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B`   U V From treating disease to promoting health , ,+  H  0޽h ? 3380___PPT10.!- 0N0 Z R p  (    s T *Footer Placeholder 2^ zMinistry of Health, Costa Rica      s @  Text Box 2Y 'Responsibility of the Costa Rican State( 2(c ( "  N TAutoShape 3Ij T   O  s @  Text Box 4O e In Costa Rica the right to health is not expressed literally in the Constitution of the Republic.4f( ecc  f "  N# ;vAutoShape 5g  T   M  s @4 Text Box 6t9  u The right to health can be inferred from a combination of constitutional, legal, and international regulations. "v( 2vc v 6  s @t6 Text Box 7#  DGutirrez, Juan Jos. The Right to Health in the Americas. PAHO.1989<E 2"c "c  E '   s @B Text Box 8  h  QGarro Vargas, Fabrizio. Constitutional Framework of the Right to Health. UCR.1994 R 2Rc  R 2"   PL AutoShape 10 guD<4___PPT9 f&% c     s B(: Text Box 11 W98 0General Health Law Art.1  The population s health is a public good protected by the State.  f( 2fa f H  0޽h ? 3380___PPT10.nV0N0 (    s T(a *Footer Placeholder 1^ {Ministry of Health", Costa Rica     P  s >j TextBox 2rL  N The right to health includes the right to access to quality health services.PO (((( O  H  0޽h ? 3380___PPT10.N>0N0 %;&(    x 0e0e?Rectangle 2t2    >Rights-based Approach     < ; #":.  <    c $x   wNeeds-based Approach 2( aC     c $     Rights-based Approach :( ePG P    c $   "Individual is a passive recipient.4#( "eC  #   c $L    $Individual is an active participant.f%( eee C  %   c $Ж  m 1It involves objectives, usually of partial care. R2( ee C  2 ]   c $D   m +It involves the universal care imperative. ,( e eP eP eePG P ,    c $8 m & 2Needs may be met without guaranteeing continuity. R3( ee C  3    c $<  m & Needs must always be respected.f (  eePe C      c $  &  $It may be organized hierarchically. R%( ee C  %    c $  &  ?Is not organized hierarchically; all rights must be respected. R@(  ee C  @   c $x   "Does not involve responsibilities.4#( "eC  #   c $     Does involve responsibilities.Z(  eeeC     c $   It is connected with a promise.4 ( eC     c $    !It is connected with obligations.L"( e eG  "   c $   9Needs may change according to culture and circumstances. R:( )ee C  :   c $    yRights are universal.4( eC     c $8   zMay be met by charity.4( eC     c $`    Charity is unacceptable.:( eG      c $  < /Meeting needs often depends on political will. R0( ee C  0   c $t  < ~Meeting needs is compulsory.$ e  TB  c $1  <TB  c $1 TB  c $1 TB  c $1m mTB  c $1& &TB  c $1 TB  c $1  TB  c $1  TB   c $1  TB ! c $1  TB " c $1<TB # c $1  <TB $ c $8c TB % c $8c< <H  0޽h ? 3380___PPT10.vAdt0N0  \(     s T? *Footer Placeholder 1^ zMinistry of Health, Costa Rica      s >I TextBox 2*8  It is a given that there are no free health services and, as a result, there are no beneficiaries. The entire population has the right to health services coverage because everyone contributes according to his/her ability. r U( ((( (V($f  |  H  0޽h ? 3380___PPT10.N0N0 $(  $` $ pN 0e0e?Title 1GB     JConceptual and Strategic Governance Model for Social Production of Health .K) K  $ s THb *Footer Placeholder 3^ zMinistry of Health, Costa Rica    H $ 0޽h ? 3380___PPT10.`0N0 !((  (y ( T Rectangle 2L$D 00 CEquitably protect and improve the health status of the population. D D D  H ( 0޽h ? 33e]___PPT10=..h +h D' T =*@B BTimeNode0Dk' =*BTimeNode1@BA?%,( < +O%,( < +D' =BTimeNode2%(D' =BTimeNode3%(D' =^BTimeNode4BBB@B0B%(D' =BTimeNode51:Bvisible*o3>+B#style.visibility<*(%(D' =BTimeNode6-s6Bwipe(left)*<3<*(+8+0+(0 +0N0 +#,3(  , , Tл Rectangle 2=9  R   2 , J 1Oval 47 3  V   & , Z0 gճgճRectangle 5 B   : Population s Health Status     , N, Rectangle 7`` R    , N! Rectangle 8` R   N , ZP, gճgճRectangle 9C hAccess, quality, timeliness, continuity, practices & 55 5    , b. gճgճfGGG1Rectangle 12C y Environmental       , \A gճgճRectangle 14<6/ Solid & liquid waste, quantity & quality of water, air & soil quality & *JB J    , bdE gճgճfGGG1Rectangle 15x q #Health Care Services for the People $# ` $  ~R  , VGHe I~oAutoShape 16 q13p  , \N gճgճRectangle 19 T  vGenetic factors, Aging process and other organic elements& *<4 <    , h` gճgճ3GGG1Rectangle 20 Y  F Biological   rR ,@ J~oAutoShape 21=C1 , b\j G+*H [1AutoShape 22  R   R , \k gճgճRectangle 23mI lLifestyle Income Educational status Cultural aspects & 77 7   , h gճgճ33GGG1Rectangle 24,6  WSocioeconomic and cultural    R , \GTHIT~oAutoShape 25 3rR , J~oAutoShape 26=, , PH AutoShape 28' R    , hZ G+*H [1AutoShape 300  P R    , h G+*H [1AutoShape 31 0    R    , h( G+*H [1AutoShape 32`   R   H , 0޽h ?O , , , ,,, ,,,,,, 3380___PPT10.p˥F`0N0 0w(  0v 0 V Rectangle 15L$D 00 >Equitably protect and improve health status of the population.? ? ?   X `  0 Group 26pM U T ,$D02 0 L 3oOval 27X `  c      6 0 s Bt Text Box 28 6  0 Social Production of Health 4 ff   H 0 0޽h ? 33___PPT10..h +N@M*DW'  =*@B BTimeNode0D' =*BTimeNode1@BA?%,( < +O%,( < +D' =BTimeNode2%(D' =BTimeNode3%(D' =^BTimeNode4BBB@B0B%(D' =BTimeNode51:Bvisible*o3>+B#style.visibility<*0%(D' =BTimeNode6-s6Bwipe(left)*<3<*0D' =BTimeNode10%(D ' =BTimeNode11%(D' =SBTimeNode12BBB@B%(D' =BTimeNode131:Bvisible*o3>+B#style.visibility<*0%(D' =BTimeNode14-s6Bcircle(in)*<3<*0+8+0+00 + ` 0N0 ME4(  4N 4 V Rectangle 15 0 BEquitably protect and improve the health status of the population.C C C    ( 4 Group 51 (,$D 0 4 nZ G#H AutoShape 23 ( R    4 s BText Box 24v zNational Health System Steering Assurance Financing Health care delivery to the public and protection of the human habitat@{ ?$H    Z   0 0  X X `  4 Group 26M U 2 4 R3oOval 27X `  0 c       4 s BText Box 28 6  Social Production of Health 8 ff   H 4 0޽h ? 33___PPT10..h +D' =*@B BTimeNode0DZ' =*BTimeNode1@BA?%,( < +O%,( < +Dt' =BTimeNode2%(D' =BTimeNode3%(D' =QBTimeNode4BBB@B%(D' =BTimeNode51:Bvisible*o3>+B#style.visibility<*4%(D' =BTimeNode6-o6Bwipe(up)*<3<*4+ 0N0 7/8(  8'B 8 3 ,EFGIQUVWX?Rectangle 2B   U Health Sector,  ` 8 x/0e0e?Rectangle 37V >6___PPT9 Z A series of public centralized and decentralized entities that have an explicit and legal responsibility to improve and protect the health status of the population.t" Z $$$$n$  H 8 0޽h ? 3380___PPT10.1B  0N0 Y Q < (  <wB < 3 CEFGIQUVWX?Rectangle 2ZG*   -Health Sector Executive Decree No. 33151-MPH.  . B < xDJ0e0e?Rectangle 3GT <4___PPT9 >Ministry of health, regulatory authority Costa Rican Social Security Fund (CCSS), in areas exclusively pertaining to health Costa Rican Institute of Water Supply and Sewerage Systems (ICAA), in areas exclusively pertaining to health Comprehensive Auditing of Health Services Council on Integrated Care for Children Council on Youth Council on the Elderly Institute for Drug Addiction & Alcoholism (IAFA) Costa Rican Institute for Research and Teaching in Nutrition and Health (INCIENSA) Costa Rican Cancer Institute (ICCC) Occupational Risk Section of the National Insurance Institute Costa Rican Institute of Sports and Recreation (ICODER) (8 May 2006)~" P" P " P)f :f f  n s  <S .@AB`TC`TGroup 42b^  I < Group 5s 2 < ha1Oval 6 }I R    < jDk1Text Box 7 X   B <B  N(uELFQ6RUVWH?0*H?50*0*0*0*|A_T`T/*`T0*^0*IH?40*H?0*@  `D h HGAutoShape 8J9  0 R   H < 0޽h ? 3380___PPT10.ݨ 0N0 G? @(  @<B @ 3 0}EFGIQUVWX?Rectangle 2@   j"National System of Health Services## # [ @ x0e0e?Rectangle 3GV >6___PPT9 Ug Consists of a series of interrelated public and private national and international entities whose basic activities include, among other things, the delivery of goods and services (final, intermediate and support), explicitly intended to protect and improve the health status of the population, regardless of whether or not they are for- or not-for profit. h" Z "7? h H @ 0޽h ? 3380___PPT10.A0m4d 0N0 0DL(  DOB D 3 'EFGIQUVWX?Rectangle 2D   }5National Health System (Social Production of Health)66 6  D xt;0e0e?Rectangle 3V >6___PPT9 Consists of an interrelated series of entities that have a significant impact on the socioeconomic, cultural, environmental, biological, and personal health services dimensions, as well as the determinants of human habitat protection." Go !  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Steering of the Health Sector: exercise of this governmental authority, management, and leadership over all sector entities (CCSS). Steering of the National Health Services System: process whereby the regulatory authority effectively leads, promotes, and coordinates the efforts of the entities of the National Health System. Steering of the National Health System: process whereby the regulatory authority effectively leads, promotes, and coordinates the efforts of key social actors and exercises its authority in health to protect and improve the health of the population.( 2 ,   f L c >ԔAutoShape 10_ H L 0޽h ? L 3380___PPT10.p@0t& 0N0   ` Pq (  PmB P   EFGIQUVWXefZ2?Rectangle 2" I   o'Functions of the National Health System((f ( V  P Group 9` %" P PD oAutoShape 10  Obligation of the National Health System to guarantee universal access to health services to the population, both for the care of individuals and for protecting and improving the human habitat, with emphasis on the vulnerable sectors of the population, especially the poorest.6+?   n P c >ԔAutoShape 11 ^ Dj= P# Group 11jD=" P s D* oAutoShape 12Dj= ^Gf p" P J{ fAutoShape 13M vSteering in health   R" P J8 ̙ffAutoShape 14  pDelivery of health services to the public and services for the protection and improvement of the human habitat qo q  " P P  AutoShape 15}%  0 mGuarantee of insurance for health services to the public and protection and improvement of the human habitat nZl n  " P P' 3f AutoShape 16 V  0 vFinancing of health care services for the public and services for the protection and improvement of the human habitatwwv   H P 0޽h ? P 3380___PPT10.p@0t&20N0 pT(  T0B T 3 ԁ EFGIQUVWX?Rectangle 2`   ^Perspectives on Insurance    T xF 0e0e?Rectangle 3to<T  <4___PPT9  Public perspective: The establishment, based on needs, performance, and impact criteria, of health services for individuals and services for the protection and improvement of the human habitat that cover the entire population grounded in the principles of equity and solidarity. Social perspective: A series of actions designed to guarantee the right of the population to receive the package of health care services and human habitat protection and improvement services established for the public. Financing perspective: Mechanism for protecting the people against the risk of disease and death by guaranteeing the availability of funds so that each individual has access to health services, when needed, without payment for services rendered.V8" n8" n8" n8" n8" n3!&UN'6<     H T 0޽h ? 3380___PPT10.:piЕ 0N0 6 .  X (  XnB X   EFGIQUVWXefZ2?Rectangle 2"    p(Functions of the National Health System ))f ) -V " X Group 9"Q" X P 3foAutoShape 10 " SA series of actions whereby the State, an insurance entity, or another public or private agency collects, administers, and allocates the necessary financial resources for producing or acquiring the health goods and services for the public and the human habitat protection and improvement services that should be provided to the population.2T`$ T  n X c >3fԔAutoShape 11  ^ Dj= X# Group 11j" X s Dv oAutoShape 12Dj= ^Gf p" X Jl fAutoShape 13M vSteering in health   R" X JT ̙ffAutoShape 14  pDelivery of health services to the public and services for the protection and improvement of the human habitat qo q  " X P  AutoShape 15}%  0 mGuarantee of insurance for health services to the public and protection and improvement of the human habitat nZl n  "  X P\L 3f AutoShape 16 V  0 vFinancing of health care services for the public and services for the protection and improvement of the human habitatwwv   H X 0޽h ? XX 3380___PPT10.p@0t& 0N0 !   #\ (  \nB \  Xp EFGIQUVWXefZ2?Rectangle 2"    p(Functions of the National Health System ))f ) " \ Np ̙ffoAutoShape 9C  Z The act of providing or delivering the basic package of health services established; this includes granting individual and community health care services, in addition to services meant to protect and improve the human habitat."( 2  q^ Dj= \# Group 11jD=" \ s D( oAutoShape 12Dj= ^Gf p" \ J fAutoShape 13M vSteering in health   R" \ J 1 ̙ffAutoShape 14  pDelivery of health services to the public and services for the protection and improvement of the human habitat qo q  " \ P(  AutoShape 15}%  0 mGuarantee of insurance for health services to the public and protection and improvement of the human habitat nZl n  " \ P 3f AutoShape 16 V  0 vFinancing of health care services for the public and services for the protection and improvement of the human habitatwwv   XB #\ 0D̙Ԕ j] H \ 0޽h ? 3380___PPT10.p@0t&0N0 OG`(  ` ` |' 0e0e?,Content Placeholder 2B+V  >6___PPT9 -STEERING OF THE SOCIAL PRODUCTION OF HEALTH *." ,, .  ` s T(- *Footer Placeholder 3^ zMinistry of Health, Costa Rica    H ` 0޽h ? 3380___PPT10.Y_0N0 d(  dnB d 3 ,/ EFGIQUVWX?Rectangle 2>   D Substantive Steering Functions for the Social Production of Health(E$D$ E H d 0޽h ? 3380___PPT10. *0N0 ))""hk)(  hE h `> ff$Rectangle 2 'g  Social Actors . &&  @ @ @ @f h ` $Rectangle 32 BEquitably protect and improve the health status of the population.C C& C @ @ @ @;V   h Group 4 3i2 h ha $Oval 5"`' E  +Public & Private Health Services Facilities, ,"  , @ @ @ @;2 h \좹 $Oval 6~  &  Ministry of Tourism &   @ @ @ @62 h \ $Oval 7tJ   Municipalities &   @ @ @ @+2 h \h8 $Oval 8 5  INS &   @ @ @ @42 h \ɹ $Oval 9 )-   Universities  &   @ @ @ @l2 h d f$Oval 10$   <Private commercial,, industrial and service establishments= =&  = @ @ @ @=2 h ^0 $Oval 11   Other social actors &   @ @ @ @2 h ^DR $Oval 12  4NGOs (churches, Red Cross& \ & & & & &   @ @ @ @.2 h ^ $Oval 13  ICE  &   @ @ @ @@2 h ^ $Oval 14J   Ministry of Education &   @ @ @ @.2 h ^ $Oval 15/ 4 ICAA &   @ @ @ @:2 h ^0, $Oval 169- } Other ministries &   @ @ @ @02 h ^ $Oval 17   MEIC  &   @ @ @ @J2 h ^ $Oval 18$ k   Ministry of Environment & Energy! !&  ! @ @ @ @2 h Lܖ $Oval 19 - R   >2 h ^ _ж_ж$Oval 20 g  Cooperation Agencies &   @ @ @ @?  h `ϱ _ж_жText Box 21 h Ministry of Labor &   @ @ @ @D2 !h ^ӱ _ж_ж$Oval 22J t Organized community groups &   @ @ @ @ "h T Text Box 23J k  R    h nZd GwC$AutoShape 24y  *0 R   S h h샱 _ж_ж$Rectangle 25?&O 'Steering of Social Production of Health( (& ( @ @ @ @E h h# _ж_ж$Rectangle 26uZ Strategic Health Planning &  @ @ @ @F h h _ж_ж$Rectangle 27C9 Health Policy Orientation  &  @ @ @ @G  h h9 _ж_ж$Rectangle 28%0 Health Marketing    @ @ @ @R  h h\ _ж_ж$Rectangle 29@  Health Regulation . &&  @ @ @ @Z  h hL _ж_ж$Rectangle 31}H  .Assessment of the Impact of Actions in Health/ /& / @ @ @ @W  h hZ _ж_ж$Rectangle 32u# +Orientation/Modulation of Health Financing , ,& , @ @ @ @U  h h _ж_ж$Rectangle 33}h  )Harmonization of Health Service Delivery * *& * @ @ @ @@ h h _ж_ж$Rectangle 34Q0 Health Surveillance  &  @ @ @ @2 h j@ 1Oval 37 V  vInternational Organizations     H h 0޽h ? 3380___PPT10.]0Gf0N0 lN(  l+B l 3 d EFGIQUVWX?Rectangle 2*   YHealth Surveillance   l xl 0e0e?Rectangle 3m f  NF___PPT9(  U Steering function, whereby the public health status, its determinants, and trends are identified, analyzed, and monitored in a continuous, systematic, multidisciplinary, intersectoral, and participatory fashion to contribute to the timely selection of the most appropriate measures for protecting and improving the health of the population.HV" P&S$ V H l 0޽h ? 3380___PPT10.K70@0N0 *"p(  p7B p 3 o EFGIQUVWX?Rectangle 1026,Gz   _Health Policy Orientation  C p ~p 0e0e?Rectangle 1027>V  >6___PPT9 7 Steering function exercised by the Minister of Health or his/her representatives (Vice Minister of Health, Director General, Directors of Steering Regions and of Steering Areas), which includes the definition of priorities and directives, spearheading strategic actions and securing resources and, in order to ensure the desired impact, negotiating directly with the social actors of the system for the Social Production of Health. R" QP  H p 0޽h ? 3380___PPT10.% 0N0 t~(  t&B t 3 0 EFGIQUVWX?Rectangle 23t   THealth Marketing   t x{ 0e0e?Rectangle 3*V  >6___PPT9 & Steering function whereby the Ministry of Health takes the necessary action to persuade or motivate the social actors that directly or indirectly impact the population health status to adopt and implement the health promotion strategy. By performing this function, the Ministry directly influences public and private organizations and, principally, the general population, with an emphasis on excluded groups, to adopt a culture of non-exclusion and demand their right to participate in decision-making, as well as in the definition, implementation, control, and evaluation of activities aimed at protecting and improving the community s health status." ";" P" PD"2P"!P"  H t 0޽h ? 3380___PPT10.&+80N0 x (  x4B x 3  EFGIQUVWX?Rectangle 2@0   bStrategic Health Planning    x xl7 0e0e?Rectangle 3/IV  >6___PPT9 L Steering function, whereby concerted goals and objectives are defined on the basis of a sound health situation analysis to bring about continuous improvements in public health; also, whereby the necessary strategies, actions, and resources for reaching the target are defined, negotiated, and agreed to with key social actors.*M" H M H x 0޽h ? 3380___PPT10.w0N0 H@|(  |*B | 3 4 EFGIQUVWX?Rectangle 2o6   X Health Regulation  n | x 0e0e?Rectangle 3DV  >6___PPT9 h  Function of the State (exercised by the Ministry of Health) that consists of defining, enacting, interpreting, applying, and controlling the regulatory framework that should apply to every individual and legal entity that provides or receives health-related goods and services; or that engages in activities or performs acts that, by nature, may have an impact on the population s health.."  $  H | 0޽h ? 3380___PPT10.rk`0N0  H(  EB  3 $ EFGIQUVWX?Rectangle 27   s+Orientation/Modulation of Health Financing ,, ,   xP 0e0e?Rectangle 3n f  NF___PPT9(  ASteering function that consists of correcting deviations from government priorities in the financing of health services for the public and of services for the protection and improvement of the human habitat; and in ensuring that the different financing modalities for public and private services complement one another..B" A$ B H  0޽h ? 3380___PPT10.R0N0 vn0(    s Bd~ Rectangle 2,h ; Function that consists of: defining the basic package of health services for the public and the services for human habitat protection that should be guaranteed by the State; determining the model through which those services are delivered and promoting coordination and complementary activities among the various public and private providers to guarantee equitable access to the public, regardless of the institution or system to which they belong or have been assigned to or that provides them services. Source: Based on PAHO. Armonizacin de la Provisin de Servicios de Salud:. Discussion Paper for the Expert Meeting, Washington, D.C., June 2001 f( 8 Z8 Zcg-gPeggP  .gFgP gC) g Px g $g$(C( ((     HD Rectangle 3 %Harmonizing Health Services Delivery8&  GG &  H  0޽h ? 3380___PPT10.`~0N0 me@(  @B  3 z EFGIQUVWX?Rectangle 2G   n&Impact Assessment of Actions in Health'' ' }  x 0e0e?Rectangle 3W9 V  >6___PPT9 w Function whereby a systematic, multidisciplinary, intersectoral, and participatory impact assessment is made of the priority actions in public health as they pertain to the health determinants and health status of the population to support strategic and timely decision-making.," _  H  0޽h ? 3380___PPT10.&-0N0 %P/(    s TL *Footer Placeholder 4^ zMinistry of Health, Costa Rica    w  / #"*X"u^  ?  s *' f [ Ministry of Health Steering of the Health Services of the Costa Rican Social Security FundD\ 3' \   0 f~ m sHealth Policy Orientation   i  0Ė f~ m Setting priorities and establishing political guidelines, assisting with the implementation of strategic actions and advocacy for securing resources.. 8^    0، fm~  mMarketing of Health     0l‰ f~ m jPositioning the health promotion strategy in the CCSS health services and the culture of non- exclusion among the institution s staff.      0tĉ f~   qHealth Surveillance    '   0Ɖ f~   SMonitoring the coverage and quality of CCSS health services and their determinants..T < T    04G f ~ ?  Strategic Health Planning 0       0(A f~  ?  BSetting priority goals and objectives for implementation of the national health services policy and developing plans, programs, and projects for attaining these goals and objectives.L &@(+     0͉ f? ~  oRegulating Health      0Ή f~ ?  BDefining and controlling the health services regulatory framework. C C C BB  3 1~ ~ BB  3 1BB  3 1mmBB  3 1BB  3 1  BB  3 1? ? BB  3 oBB  3 oBB  3 oBB  3 oH  0޽h ? 3380___PPT10.o^% 0N0 }u` (  UB  3 0Ή EFGIQUVWX?Title 1Z   GRegulating the Health Services of the Costa Rican Social Security FundHH H r  ( 0e0e?,Content Placeholder 2T  <4___PPT9 ZvOperating license (authorization): compulsory, emphasis on structural indicators. Accreditation: voluntary, includes process indicators. Quality assessment: - Assessment of first-level care health services (structure-process-outcome). - Analysis of deaths in children. - Analysis of maternal deaths. - Tracer evaluation. - Addressing complaints. " "   '   v    s T *Footer Placeholder 3^ zMinistry of Health, Costa Rica    H  0޽h ? 3380___PPT10.P5 !0N0   p (    s T *Footer Placeholder 4^ zMinistry of Health, Costa Rica    A  *   #""YYY*   M  s *T f*( ] Ministry of Health Steering of the Health Services of the Costa Rican Social Security Fund D^ 4( ]   0 f*( c +Orientation/Modulation of Health Financing 0,    ,   0 f (c FApproval and monitoring of the funding allocated in the CCSS for addressing the priorities set in the National Health Policy and determining corrective measures when deviations are found.L     0T f*c ^  {!Harmonization of Health Services" " "   0З f c^  RHarmonization of CCSS health services with other the services of other providers.S S S    0E f*^  #Impact Assessment of Health Actions0$  $ ;   0d? f ^   wAssessment of the impact of the priority plans, programs, and projects of the CCSS related to national health policy.x x x BB   3 1 ( BB   3 1*((BB   3 1*ccBB  3 1*^ ^ BB  3 o** BB  3 o BB  3 o*BB  3 o*  H  0޽h ? 3380___PPT10.o` "0N0 VN(  LB  3 G EFGIQUVWX?Rectangle 2*   z2Strategies for Operationalizing Steering in Health33 3 Z  x: 0e0e?Rectangle 3WV  >6___PPT9 TpHealth sector reform: Separating the steering and health service delivery functions. Identifying the roles of National Health System institutions in terms of the steering, insurance, financing, and service delivery functions. Intensifying the decentralization of the Ministry of Health. Separation and complementation of central, regional, and local functions. Wv_" _v_" _>v_" _Kv_[ q H  0޽h ? 3380___PPT10.&-#0N0 y(  MB  3 D( EFGIQUVWX?Rectangle 2*   {3Strategies for Operationalizing Steering in Health44 4   x, 0e0e?Rectangle 3WYV  >6___PPT9 Design and dissemination of the Conceptual and Strategic Model for Steering of the Social Production of Health. Steering based more on leadership than on  legal authority. Adjustment of the Ministry of Health s Strategic Framework. Implementation of organizational development: functions  products - processes  procedures - structural adjustment - human resource profiles. rv_" _|v_" _v_ PT,  H  0޽h ? 3380___PPT10.&-D$0N0 ,(    x 0e0e?Rectangle 2TZV  >6___PPT9 & The greater danger for most of us lies not in setting our aim too high and falling short; but in setting our aim too low, and achieving our mark. Miguel Angel (Paraphrased from: daily inspiration from The Monk who Sold his Ferrari: A spiritual fable& By: Robin S. Sharma)" Z" Z<333371$   H  0޽h ? 3380___PPT10. E,|_%0N0 d(    s B& Rectangle 6^ zMinistry of Health, Costa Rica    8B  3 / EFGIQUVWX?Rectangle 4    f Thank You!,  0(  H  0޽h ? 3380___PPT10.pp7Dd0 ~v(     d?4Slide Image Placeholder 1    "   Ly 0e0e?(Notes Placeholder 2 0    R     f 6Slide Number Placeholder 3_  j*    H  0޽h ? 3380___PPT10.K73+L0 ~v(     d?4Slide Image Placeholder 1   "   { 0e0e?(Notes Placeholder 2 0   R     fHh 6Slide Number Placeholder 3_  j*    H  0޽h ? 3380___PPT10.K7-h0 bZ(     d?4Slide Image Placeholder 1      b 0e0e?(Notes Placeholder 2 0   6    f o 6Slide Number Placeholder 3_  j*    H  0޽h ? 3380___PPT10.K7-e0 f^(     d?4Slide Image Placeholder 1      h 0e0e?(Notes Placeholder 2 0   6    fl6Slide Number Placeholder 3_  n*    H  0޽h ? 3380___PPT10.K7-0 bZ(     d?4Slide Image Placeholder 1      0e0e?(Notes Placeholder 2 0   6    f)6Slide Number Placeholder 3_  j*    H  0޽h ? 3380___PPT10.K7-i0 bZ(     d?4Slide Image Placeholder 1      860e0e?(Notes Placeholder 2 0   6    f;6Slide Number Placeholder 3_  j*    H  0޽h ? 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