From the design to implementation: the case of the Health Care Integration Councils (CIRA) in Chile
© Arteaga et al; licensee BioMed Central Ltd. 2012
Published: 23 January 2012
Material and methods
Thirty five semi-structured interviews were carried out to members of CIRA belonging to a purposive sample of six HS in different regions of the country. All the interviews were recorded after participants’ informed consent. Interviews were performed and analyzed by the group of researchers using Grounded Theory.
Stakeholders’ perceptions are that CIRAs have been implemented in ways that depart from what was designed in the regulatory framework. This is particularly evident in relation to CIRA members, selection procedures and partially regarding to CIRA role. The regulatory framework is not explicit about the selection of their members. CIRAs were implemented in each HS differently: from non-participatory and rather authoritarian appointment of members to democratic election of some of them. In the regulatory framework CIRA had an advisory role and according to interviewees’ general perceptions, this role is being accomplished. However, the view of some stakeholders is that, in practice, this role has turned CIRA into a structure to exchange information only. Interviewees recognize important contributions coming from CIRA policy. Regardless the ways in which CIRAs were implemented, stakeholders agree to see them as an institutionalized space within the health care network. All levels of health care acknowledge CIRA existence, the issues that are discussed, and respect the decisions taken in this Council.
Although CIRA has been implemented differently from that stated in norms when it was created (e.g. integrating members), CIRA is valued as a relevant institution within the health care network.
Project funded by a grant (SA09I20064) from FONIS (Chilean Health Research National Fund).
- Arteaga O, Astorga I, Pinto AM: Inequalities in public health care provision in Chile. Cad Saude Publica. 2002, 18 (4): 1053-1066.View ArticlePubMedGoogle Scholar
- Unger JP, De Paepe P, Cantuarias GS, Herrera OA: Chile's neoliberal health reform: an assessment and a critique. PLoS Med. 2008, 5 (4): e79-10.1371/journal.pmed.0050079.PubMed CentralView ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.