"Peri-border" health care programs: the Ecuador-Peru experience

Area of Science:

• Public Health
• International Health Systems
• Health Policy

Background:

• Cross-border health initiatives face unique challenges in integrating national systems.
• The Ecuador-Peru "peri-border" health program aimed to harmonize healthcare delivery in a shared region.

Purpose of the Study:

• Evaluate the strengths, weaknesses, and challenges of the Ecuador-Peru peri-border health program.
• Analyze legislative, managerial, and organizational strategies for health system integration in the border area.

Main Methods:

• Qualitative case study utilizing literature review and analysis of official documents.
• Conducted 18 semi-structured interviews with key informants.
• Surveyed all health workers within the Suyo-Macará binational micro-network.

Main Results:

• A significant challenge was the lack of reciprocity: Peruvian citizens received free care in Ecuador, but not vice versa.
• Identified a need for human resource improvements within the binational system.
• The program's strength lies in its organizational structure, facilitating a binational network and patient referral system with clinical information transfer.

Conclusions:

• Peri-border health programs are feasible and replicable despite challenges.
• Key success factors include a binding binational agreement, standardized healthcare quality, and an integrated binational information system.