BOLIVARIAN REPUBLIC OF VENEZUELA

MINISTRY OF POPULAR POWER FOR UNIVERSITY EDUCATION

SCIENCE AND TECHNOLOGY
BOLIVARIAN UNIVERSITY OF VENEZUELA
Sedefalcon

SITUATIONAL ROOM HUGO RAFAEL CHÁVEZ FRÍAS

UNDER THE NEW MODEL OF THE HEALTH SYSTEM

MEMBERS:
Lugo Gabriela
Diaz George
Otero Javielys

TEACHER:
Alcira Chirino

OCTOBER, 2016
 INTRODUCTION

As it is reflected in the Constitution of the Bolivarian Republic of

Venezuela, to guarantee the right to health, the State will create, will exercise the
rectorate and will manage a National Public Health System, of a character
intersectoral, decentralized and participatory, integrated into the system of
social security, governed by the principles of gratuity, universality,
integrity, equity, social integration, and solidarity.

The rectorate and formulation of health policies is under the Ministry of Power
Popular for Health, however, healthcare is found
fragmented, dependent on the Ministry of Popular Power for Health and the
Governorships, the institutions dependent on the Venezuelan Institute of
Social Insurance (IVSS), Institute of Social Prevention of the Armed Forces,
Oil of Venezuela (PDVSA), National Institute of Geriatrics, the Corporation
Venezuelan of Guayana, Municipal Mayor's Office of Miranda, State Police of Caracas and the
private sector or private clinics.

The structuring of the new National Public Health System is

organized in a network system of health services and levels of care,
with a vision that grants governance and regulation to the Ministry of Power
Popular for Health, creating a unique system.
Brief Historical Review of the evolution of health in Venezuela until
reaching the ASIC. Why this new health model?

To introduce ourselves to the topic of public health in our country, it is necessary

interpret it and understand it as it is outlined in the Constitution of the
Bolivarian Republic of Venezuela, to guarantee the right to health,
The State will create, exercise its authority over, and manage a National Public System of
Health, of an intersectoral, decentralized, and participatory nature, integrated into
social security system, governed by the principles of gratuity,
universality, comprehensiveness, equity, social integration, and solidarity.

The structuring of the new National Public Health System is

organized in a system of health service networks and levels of care,
with a vision that confers the leadership and regulation to the Ministry of Power
Popular for Health, creating a unique National Public Health system
able to comply with what is established in the constitution of the Republic, with
quality, effectiveness, and efficiency that ultimately allows providing to the population
Venezuelan an optimal service.

To delve into public health in Venezuela firstly

we will analyze a bit the historical evolution of health in Venezuela.

Year 1936: In this stage, health is not linked to the concept of the State, everything
on the contrary, it is more associated with popular culture, traditional medicine,
and to what could have been the spontaneous development of the different concepts
that the popular sectors had regarding the health issue and the
disease.

Between 1936 and 1961, the history of the health system is born and developed in
Venezuela.

In 1936, the Ministry of Health and Social Assistance (M.S.A.S.) was founded, as a
economic need to respond to the newly initiated process of
development of the oil industry that imposed on us the eradication of a
a set of scourges that plagued the health of Venezuelans.

In 1961, the golden age of health in our country ends and a beginning of a new era starts.
period marked by the Punto Fijo Pact. This pact between AD, COPEI, and URD,
made the party political component impose itself
progressively within the institutions.

It is a time when a curative individual model is imposed, it begins

to deteriorate preventive programs and to build criteria for
administration without economic foresight. This combined with some unions and
unions that prioritize the defense of the interests of their members over
health problem of a population; some universities that train doctors
exclusively for the private practice of the profession; an imbalance
progressive between the scope of public health policies and construction
from a private health device that at this moment had more capacity
resolutive that the state apparatus, and the increase of bureaucracy in the
The ministry determines the death of the public health service in our country and
the weakening of the State apparatus.

This process is accentuated by neoliberalism that imposes it forcefully

privatization of the healthcare system, dismantling the already existing one regardless
the health of the vast majority of Venezuelans who, in the last 40 years
they were pushed into poverty.

Since 1998, a revolutionary change process begins in Venezuela,

deeply participatory, democratic, and libertarian. In the case of health, it has
has been a difficult process, the health team, the doctors and professionals in the area,
they come from universities prepared and designed to understand health
starting from the concepts imposed by classes that dominated and continue
dominating somehow for their own interests. They begin in the
ministry discussions about ideas regarding the recovery of hospitals,
the eradication of corruption, the resizing of the teams
sanitarians, etc., without realizing that health policies are not established
those that are technically formed for their execution, but rather the directions
policies that countries or societies have. In the country, a was being born
new health policy, with a vision that can only be held by those who
they politically understand the country and those who have a proposal directed at a
different sector of society, to those who were made invisible during
years.

The CRBV establishes the mandate for the creation of the SPNS integrated into the System
of Social Security, points out the financing of the system as an obligation of the
State and prohibits privatization. The Social Security System is defined as
which is integrated into the SPNS and it is indicated that it will be regulated by an organic law
special. In this context, the Barrio Adentro Mission arises, with a new model
in the conception, management, and provision of health services and with a
important component of community participation from the beginning.

The strengthening of Barrio Adentro as a permanent strategy for the

transformation of the National Public Health System (SPNS) is the main
Public policy to universalize access to health services as much as possible
as close as possible to the people, the family, and the community; that is why
following the constitutional definition of the care model with an approach
promotional and socially integrated preventive, the need arises to
evolve the structural organization of the SPNS with the conception of the Network of
Community Health Attention (RACS) based on integrality and the
Areas of Community Integral Health (ASIC) as a fundamental social territory.

The Community Health Care Network has been built to provide a

100% coverage of the population according to the Comprehensive Care Model,
but its real reach is still below the standards it aspires to
National Public Health System (NPHS). With the intention of perfecting the
access to health services, the same social determination with which it
they laid the foundations of Barrio Adentro, originated a basic territorial unit of
integration that is the Comprehensive Community Health Area (ASIC), which
administers and integrates the SPNS with all social missions and other services
to the population. Within the ASIC, 94% of the centers are located.
assistive services of the country, which represents the largest network of the Public System
National Health.

The ASIC arose from the need to organize services in the Barrio Mission.
Inside and over the last 10 years it has become a new
concept of regionalization in health for all SPNS facilities, it
which according to social territoriality aligns to a large extent with the
current communal aggregation system.

What is the Community Integral Health Area (ASIC).

It is the basic unit of social and territorial integration of the Public System.
National Health, are based on the social territories that it
correspond and articulate all communal or community institutions,
assistance, teaching, research, technological, or others, based on the
Neighborhood Inside strategy, prioritizing health promotion and prevention
of diseases, without neglecting healing and rehabilitation.

The ASIC represents a participatory management instance that guarantees

comprehensive responses about health through a care model and a
management methods, suited to the existing conditions in each place, with a
integral, interinstitutional, and intersectoral approach with active participation
the protagonist of the community, who exercises popular power.

General Objective of the Community Integral Health Area (ASIC).

Integrate and articulate the People's Power with public institutions, in order to
exercise the right in decision-making in design, planning,
execution, control, monitoring and evaluation of public health policies
in this way, expand the free coverage of services by 100%
quality medical assistance.

Having specific objectives:

 Develop and implement the Participatory Health Plan of the Health Area
Community Integral (ASIC).
Promote and facilitate the leading participation of the People's Power and the
social oversight in health.
Manage the overall assurance for the proper functioning of
the establishments and healthcare services under your charge,
following guidelines from the Ministry of Popular Power for Health
(MPPS).
Monitor compliance with 100% coverage of your social territory.
Supervise and coordinate the support and assistance human team.
comprehensive care for the population.
Articulate the Medical Reference and Counter-Reference System and
Communal.
Ensure academic training and professional or technical instruction of
good quality to your health personnel.
Monitor the timely and reliable collection of the required data by the
National Health Information System (SIS), as well as process and
analyze the information on quality of life and social determinants
for the Health Situation Analysis.

Structure of the ASIC

ASIC of the Falcón State:

Structure:

In the title are the municipalities that it encompasses.

The name of the ASIC is the same as the name of the CDI.

The boxes in the purple box represent the first level of

attention or popular clinics type 1 where in some cases only have
nurses.

The green square represents the clinics or community health centers.

Type II or III where there are doctors and in some cases there is also
dental and/or laboratory service.

In the largest or turquoise blue box, we have the centers of

references such as CDI and in some cases hospitals.

Some ASICs are still without a coordinator or person in charge.

working to resolve such a situation.)

DABAJURO DISTRICT:
CORO DISTRICT:
PARAGUANÁ DISTRICT:
TUCACAS DISTRICT:
SAN LUIS DISTRICT:
CHURUGUARA DISTRICT:
Methodology:

The main techniques for data collection in this study were the
interviews directed at authorities and those in charge of specialized areas, the
review of the documentary information and observation. Within the
the instruments used include records, lists, statistical tables and
statistical yearbooks and management reports of public administration and
publications of different levels and/or modalities.

Within the qualitative analysis, distributions were mainly used.

graphs, which allowed for a description and exploration in summary,
about the conceptual bases of the categories and dimensions of the study.

Finally, the analyses were integrated with all the associated data sources.
bibliographies and the authors' and study groups' own criteria
academics.
Hugo Rafael Chavez Frías Health Situational Room.

The health situation analysis (ASIS) is considered the basic input

for decision-making in the health sector. To know and understand the
complexity in which health, illness, and quality processes develop
of the lives of populations, allows for proper and relevant planning of
interventions from the state and the community itself.

ASIS gathers a series of systematic and analytical processes that allow

characterize, measure and explain the health-illness process of the individual, the
families and communities. It is an instrument that generates a perspective
comprehensive of the various dimensions of the health-disease process,
as input to guide the development of policies that are being created to
through concrete actions with defined sectoral computers and
intersectoral, which contribute to changing the health situation of the
individuals, family and community, translated into well-being.

From a rights-based approach and recognizing that, as it states the

analysis of social determinants, health is a historically social production
where diseases are the result of social interactions,
biological, cultural, historical, and political aspects of individuals and collectives, the
analysis center of the ASIS will be the people who share the same
territory immersed in dynamics and social positions that allow
express different degrees of vulnerability.

The ultimate goal of social and health intervention is the development of autonomy.
of people and collectives, after locating the different territories, the center
of analysis and recognition will be in the stages of the life cycle, of
set of characteristics that compose them (gender/race/ethnicity/class)
social/mental capacity, physical/sexuality) and conduct equity analysis that
they can show the existing inequalities or not due to these conditions.

In that context, information systems must behave like

open systems that constantly interact with behavior and
human and social dynamics, in order to allow modifications that
respond to the minimum necessary to characterize the conditions of the
collectives in the territories, their individual characteristics and deliver
supplies that allow for the construction of an explanatory model of reality.

PURPOSE

Develop the health situation analysis process through various

methodological phases that allow identifying inequities in health and their
determinants, as input for the construction of cost interventions
more comprehensive and integrated actions, articulated with other sectors, that contribute to
improve the health and living conditions of the individual, the family and the
community.

Seeks to identify, analyze, understand, and measure the determining factors of

health, with the aim of advancing in the reduction of gaps and situations
intolerable and apply social resources equitably that contribute to
to modify the living conditions of the populations and strengthen the way of
management of health services.

Finally, whatever the ASIS model is, it must incorporate the

citizen participation, within the framework of local decentralization processes,
and the emphasis on the development of community-based interventions.

OBJECTIVE

Study the relationship between living conditions and differential behavior

of the health and illness process of human groups, in a unit
geopolitical, within a historical, geographical, environmental context,
demographic, social, cultural, political, and advancement of scientific knowledge
public health technician, with the aim of feeding the planning, execution and
evaluation of public health policies and programs.
 CONCLUSIONS

ASICs are the basic unit of integration and action of the SPNS at the local level,
consisting of all social, assistance, and educational institutions,
investigative, technological, or others, that provide health services to the
population in a specific geographical area, based on the strategy of
Barrio Adentro, prioritizing health promotion and prevention of
diseases, without neglecting healing and rehabilitation.

An ASIC corresponds to the social territory of several Councils.

Communal

In it, the primary health services network is articulated with the networks.
community social and other Social Missions.

The ASIC service network applies a comprehensive and intersectoral model of

continuous family and community health care, universal and free.

In the future, an ASIC should largely align with territoriality

from a Commune.

Since last year, work has been ongoing in the Falcón State in the
formation of the ASIC starting in June 2015. "Currently, it is already
it has 22 Community Integral Health Areas and is being organized
each of them to respond from the first level of care,
working with our healthy population and preventing diseases.

In the same way, the 6 Health Districts can be broken down with their
respective ASICs such as Sanitary District Coro, which has 7 ASICs; the
Paraguaná Health District has 5 ASIC (including Adolfo Martínez)
Guzmán, Raúl González Castro and José Ramón Játem from the Carirubana municipality;
Francisco de Miranda in the municipality of Los Taques and Josefa Camejo in the
Falcón municipality; Dabajuro Health District has 2 ASIC; District
Sanitary San Luis has 2 ASIC; Sanitary District Tucacas has 3 ASIC and
Health District Churuguara 2 ASIC.

In our state, health is a regional priority starting from primary care.

of health, to improve coverage and the quality of care assuming as
unique challenge of rescuing the public healthcare system and above all the
transformation of the care model according to the principles of equity,
integration, universality, solidarity, and quality of programs and services
that the public sector provides to the entire population.

Within the ASICs, 94% of the care centers of our

State, which represents the largest network of the national public health system. And
this arises from the need to organize services according to the
social territoriality, which is why ASIC represents a management instance
participatory approach that will ensure comprehensive responses regarding health through a
model of care and a mode of management, in accordance with the existing conditions
in each place, with a comprehensive, inter-institutional, and intersectoral approach and with
the active and leading participation of the community, which exerts power
popular.