CASALUD, Carlos Slim Foundation’s NCD solution: Securing public health financing

A few weeks ago, I had the opportunity to travel to Mexico to learn more about the Carlos Slim Foundation’s (CSF) work in healthcare. The CSF was founded in 1986 with a vision to develop interventions that improve the quality of life of people of all ages, promote the formation of human resources and create opportunities that foster the integral development of individuals and their communities. With 12 areas of focus, health is one of the foundation’s four priorities. CSF is addressing the main health issues facing the most vulnerable populations by finding innovative, sustainable and replicable solutions that improve people’s health across Mexico.

As I became more familiar with CSF’s work, what struck me the most was how different their approach is to what we otherwise see; putting private sector thinking and methodologies at the centre of everything they do. CSF first builds a good understanding of the problem, then identifies solutions, and only afterwards, supports in the provision of the necessary resources to solve the problem. As in the private sector, CSF builds ways to collect evidence for every solution and track the results. Where required, they support implementation partners to achieve scale and sustainability with the utmost success: leading to inclusion in the national public policy.

With a rapid increase in the prevalence of non-communicable diseases (NCDs) and an increased ratio of morbidity and mortality attributable to NCDs; 55% of deaths in 1990 and 80% of deaths in 2016, CSF identified NCD area as its priority. The rise in NCDs, in particular, has a profound impact on health systems, as NCDs often occur alongside multiple health conditions (co-morbidities) that require long-term health management across various levels of care. An important way to address this is to increase the provision of people-centered, proactive care at the community level that covers the entire continuum of patient care.

CSF’s NCD solution, Casalud, strives to re-engineer primary healthcare services, centring its model on proactive prevention and detection of risk factors and NCDs, as well as evidence-based disease management. As a holistic model, its operation relies on the use of digital tools to connect households and primary care clinics, enhance patient-centered care by healthcare providers, detect diseases in a timely manner, and improve data reporting and management and, the availability of medicines and lab supplies.

CSF focuses on:
Integrated metabolic approach: Looking across disease areas of obesity, diabetes, hypertension and dyslipidaemia
Anticipatory approach: Proactive prevention through systematic risk assessment
Coordinated approach: Throughout the continuum of care
Performance-based approach: Evidence-based disease management
Accountable care: Enabling transparency
In October 2013, CSF’s Casalud suite of services was incorporated into the National Strategy for the Prevention and Control of Overweight, Obesity and Diabetes. You will be able to learn more about CASALUD in our next case study. In the meantime, I would like to share some recommendations with you by Pablo Kuri, Undersecretary of Health Prevention and Promotion, at the Federal Ministry of Health.

Securing public health financing. Recommendations by Pablo Kuri, Undersecretary of Health Prevention and Promotion, Federal Ministry of Health, Mexico

According to Pablo Kuri, it all starts with demand creation. Governments must recognise the need for innovation and new solutions and create an environment that enables innovations. The regulatory framework needs to be strengthened; evidence with cost savings spotlighted and agencies created to ensure innovation is at the centre of all future development.

Partners need to work together to ensure mutual benefits are realised, with the patient at the centre of solution development. Strong alignment between partners (in this case MoH and CSF) is crucial, with the MoH providing leadership on the health side and CSF providing leadership on the tech side.

Innovation will always be met with challenges and resistance. This can be addressed with capacity building, transparent processes and evidence, clearly communicated benefits, empowered people with good information and solutions developed closely with the end users.

We will publish a case study on CASALUD in the next few weeks. In a recent webinar with Rodrigo Saucedo-Martínez, Health Innovations Senior Manager at CSF, we discussed the lessons learnt and recommendations made based on CSF’s experience over the past few years, mainly focusing on the work with the government. Let us know if you have any questions.

 

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