Strong Primary Care, history, current diagnosis and proposals for Chile

Abstract

Chile has a long tradition of development in the field of health. During the 19th century, the town was organized in Mutual Relief Societies, an alternative expressly opposed to charity in health. In 1924 the Compulsory Labor Insurance Law was passed, by which employers and workers had to impose monthly to a solidarity fund of illness and disability. In 1952, the Law that establishes the National Health Service, a public body in charge of carrying out all sanitary actions, was enacted. During the month of September 1978, the International Conference on Primary Health Care was held, establishing the Declaration of Alma Ata. 25 years later, the Pan American Health Organization adopted a Renewed Strategy for Primary Care, and in 2008 the World Health Organization drafted the World Health Report “Primary Health Care, More Necessary than Ever”. The current health reform in Chile proposed placing Primary Health Care as the central axis of the system. However, in spite of these stated intentions and that resources destined to the first level of attention have progressively increased, in practice there are problems that are not addressed that threaten the success of this process and which maintain low levels of user satisfaction, as well as control of chronic diseases. The following article aims to review the history of PHC, its development in Chile, establish a current diagnosis and make proposals to deepen this strategy.