboratory and diagnosis images. Hospitalization services with 51
beds is also available. In this institution there are surgery services, intensive
care unit for adults and newborns, delivery and pediatric wings functioning. The
number of beds for hospitalization is 110.


<b>Crash course in habilitation</b>

To guarantee better quality in health services from the city’s entities, the
Bogotan Health Department initiated a crash course for the verification of the
habilitation standards in the entities that offer services in Bogota. The
habilitation crash course is designed to follow up and certify the habilitation of
14,500 health related entities where the suitability completion of human
resources, physical infrastructure, installations and maintenance, endowment,
and priority assistance processes, among others are verified. To this date visits
have been made to 10% of these entities , some 1,400 in which independent
professional practices, IPS and ambulance businesses are included. Basically,
the protocol has been found unfulfilled, the surrender of spoiled medication has
been neglected, professionals that cannot prove their studies have been found
and supply of equipment and physical deficiencies in the infrastructure have
also been noted.

<b>Inauguration of the Hospital of Engativá</b>
The Engativá community had to wait seven years to see up and running its
public hospital. This is the first second level public hospital in the north-west
sector of Bogotá. It was an investment of 32,000 million pesos, from which
27,000 went to construction and 5,000 for equipment. The hospital’s services, in
its impressive structure, include 24 hour emergency, surgery, hospitalization
and gynec-obstetric units. It also attends to specialities such as ophthalmology.
The estimate of benefited people from the opening of this hospital is 2 and a
half million citizens. The hospital is equipped with 214 beds and will be able to
attend to approximately 200 ER patients and 350 consultation patients a day,
and will be able to realize in surgery and deliveries about 1,200 procedures a
month.

January 6, 2005

								
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