Chile: New health and institutional challenges in a country in transition

Abstract

Public health policies have been a priority issue in Chile since 1950. Major progress has been made in basic aspects of public health, such as drinking water coverage and the prioritization of primary health care, leading to communicable disease control, the reduction of maternal and child mortality, and the elimination of malnutrition. Through a mixed health care model, Chile has met the commitment in the Declaration of Alma-Ata to the attainment of an “acceptable level of health for all the people,” achieving the best health and socioeconomic indicators in Latin America. However, attaining an acceptable level of health in the population is an open-ended goal, and progress in this direction appears to have stalled in Chile. The challenge is therefore to define the new health goals for the country, which is no longer a low-income country but an upper middle-income country with a different profile of health problems. Specifically, Chile must continue to improve health care for its population through health policies focused on non-communicable diseases (such as cardiovascular disease and cancer), health promotion, and disease prevention. To accomplish this, the Ministry of Health must modernize its management and resume its role as the overseer of health objectives, a role that has been eclipsed by its administrative responsibilities. It must do so without losing the complementarity achieved between the public and private sector in order to minimize the current limitations of the public system.