Open AccessThe absence of stewardship in the Chilean health authority after the 2004 health reform
Author(s) -
Tania Herrera,
Sergio Sánchez
Publication year - 2014
Publication title -
medwave
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.178
H-Index - 7
ISSN - 0717-6384
DOI - 10.5867/medwave.2014.10.6040
Subject(s) - stewardship (theology) , politics , public administration , political science , government (linguistics) , health care , population , corporate governance , population health , welfare economics , humanities , medicine , management , law , environmental health , philosophy , linguistics , economics
Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authority’s stewardship rol