It is a Citizen Engagement Project of Massive Open Online Course (MOOC) "Engaging Citizens: A Game Changer for Development?". The objetive of Project is to create a sustained national multi stakeholder dialogue in health. That aim to legitimately decide about coverage benefit plan and resource allocation with the objective of improving health outcomes in a new social contract.

1. NATIONAL MULTI STAKEHOLDER
DIALOGUE IN HEALTH
Mery Bolivar

2.  Population : 47.1 million
 Woman: 51%
 Urban population: 76%
 GDP: USD$ 378.1 billion
(2013)
 GDP per capita (PPP):
USD$7.826 (2013)
 GDP in health: 6.8% (2013)
 Real growth rate: 4,3% (2013)
 Inflation: 1,9% (2013)
 Unemployment: 8.4% (2013)
 Gini: 0.539 (2012)
 Life expectancy: 79 (2012)
COLOMBIA INFORMATION

3. COLOMBIA HEALTH SYSTEM
Colombia has already achieved Universal Health
Coverate, we constantly ask ourselves what lays ahead:
1. Increased quality in service delivery
2. Breaching equity gaps
3. Enhanced governance, transparency and
accountability
However, we must be mindful of the need to preserve
the financial sustainability of the health care system.
Striking a fair balance between what we want to deliver
and what we can afford is not an easy task!

4. SOCIETAL HEALTH PROBLEM
Colombia has a wide and comprehensive benefit
package. It covers all diseases since health
promotion until catastrophic diseases and it
includes heath technologies, e.g. immunization,
pharmaceuticals, medical and surgical
procedures, etc.
However, making decisions about coverage plan
is not legitimate for citizens. As a result, the
limits of the benefit basket neither are and
population claims their rights trough of judicial
mechanism.

5. OBJECTIVES OF NATIONAL DIALOGUE
Rights-based
approach to
health care
Needs of the
population
Effectiveness of
health technology
Citizen’s values
and preferences
Financial
sustainability of
the health system
It is necessary to create a sustained national multi stakeholder
dialogue in health. That aim to legitimately decide about coverage benefit
plan and resource allocation with the objective of improving health
outcomes in a new social contract

6. KEY PLAYERS
Ministry of Health (Leader)
Ministry of Finance
Citizens
Patients
Human resources in health
Hospitals
Insurers
Workers
Employers
Entrepreneurial health sector
Academy sector
Advocacy organization
Media
Ombudsman
Prosecutor

7. KEY PLAYERS RECRUITMENT
Unions or organizations
that represent key
players will send three
curriculum vitae and the
Ministry of Health will
chose one representative
of each organization.

8. DIMENSIONS OF NATIONAL DIALOGUE
Coverage benefit plan and
resource allocation
Financial sustainability
Rights-based approach to health care
Citizen’s values and preferences
Effectiveness of health technology
Needs of the population

9. DESIGN ELEMETS OF NATIONAL DIALOGUE
Final objective Level of
cooperation
level of shared
decision
authority
Participatory
mechanisms –
Tactic
Communicati
on mode
Informational
materials
Recurrence
Coverage benefit
plan and resource
allocation
Interest-based
processes
CE Empower as
part of a multi-
stakeholder
dialogue
Small tablet
format – Thin
Deliberative Results of
intermediate
objectives
Each two
months
Intermediate
objectives
Rights-based
approach to
health care
Interest-based
processes
Stakeholder
internet
consultation
Massive –
Thick
Two ways Laws and
international
agreement of
right to health
Each two
years
Needs of the
population
Interest-based
processes
Collaboration
with
stakeholder
Massive –
Thick
Two ways Demographical
and
epidemiological
profile
Each two
years
Effectiveness of
health technology
Position-based
processes
Citizen
consultation
Small tablet
format - Thin
Two ways Cost effective
results
Each six
months
Citizen’s values
and preferences
Interest-based
processes
Citizen internet
consultation and
empowerment
Massive –
Thick
Deliberative International
values and
preferences
Each one
year
Financial
sustainability
Position-based
processes
Information to
stakeholder
Massive –
Thick
One way Budgets Each two
months

10. RISKS OF NATIONAL DIALOGUE
Opportunities that could be
leveraged to maximize the
potential of initiative are
that health is a
fundamental right and new
forms of participation with
use of technologies
transforming the process
more inclusive, responsive,
and accountable
Challenges might initiative
face is to achieve a
legitimate process, low
participation and real
construction of citizenship
with the transformation of
subjects into citizens with
rights and responsibilities.

11. RISKS OF NATIONAL DIALOGUE
Initiative will bring:
-Greater realization of
rights and greater access
to health care services.
-Transforming the process
more inclusive, responsive,
and accountable
Strategies are:
-Increasing civic and political
knowledge with informational
materials with focus group
discussions by municipalities.
-Using new technologies like
virtual activities, consultation,
collaboration by internet in
computers, tablets or mobiles.

12. BALANCED SCORECARD OF NATIONAL DIALOGUE
Final objective Indicators Reasons
Coverage benefit
plan and resource
allocation
# of health technologies approved by
year
% access a new technologies
Morbility and mortality related with
new health technologies
# of Health Technologies Litigated by
year
Real outputs
Utilization
Outcome
Legitimacy
Intermediate
objectives
Rights-based
approach to health
care
Gap between international
agreement and national agreement
Realization of rights
Needs of the
population
Gap between epidemiological profile
and felt needs
Perception of citizens
Effectiveness of
health technology
# of assessment health technologies
by year
Real outputs
Citizen’s values and
preferences
% participation in consultation Real construction of
citizenship
Financial
sustainability
% of health technologies does not
approved by financial reasons
Economical restriction

13. THANKS!