Initiative: Work in Integrated Health Networks
Institution: Ministry of Public Health of Ecuador
Problem: Ecuador has a severely fragmented health care sector. In addition, most of the specialized personnel were concentrated in urban areas. Only 21 per cent of the population had some type of health insurance. Inaccessibility to public health services were found to generate inequality and social exclusion.
Solution: The solution was to have a legal basis in the Constitution of the Republic of Ecuador, whereby health was recognized as a fundamental human right. The constitutional amendment stated that health care should be free and guarantees access through the National Health System Organization through the creation of the Comprehensive Public Health Network and private network that complements it. The main milestones in the construction of the National Health System (NHS) of Ecuador are: (i) the approval of the Law that governs it (2002); (ii) the implementation of the Comprehensive Health Care Model; (iii) the signing of the Interinstitutional Framework Agreement that consolidates the Integrated Public Health Network and the Complementary Private Network; (iv) the financial administrative decentralization with the Management and Structure Model of the MSP; (v) the renewal of the old Interinstitutional Framework Agreement; and (vi) the approval of structures of subsystems of public providers in the NHS.
Impact: The economic barriers to access health care were overcome. More than 8,000 benefits are being provided through public and private networks, guaranteeing access to high quality health services for all social groups.