Social Protection Ministry Republic of Colombia Ministry of Social Protection Republic of Colombia

Social Protection Ministry Republic of Colombia PANDEMIC FLU PREPARENESS AND ATTENTION PLAN PREP & ATTENTION PLAN FOR THE INFLUENZA PANDEMIA

Social Protection Ministry Republic of Colombia The Colombia plan includes the recommendations of the WHO/OPS 1.National preparation and coordination in order to respond against the pandemic 2.Supervision in public health of acute respiratory illnesses caused by the virus 3.Attention and reduction of morbility and mortality of acute respiratory illnesses 4.Prevention and control of illness transmission among the community 5.Preservation of basic services 6.Research and evaluation PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia Ministry of Social Protection Territorial Institutions: Departments and districts Municipalities Insurance companies Responsibilities in the SGSSS PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia NATIONAL PREVENTION SYSTEM AND REACTION TO DISASTERS (SNPAD) National team in preparing and reacting to the pandemics (SNPAD) PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia Components Prep work Notification Alert – alarm Health services Support Services Epidemiological Supervision Response Formation in personal health Creation of supervision teams and response Strengthening the notification system and diagnosis network Public awareness

Social Protection Ministry Republic of Colombia diagnosis services network Strengthening the capacity of the diagnosis services network attention to patients services network Strengthening capacity of the attention to patients services network Preserving bio security levels Prep work PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia diagnosis services Strengthening the capacity of the diagnosis services network Determining geographical areas of greater risk. Identifying installed capacity of the diagnosis services network Handling Samples: guidelines for drawing samples, gathering and transporting respiratory and blood samples Typifying and sub-typifying system of samples by National reference Laboratory PREP & ATTENTION PLAN FOR THE INFLUENZA PANDEMIA

Social Protection Ministry Republic of Colombia attention to patients Strengthening capacity of the attention to patients networks Identifying installed capacity of the IPS network per area and per level of complexity. Determining the requirements: IPS, Human Talent, GIA, supplies and medicaments, technology, coordination and support mechanisms Organizing the services network: IPS (public and private ones), incorporating insurance companies Defining the information and statistics system Administrative Component PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia Ambulatory Spheres Guidelines: early detection, isolation and reporting possible cases, preventive isolation due to suspicion or confirmation of cases; respiratory hygiene and cough handling Availability of resources and supplies and operation of ERA rooms Strategies of home attention Community Information TH training PANDEMIC FLU PREPARENESS AND ATTENTION PLANS attention to patients Strengthening capacity of the attention to patients services networks

Social Protection Ministry Republic of Colombia Hospital spheres Validation and socialization of handling Guidelines Reference and counter reference System of patients. Handling Guidelines of Hospital waste, elements and equipments for patient care, handling of corps. Recommendations for bio-safety: health workers, family and visitors. Availability of resources and supplies Training of TH Emergency Plans and simulation PANDEMIC FLU PREPARENESS AND ATTENTION PLANS attention to patients Strengthening capacity of the attention to patients services networks

Social Protection Ministry Republic of Colombia Response Notification Alert - Alarm Suspicious Cases Confirmed Cases Possible expansion PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia EMERGENCY REGULATING CENTERS AND EMERGENCIES COORDINATION SCHEMES PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia Source: Presentation by Dr. Díaz Cabrera, President of SIEM in Asunción - Paraguay, in the IX CONGRESS OF ALAMI, - ASOCIACION LATINOAMERICANA DE MEDICINA INTEGRAL - COMPONENTS

Social Protection Ministry Republic of Colombia NOTIFICATION SYSTEMS

Social Protection Ministry Republic of Colombia C.R.U.E. OF BOGOTA PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia Rescue chain Eventos de aviso corto vs. prolongado E - I E - II E - III Immediate local Response (Community, Local Health System, CLOPAD) Ambulatory Response (Response Teams)) Hospital denomination (Medium and high complexity ) PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia Social Protection Ministry Republic of Colombia Obligatory system for quality control (Decree 1011 dated April 3, 2006) PREP & ATTENTION PLAN FOR THE INFLUENZA PANDEMIA

Social Protection Ministry Republic of Colombia TOTAL REGISTERED SERVICE PROVIDERS Free lance Professionals IPS Source: registry of special service providers as of November 30, 2005 PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia IPS registered beds * June 30, Points of service of the Public network Points of service of the Private network Source: registry of special service providers as of November 30, 2005 PREP & ATTENTION PLAN FOR THE INFLUENZA PANDEMIA

Social Protection Ministry Republic of Colombia PANDEMIC FLU PREPARENESS AND ATTENTION PLANS SERVICE DECLARED BY THE SERVICE PROVIDER No. OF DECLARED BEDS % DIVED BY THE TOTAL General adult Service ,42% Pediatrics ,76% Obstetrics ,58% Psychiatry3.6967,04% Neonatal Intermediate Care1.5142,89% Drug Dependency1.4182,70% Adult Intensive Care1.1802,25% Newborn (neonatal) Intensive Care8111,55% Adult Intermediate Care6961,33% Pediatric Intensive Care3790,72% Burn Unit2510,48% Pediatric Intermediate Care1540,29% Total registered beds % Source: registry of health service providers 2004 MPS Percentage distribution of beds per registered service

Social Protection Ministry Republic of Colombia PANDEMIC FLU PREPARENESS AND ATTENTION PLANS Source: registry of health service providers 2004 MPS DECLARED SERVICEBED TOTALS BEDS ÉR EACH 1000 HAB. General Adult Service ,55 Pediatrics Obstetrics7.6520,17 Psychiatry3.6960,08 Neonatal (newborn) Intermediate Care1.5140,03 Drug dependency1.4180,03 Adult Intensive Care1.1800,03 Neonatal Intensive Care8110,02 Adult Intermediate Care6960,02 Pediatric Intensive Care3790,01 Burn Unit2510,01 Pediatric Intermediate Care1540,003 Ratio of beds per service per one thousand inhabitants

Social Protection Ministry Republic of Colombia PANDEMIC FLU PREPARENESS AND ATTENTION PLANS Source: registry of health service providers 2004 MPS DECLARED SERVICENUMBER OF SERVICE PERCENTAGE DISTRIBUTION Odontology ,87 General Medicine ,66 Physiotherapy1.6577,03 Psychology1.5286,48 Respiratory Therapy1.0564,48 Phono-audiology6002,55 Speech Therapy2911,23 Occupational Therapy2801,19 Infirmary1190,50 Percentage distribution of declared services by independent professionals

Social Protection Ministry Republic of Colombia PANDEMIC FLU PREPARENESS AND ATTENTION PLANS Source: ASCOFAME. Human Resource in Medicine: formation, distribution and basis for a political proposal Size of the municipality Total inhabitants % inhab over the national total Total physicians % Physicians over the national total Rate x 10 thousand inhab Less than ,12921,30,44 Between and ,89454,21,15 Between and , ,23,10 Between and , ,65,29 Between and , ,37,26 Over , ,410,42 Distribution of general physicians By municipalities according to the size of the town. Year 2000.

Social Protection Ministry Republic of Colombia General Installed Capacity by level Public offer in throughout the territory Source: Information reported by public IPS as of December 31, Decree 2193 dated 2004 PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia PANDEMIC FLU PREPARENESS AND ATTENTION PLANS Source: Information reported by public IPS - Decree 2193 dated 2004 LEVELCONCEPT First level Occupational percentage34,50%33,80%37,80% Average Stay in days1,971,871,85 Bed turnaround53,4957,2763,23 Second level Occupational percentage65,80%68,00%73,50% Average Stay in days2,993,323,4 Bed turnaround76,6671,3574,99 Third level Occupational percentage87,00%87,10%84,60% Average Stay in days5,185,125,48 Bed turnaround66,2867,6658,41 NATIONAL TOTAL Occupational percentage58,60%59,00%63.0% Average Stay in days3,143,23,23 Bed turnaround65,164,8266,61 Indicators of Hospital Bed’s usage Public Institutions providing health services – 2004

Social Protection Ministry Republic of Colombia TRANSPORTING PATIENTS PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia No OF ENABLED AMBULANCE SERVICES IN COLOMBIA (*) 2004 BASIC ASSISTED TRANSPORT MEDICALIZED ASSISTED TRANSPORT 91 TOTAL *1.263 (*) DATOS PARCIALES 2004 Source: Registro Especial de Prestadores de Servicios de Salud PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia EMERGENCY SERVICE PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia TOTAL (*) DATOS PARCIALES 2004 Source: Registro Especial de Prestadores de Servicios de Salud AVAILABILITY OF EMERGENCY SERVICE IN COLOMBIA (*) 2004 PANDEMIC FLU PREPARENESS AND ATTENTION PLANS

Social Protection Ministry Republic of Colombia Ministry of Social Protection Republic of Colombia FINANCING THE PREP WORK & ATENTION PREP & ATTENTION PLAN FOR THE INFLUENZA PANDEMIA MPS: 6 million dollars ECAT: 20 million dollars (approx.)

Social Protection Ministry Republic of Colombia THANK YOU WELCOME THANK YOU WELCOME PREP & ATTENTION PLAN FOR THE INFLUENZA PANDEMIA