2. Functions of the health sector

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funciones del sector salud

The health sector is defined as the set of values, standards, institutions, and actors that produce, distribute, and consume goods and services whose principal or exclusive objectives are to safeguard the health of individuals or populations.

The activities of these institutions and actors are designed to prevent and control disease, care for the ill, and conduct health research and training.

The above definition is part of a conceptual framework based on the definition of health adopted by the World Health Organization (WHO), and on recognition of the determinants and factors that shape populations’ and individuals’ health. These include include:

  • The recognition that each country has its own definition of the health sector, and that these definitions, which are designed to promote individual countries’ national process of development in health, must be taken into account.
  • The relationship of the health sector with other sectors that play a role in social and economic development.
  • A dynamic vision of the health sector, which highlights ongoing changes in the institutions and actors that make up the sector, the economic environment in which they carry out their activities, and their values, knowledge, abilities, resources, technologies, attitudes, and interests.
  • Functional analysis of the health services system, and implications for action.

The health sector must be view as being comprised not only of public institutions, but also private institutions, civil society organizations, institutions that provide health education, and research institutions, as well as providers of water and sanitation services. Together, the institutions of a country’s health sector form the national health system, whose organizational and operational modality is a function of the particular country’s political and administrative organization. In all cases, however, the ministry of health leads the sector.

There is no single or correct way tor organize the health sector to manage risk and emergency response. The scope of emergency and disaster prevention and response and the consequent responsibilities of the sector in these matters are a function of each country’s structure, operation, and legislation. As a result, how issues are addressed and how the various actors organize at the national level and within the sector vary from country to country. The essential point is that a country and its health sector must have organizational structures that are flexible enough to adapt to the political, social and technical realities that present during emergencies.

In its leadership role, the ministry of health is responsible for coordinating, preparing, and executing emergency and disaster preparedness plans to reduce the vulnerability of health services and provide for sanitation measures and others that will diminish risk factors, protect the health of those affected, reduce mortality and the overall health impact on the population.

Most health ministries have mechanisms—whether formal programs or technical areas (as in the large countries) or focal points (as in the Caribbean islands)—for planning and implementing strategies to strengthen the sector and create close coordination with other national entities that have responsibilities related to risk reduction, preparedness, and emergency and disaster response.

In addition to establishing a permanent entity responsible for coordinating and executing ongoing activities, there must be a clear delimitation of levels and scopes of authority, responsibility, delegation of functions, decision-making functions, leadership, and control within the ministry of health—and by extension in the sector’s institutions in general. This issue is of special importance, and calls for putting procedures in place to improve safety in health facilities, strengthen the sector’s capacity for dealing with emergencies and disasters, facilitate the implementation of humanitarian assistance activities that support health, and develop processes to rehabilitate and rebuild health programs and services.

The table below illustrates the health sector’s main responsibilities in risk management, preparedness, and response:

Health sector’s main responsibilities in risk management, preparedness, and response

Risk management
  Identify and assess threats and risks.
  Prepare emergency and disaster plans and programs.
  Organize and coordinate response by the sector, and provide support for operational activities.
  Identify vulnerability of health care facilities, water supply, vital sectoral services, and technical areas and programs.
  Strengthen the operation of the health facilities network.
  Ensure the continued delivery of health services throughout the emergency/disaster.
  Include risk reduction programs (such as the ‘Hospitales Seguros’) as part of the institutional structure.
  Develop, organize, and conduct training programs.
  Evaluate the impact and mobilize technical, material, and financial resources for the emergency as well as for early rehabilitation.
  Participate in, and ensure that health units are a part of the national early warning network.