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Peru Program Overview

PROGRAM FOCUS: Over six million people in Peru receive health care from primary care centers managed by community associations known as CLAS (Comunidades Locales de Administración de Salud).  CLAS-administered health facilities are different from regular government health posts in that:

1. They are managed by a legally registered non-profit association composed of the health center manager (usually a doctor or nurse) and five people elected by and from the community who receive public funds transferred from the government for local payment of health personnel who are contracted under private law, but who work in a government-owned health facility ;
2. All money earned by the health center from a new government health insurance reimbursement program or from fees-for-services stays within the CLAS and can be re-invested in the health center or to meet other community development needs, according to decisions made by CLAS.

This system of organizing primary health care services with decentralized and community-controlled financing operates as the Shared Administration Program under the Ministry of Health.  The program has spread rapidly since first established in 1994 and now covers 35% of all primary care services.  Over 800 CLAS Associations now manage over 2000 of 6700 primary care centers in Peru , in both urban and rural areas extending from the coast to the high dry Andes and to the tropical forests of the upper Amazon. 

PROGRAM GOAL:Future Generations Peru works in partnership with CLAS Associations and the Peruvian Ministry of Health to create a sustainable model for CLAS that achieves quality of services, equity of access and outreach, enhanced community input and control, and mobilization of community action for behaviour change and local development; and to take this model to scale throughout Peru ’s system of CLAS health centers.

PROGRAM STRATEGY: Future Generations Peru works as an outside-in partner to support CLAS at both the national and community levels. Future Generations Peru:

• Builds a three-way partnership with CLAS health facilities, community, and government for the design and development of Model CLAS, which are intended to be exemplary health centers that effectively combine an organized and sustainable system of community-based health and local development planning and action with improved quality of primary health care services in a decentralized and community-controlled model of financing and management.   Model CLAS aim to become action learning and experimentation centers to train other CLAS throughout a region.  For more details, see <project sites>;
• Advocates with various levels of government and civil society to promote CLAS and community-based multisectoral health and development as part of national health strategy.
• Conducts and publishes research on the CLAS program and its impact on health, equity, quality of care, and access in Peru ;
• Provides technical assistance to public and private institutions nationwide to strengthen CLAS and the Shared Administration Program;
• Provides training to local community partners, government partners, and other change-agent partners in the SEED-SCALE process of community change.

MAJOR ACHIEVEMENTS:  Future Generations Peru is playing a significant role in helping to:

• strengthen Ministry of Health commitment to health policy reforms to support CLAS and the Shared Administration Program,
• draft and advocate for Congressional legislation to create an enabling framework for the government of Peru to continue to support CLAS;
• establish the first Model CLAS in Las Moras in the district of Huanuco in central Peru ;
• train CLAS Association members, health personnel, volunteer health promoters and community leaders in an expanded model of community health and local development through community empowerment;
• provide training and technical assistance to CLAS nationwide on financial and legal management of primary health services under the Shared Administration Program.
• facilitate partnerships between local CLAS, regional health offices, municipalities and other community-based organizations.

HISTORY OF PARTNERSHIP: Future Generations staff member, Dr. Carl Taylor, guided the design and development of CLAS and the Shared Administration Program when it was first established in 1994. Future Generations Peru was established in 2001 to support the CLAS program, which had spread so rapidly that it was in need of support and capacity development.  The staff of Future Generations Peru have a long history of supporting CLAS and community health in Peru .    Dr. Ricardo Diaz was manager of a rural CLAS health center in the mid-90’s, became national technical coordinator of the Shared Administration Program within the Ministry of Health from 1998-2000, and was a founding member of FGP.  Dr. Laura Altobelli started working in Peru in 1983 as a public health program consultant and researcher, conducted numerous studies and evaluations of CLAS beginning in 1996, and joined Future Generations Peru as Country Director in 2002.   Dr. Luis Espejo brings to Future Generations Peru his significant experience in designing and directing major innovative community-based health and multisectoral development programs in rural areas of Peru in the past 15 years.  

PARTNERS: Peruvian Ministry of Health, Regional Health Office of Huanuco, CLAS Las Moras, Municipality of Las Moras, ForoSalud, Alliance for Equity in Health.

MORE INFORMATION: This website contains many pages of detailed information on each project site. To learn more, click here to visit <Project Sites>, <Going to Scale> and <Related Links>

PERU
Futuras Generaciones Peru
Av. Andres Reyes 165, Dpto. E
San Isidro
Lima 27 , Peru
Telephone: 511.434.2791 or 511.944.3220
Email:  >  peru@future.org

Future Generations
HC 73 Box 100
North Mountain
Franklin, WV 26807 USA
Telephone (304) 358-2000 / Fax (304) 358-3008
Email:  >  info@future.org