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This paper presents the position of the Latin American working group of the International Foundation for Integrated Care (IFIC). The working group brings together various Latin American actors and organizations in support of actions that facilitate the transformation of health systems in the region towards integrated systems that focus on people not as isolated individuals but as subjects of law in the complex social and environmental contexts where they live and interact. The working group proposes nine pillars of integrated care to be used as a conceptual framework for policy development and changes in practices: 1) shared vision and values; 2) population health; 3) people and communities as partners; 4) resilient communities; 5) capacities of human resources for health; 6) governance and leadership; 7) digital solutions; 8) aligned payment systems; and 9) public transparency. Based on these pillars, lines of work are proposed to strengthen alliances and networks, advocacy, research, and capacity-building, in order to help develop health and social systems that are effectively integrated and focused not only on people but also on communities in Latin America. [ABSTRACT FROM AUTHOR]

The achievements and challenges arising from the application of eHealth in the Cuban context to support universal health are presented. The Ministry of Public Health defi- ned the Computerization Strategy, whose lines of work are based on the components declared in the Strategy and Plan of Action on eHealth of the Pan American Health Organization, and in the Policy for the Computerization of the Society, approved by the Cuban Government. The paper describes the actions of the Cuban strategy elaborated to solve the limitations in the technological infrastructure, to develop the platforms, the tools and the applications required by the health services, and to stimulate the professionals' abilities to use them. The results of eHealth in Cuba are based on the application and evaluation of the strategy implemented in the framework of the improvement of the health sector through projects such as the electronic medical record called Galen Clínicas, the training of human resources and the resources for information and education from the Infomed Health Telematics Network. These models of solidarity and collaborative networking have contributed to universal health and positively impacted on the health system beyond the borders. The challenges of eHealth are the development of initiatives in mobile health --in which there is little experience--; telemedicine --a project that is stopped--; integration and interoperability among applications; the sustainability of the implemented solutions; insufficient technological infrastructure; and strengthening of the legal framework. [ABSTRACT FROM AUTHOR]

This paper presents, in the context of the universal health strategy, some general considerations and economic actions on financing, efficiency and other economic challenges of public health in Cuba. Official bibliographic sources of the Cuban state were revised up to 2015. The analyses of time series were adjusted to constant prices of 1997 and the official exchange rate of 1 Cuban peso = 1 US dollar. The Cuban National Health System has a solid infrastructure, consisting of a wide network of health facilities that guarantee full coverage, access and equity in the services provided to the population through qualified human resources. An economic analysis was carried out under the conceptual framework of the universal health strategy, with an emphasis in financing, efficiency and challenges of the Cuban public health system to maintain the right to health of its citizens, equity, coverage and access to the services provided, including the elimination of economic, sociocultural and gender barriers, as well as solidarity with the Cuban population and the world. It was concluded that in Cuba, universal health is considered one of its most valuable achievements, although it is needed a most efficient analysis of reliable and available sources, research and application of results to practice on the strengths and weaknesses of the system regarding health economics, updating and a better use of resources and technologies, as well as deepening the lessons learned and facing remaining challenges. [ABSTRACT FROM AUTHOR]

Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing. [ABSTRACT FROM AUTHOR]

Health information systems play a key role in enabling high quality, complete health information to be available in a timely fashion for operational and strategic decision-making that makes it possible to save lives and improve the health and quality of life of the population. In many countries, health information systems are weak, incomplete, and fragmented. However, there is broad consensus in the literature of the need to strengthen health information systems in countries around the world. The objective of this paper is to present the essential components of the conceptual framework to strengthen health information systems in Peru. It describes the principal actions and strategies of the Ministry of Health of Peru during the process of strengthening health information systems. These systems make it possible to orient policies for appropriate decision-making in public health. [ABSTRACT FROM AUTHOR]

Research on health policies is considered essential to ensure the effectiveness and efficiency of public policies. Analyses of public health policies have various objectives, including helping to solve the problems for which the policy was originated. That objective faces two large obstacles: (1) the ambiguity and heterogeneity of the models applied for the analysis of public policies, conditions that hinder the selection of analytical methods and the assessment of the scope of the objective; and (2) the traditional methodological approaches that limit the capacity of analyses to help solve the problems detected. This paper reviews the epistemology of the predominant models of public health policy analysis in order to assess their scope and limitations. It concludes that the development of new conceptual approaches could improve the quality of research on public policies and their ability to favorably impact decisions. [ABSTRACT FROM AUTHOR]