Inter-sectorial and inter-institutional cooperation and coordination in Public Health within the market model of the colombian Health Care System, 2012-2016

Abstract

To describe the characteristics of inter-sectional and inter-institutional relations regarding decision-making processes for the development of public health policies and programs in six Colombian cities. A qualitative study was developed in six Colombian cities using the Grounded Theory method. An individual interview was conducted with 108 professionals with extensive experience and knowledge in public health, who were linked to the development of policies and programs in this field. There were also 14 focus groups with leaders of community health organizations. Interviewees place great value on inter-sectorial and inter-institutional cooperation and coordination for the development of public health. Some good experiences have been reported, although they have been short and related to specific programs. The market-based health care model, competition and profit-making goals of most actors involved in the health care system has made cooperation and articulation among them difficult, preventing the achievement of greater development of public health policies and programs. Inter-institutional cooperation and articulation are recognized as essential for the development of the public health. Some specific and short-term experiences have been reported. The market and competition model of the Colombian Health Care System does not allow for strengthening the values required to achieve sustainable development in public health.