Evaluation of a Primary Health Care Model in Santander, Colombia
DOI:
https://doi.org/10.17533/udea.rfnsp.v34n1a11Keywords:
primary health care, evaluation of health care services, RE-AIMAbstract
Objective: To evaluate the experience of implementing a Primary Health Care Model (PHCM) in predominantly rural areas of the department of Santander, Colombia. Methodology: The five dimensions of the RE-AIM model were used: coverage, effectiveness, adoption, implementation and maintenance. Mixed methods were used including case studies and quantitative evaluation of the model's performance and health outcomes in six municipalities. Results: The coverage, development and implementation of the PHCM were found to be heterogeneous at the municipal level. The rating of the attributes of the PHCM and the perception of the individual health status was more favorable in the municipalities where the PHCM was more developed. However, no changes were found in the basic health indicators attributed to PHCM. Weaknesses were identified in the operational continuity of the model and in the coordination with other intersectoral strategies. Conclusions: Although some positive intermediate results are evident in the municipalities where the PHCM is more developed, in general, the level of development of the PHCM on basic health indicators is not yet evident in this first evaluation and various organizational factors at the departmental and municipal level, as well as the structure of the Colombian health system itself, threaten its continuity.
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