[Developing human resources for the administration of local health systems]

The author provides a brief historical review of the education of health services administrators in Latin America. Subsequent to the Conference of Alma Ata (1978), great emphasis was placed on actions to extend coverage of services, primary health care, community participation, appropriate primary health care technology, and development of health personnel to deal with the demands ensuing from such actions. The health policies of the countries of the Region of the Americas have most recently been directed toward horizontal integration of services--including the most complex hospitals--in a specific geographical area, by encouraging the setting up of local health systems (SILOS). In such systems, the new health administrator must be able to manage a hospital or peripheral health center, organize the community, and above all, to ensure that the health institution, regardless of the source of financing, functions harmoniously, possesses fluid mechanisms for case referral and counter-referral, and input distribution. Thus, the health administrator in a given geographical area should be capable of managing more than one institution, as well as its financial, human, and material resources. In order to carry out this mission, in the last quarter of this century the Regional Program for Training in Health Services Administration (PROASA) and the public health schools in the Region will be asked to make a sustained effort to train teaching personnel, introduce new disciplines, and institute supervised internships for in-service training in keeping with these new social requirements.