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Published: 20 Jun, 2018

Developed primary health care improves public health in vulnerable countries

NEWS Despite many difficult challenges, a new primary health care strategy in Bogotá, Colombia, has succeeded in improving the quality of care and child health, while at the same time reducing the disparities in health between different sections of the population. This is presented in a thesis to be defended by Paola Andrea Mosquera on 11 April at Umeå University.

At the same time as Colombia is one of the most socioeconomically developed countries in Latin America, it is also one of the countries with the largest disparities concerning the socioeconomic status and health of the population.

The capital of Colombia, Bogotá, has for a long time experienced significant problems with poverty, social injustice and a lack of health and medical care. Therefore, in 2004, the political leadership in Bogotá decided to implement a primary health care strategy in order to improve the quality of life and the level of public health, as well as to reduce health-related disparities in the population.

An evaluation of the primary health care strategy, conducted by Paola Andrea Mosquera, doctoral student at the Department of Public Health and Clinical Medicine, shows that the strategy has been effective in several different ways. This in spite of the conditions for the introduction of necessary changes in primary health care being resisted from a political direction and by the prevailing capitalistic system within the health care sector.

In her thesis, Paola Andrea Mosquera shows that, as a consequence of the primary health care strategy in question, the quality of first-line health care institutions, corresponding to Sweden's health centres (vårdcentraler), has improved. Child mortality for children under five years old was reduced by 13.8 per cent, infant mortality caused by pneumonia was reduced by 37.5 per cent, and at the same time vaccination coverage relating to the diseases diphtheria, parotitis and tetanus increased by 4.9 per cent.

Paola Andrea Mosquera also concludes that the new primary health care strategy reduced the disparities in terms of health in Bogotá. In the most socioeconomically vulnerable areas, the societal disparities in child mortality among children under five years old were reduced by 24 per cent, and the disparities in infant mortality were reduced by 19 per cent, compared to before the implementation of the new primary health care strategy. The disparities in starvation and malnutrition were reduced by 7 per cent, while the vaccination coverage for the diseases in question increased by 20 per cent.

“The thesis shows the importance of this kind of primary health care programme when it comes to impacting public health. Action programmes in primary health care can be effective in socioeconomically vulnerable countries across the world. Countries that decide to improve people's health and reduce disparities in health have good opportunities of reaching their goals if this is prioritised,” says Paola Andrea Mosquera.

Paola Andrea Mosquera comes from Bogotá, Colombia, is originally a psychologist with degrees in epidemiology and social policy, and is a doctoral student at the Department of Public Health and Clinical Medicine at Umeå University. She can be reached at:Telephone: +46 (0)70-666 17 37
E-mail: paolamosquera@gmail.com

Photo: Paola Andrea Mosquera.

On Friday 11 April, Paola Andrea Mosquera, Department of Public Health and Clinical Medicine, defends her thesis entitled: Evaluation of a primary health care strategy implemented in a market-oriented health system: the case of Bogota, Colombia. (English title: Evaluation of a primary health care strategy implemented in a market-oriented health system: the case of Bogota, Colombia).Opponent: Pol de Vos, senior lecturer, Institute of Tropical Medicine, Belgium.
Principal Supervisor: Miguel San Sebastian.

The defence of the thesis will take place at 13.00 at Norrlands University Hospital, Room 135, Family Medicine, entrance X5, building 9A.

The thesis is published digitally.

Editor: Mattias Grundström Mitz