Health planning in Latin America

Health planning in Latin America became an organized activity with the Charter of Punta del Este in 1961. The charter's 10-Year Public Health Program set forth a series of objectives that stressed international cooperation, the link of public health with economic development, and assistance from the Pan American Health Organization (PAHO) and the U.N. through Economic Commission for Latin America. The basis for most planning efforts in the region has been the PAHO/Center for Development Studies (CENDES) method, a joint venture of WHO and the Central University of Venezuela. This methodology suggests health programs that are organized from the bottom up beginning with "program areas" for populations that lie not more than 2 hours from a health clinic. The program areas comprise a regional area, which in turn is serviced by specialized clinics not affordable in program areas. The regional areas serve as the building blocks for the national programs. Beginning in 1963, several countries undertook planning activities using the PAHO/CENDES procedures. In many countries, however, the evolution of the planning process did not measure up to the expectations of 1961; only a few countries actually completed the program cycle. The problems confronted by these programs demonstrated that health planning has to be more than the intermittent exercise of preparing plans and documents.