Claudio A . Castillo

El presente documento releva y sistematiza aquellos elementos claves del diseño, implementación y ejecución del Sistema ChCC, como insumos que pueden enriquecer el aprendizaje horizontal entre países que tengan interés en avanzar en la implementación de estrategias equivalentes.

Es: Documento describe como la colaboración intersectorial entre los sectores Salud, Protección Social y Educación permitió a Chile Crece Contigo apoyar a que todos los niños y niñas alcancen su pleno potencial de Desarrollo. En: Describe how intersectoral collaboration between health, social protection, and education sectors enabled Chile Grows with You (Chile Crece Contigo) to help all children reach their full developmental potential.

As the COVID-19 pandemic continues causing problems around the world, Chile is facing a new episode of increasing cases and deaths. However, at the same time, the country has succeeded in providing vaccines for an important part of its population over a short period. What are the factors behind this successful process? What are the challenges faced by the country today? This article explores potential explanations for the “Chilean paradigm”, regarding the COVID-19 vaccine rollout. Borrowing from implementation science frameworks, the analysis proposed an alternative explanation—based on multiple actors, approaches, and history—as opposed to one in which the outcome is due mainly to the government’s performance. The rapid and extensive coverage of vaccination can be explained by the role played by the government and the academia in securing vaccines through a pragmatic approach; the capacity built at local level, as well as the coordination between the health system and local authorities; and favorable vaccine culture, developed through the implementation of the National Immunization Program. Short and long-term elements (such as investment in infrastructure and relationships between stakeholders, and actions carried out during the pandemic), as well as contextual factors (such as the political and socioeconomic context), provide a more complex story to explain the observed outcomes. While other countries could try to follow the Chilean example, the article shows that short-term actions are necessary but might not be sufficient to achieve results. At a global level, the situation calls for rethinking how countries will face these global challenges, including issues such as international cooperation and global health governance.

Personal protective measures such use of face masks, hand washing and physical distancing have proven to be effective in controlling the spread of the Covid-19 pandemic. However, adherence to these measures may have been relaxed over time. The objective of this work is to assess the change in adherence to these measures and to find factors that explain the change For this purpose, we conducted a survey in the Metropolitan Region of Chile in which we asked the adherence to these measures in August-September 2021 and retrospectively for 2020. With the answers obtained we fit a logistic regression model in which the response variable is the relaxation of each of the self-care preventive actions. The explanatory variables used are socio-demographic characteristics such as the age, sex, income, and vaccination status of the respondents. The results obtained show that there has been a significant decrease in adherence to the three personal protection measures in the Metropolitan Region of...

El actual Sistema de Salud chileno nace en 1952 con la conformacion de una extensa red asistencial, con distintos niveles de atencion y presencia en todo el territorio. Este sistema se modifico durante la dictadura militar, traspasando la Atencion Primaria de Salud a los municipios y creando una nueva institucionalidad. El sistema de salud es segmentado y fragmentado, en el financiamiento y aseguramiento como en el modelo de organizacion, gestion y atencion de la provision de los servicios, respectivamente. La rectoria y la regulacion recaen en el Ministerio de Salud. El aseguramiento puede ser publico (Fondo Nacional de Salud), privado (ISAPRES), institucional cerrado (Fuerzas Armadas y Carabineros, con financiamiento principalmente fiscal) o laboral (Mutualidades privadas con financiamiento de trabajadores y empleadores). El sistema de salud hoy atiende a una poblacion envejecida y con un perfil epidemiologico donde predominan las enfermedades no transmisibles y alta presencia de ...

Demographic, health, and socioeconomic factors significantly inform COVID-19 outcomes. This article analyzes the association of these factors and outcomes in Chile during the first five months of the pandemic. Using the municipalities Metropolitan Region’s municipalities as the unit of analysis, the study looks at the role of time dynamics, space, and place in cases and deaths over a 100-day period between March and July 2020. As a result, common and idiosyncratic elements explain the prevalence and dynamics of infections and mortality. Social determinants of health, particularly multidimensional poverty index and use of public transportation play an important role in explaining differences in outcomes. The article contributes to the understanding of the determinants of COVID-19 highlighting the need to consider time-space dynamics and social determinants as key in the analysis. Structural factors are important to identify at-risk populations and to select policy strategies to preve...

The identification of COVID-19 waves is a matter of the utmost importance, both for research and decision making. This study uses COVID-19 information from the 52 municipalities of the Metropolitan Region, Chile, and presents a quantitative method—based on weekly accumulated incidence rates—to define COVID-19 waves. We explore three different criteria to define the duration of a wave, and performed a sensitivity analysis using multivariate linear models to show their commonalities and differences. The results show that, compared to a benchmark definition (a 100-day wave), the estimations using longer periods of study are worse in terms of the model’s overall fit (adjusted R2). The article shows that defining a COVID-19 wave is not necessarily simple, and has consequences when performing data analysis. The results highlight the need to adopt well-defined and well-justified definitions for COVID-19 waves, since these methodological choices can have an impact in research and policy mak...