The challenge of sustainability of expanded programs on immunization/ El desafio de la sostenibilidad de los programas ampliados de inmunizaciones/O desafio da sustentabilidade do Programa ampliado de imunizacao

• Published in: Revista panamericana de salud pública 2017-12, Vol.41 (8)
• Main Authors: Cid, Camilo, Bascolo, Ernesto, Urrutia, Maria Soledad, Pagano, Juan Pablo, Del Riego, Amalia
• Format: Article
• Language: Spanish
• ISSN: 1020-4989

Objective. Analyze the sustainability and integration of priority programs in the framework of the Pan American Health Organization's 2014 Strategy for Universal Access to Health and Universal Health Coverage (Universal Health). Methods. A non-systematic review was carried out of the recent literature focused on analysis of integration and sustainability. Results. The main result extracted from the literature review is the need to address sustainability in a way that goes beyond the limits of any analysis restricted to financial sustainability. Although integration and sustainability are not interpreted uniformly, an approach that includes integration as a facilitating factor of the EPI sustainability process does stand out. Conclusions. Effectiveness of EPI integration strategies depends to a large extent on considering the presence, strengthening, and transformation of organizational and institutional structures that facilitate the participation of actors with the technical and political ability to ensure its implementation processes. Thus, political processes can be weighed that legitimize an agenda to include EPI in the Universal Health strategy and, accordingly, as an integral part of health systems strengthening. Keywords Systems integration; universal access to health care services; health systems. Objetivo. Analizar la sostenibilidad y la integracion de los programas prioritarios en el marco de la Estrategia para el acceso universal a la salud y la cobertura universal de salud (Salud Universal) de la Organizacion Panamericana de la Salud de 2014. Metodos. Se llevo a cabo una revision no sistematica de la bibliografia reciente enfocada al analisis de la integracion y la sostenibilidad. Resultados. El principal resultado que se extrae de la bibliografia revisada es la necesidad de abordar la sostenibilidad de tal modo que se superen los limites de cualquier analisis restringido a la sostenibilidad financiera. Aunque la integracion y la sostenibilidad no se interpretan de forma homogenea, sobresale un abordaje que contempla la integracion como un factor facilitador del proceso de sostenibilidad del PAI. Conclusiones. La efectividad de las estrategias de integracion del PAI depende en buena medida de que se consideren la presencia, el fortalecimiento y la transformacion de las estructuras organizativas e institucionales que faciliten la participacion de los actores con capacidad tecnica y politica para garantizar sus procesos de implementacion. De esta