It is estimated that to ensure the proper functioning of the infrastructure and necessary equipment, the public health network of Latin America and the Caribbean presents an investment deficit exceeding US $150 billion. In addition to this estimate, there is a growing demand for health services as a result of the increase in the prevalence of chronic non-communicable diseases, technological innovation and the promise of moving towards Universal Health Coverage.
In a context of budgetary restrictions, the way to respond to these requirements is to strengthen effective and efficient public investment and maximize available resources. To this end, it is necessary to establish planning processes to identify requirements and prioritize criteria for selecting the most critical projects-whether at the national or subnational level.
Within this framework, Health Investment Master Plans (HIMPs) become a key tool for improving the impact and sustainability of health projects. What do they consist of? This blog explains.
Health Investment Master Plans: What Are They and How to Build them from a Network Approach?
HIMPs are a roadmap for the short, medium and long term, designed to optimize the use of resources and improve the effectiveness of investments in the construction of sustainable health responses. These plans are based on an approach that combines analysis of the demand and supply of services, both in their current and projected situation, and implements network management measures.
At the regional level, only a small number of countries have HIMPs. This shortcoming jeopardizes the effectiveness, impact, and sustainability of health projects. Therefore, to support the countries of the region in the investment planning and prioritization processes, the IDB has prepared a Reference Guide for the Preparation of Investment Master Plans with a Network Approach (Guía de referencia para planes maestros de inversiones en salud con enfoque de red, available in Spanish).
The network approach consists of responding to the health demand by considering the set of facilities in a territory, optimizing their operation and the complementarity between hospitals and the first level of care or primary care.
Optimizing Health: Success Stories in Latin America
The guide’s methodology is flexible in terms of its thematic and territorial scope, which has allowed its application in various countries for the identification of investment priorities and/or the design of networks.
In Argentina, for example, the Ministry of Health coordinated the creation of a HIMP with the provinces, which allowed the country to identify and strengthen care networks, as well as to plan the budget and investments to be made. In addition, this allowed the technical prioritization of investment in physical resources, which resulted in the creation of a Federal Investment Plan, a health intelligence room for the construction of information governance mechanisms, the training of managers with a network approach and the upgrading of health facilities.
In Guatemala, the network study conducted in 2018 made it possible to identify health gaps (morbidity and mortality by department), coverage (primary health care and hospitals), human resources, infrastructure and equipment, as well as network functioning. Its results made it possible to formulate an investment program to address the most priority gaps, both in terms of investment and management.
In Peru, an analysis of the hospital network of Lima and Callao was carried out in 2015, which made it possible to determine the size of the gaps in care and investment priorities in order to define the scope of a broad hospital investment program.
In Chile, the application of this approach in 2002 contributed to the design of neurosurgical and cardiac-surgical care networks, making it possible to propose levels of complexity and referral routes (lines of care) according to the territories.
In summary, the construction of Health Investment Master Plans can optimize the impact and improve the sustainability of health infrastructure projects.
In the short term, the creation of HIMPs allows the implementation of physical infrastructure projects in order to recover the capacity to respond to health demands. In the medium and long term, these can contribute to the development of actions in response to new challenges linked to the processes of modernization and sustainability of the system. Thus, a health system with limited financing can optimize its financial and operational resources by planning and executing a HIMP.
Learn about the contents needed to develop a Master Investment Plan with a Network Approach -from the diagnostic phase to its elaboration-, in our methodological guide. And access more strategies and tools for more efficient health spending in our publication Smart Spending for Health: How to Make Each Dollar Count.
Leave a Reply