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Integrated Health Service Delivery Networks (IHSDN) based on primary health care (PHC) are the most promising solution for health systems to satisfy the health needs of the population and to address access, efficiency, quality and equity challenges faced by health systems of the world. PHCs essential attributes (people and family centered care, comprehensiveness, continuity, longitudinality) position this approach as one of the key strategies for countries to meet the aspiration of achieving universal health coverage. Creating care networks has been a common thread running through Latin America and the Caribbeans health policy agendas. In terms of actually putting the IHSDN model in action, there is a wide range of interpretations and experiences, with designs, scales, organizational methods, and maturity levels that vary within and between countries. This book shares evidence of the progress made in forming and launching IHSDN in Latin America based on four case studies conducted in Argentina, Brazil, Colombia, and Mexico. The results were found by systematically applying an instrument that collects regional information on the context and features of the IHSDNs governance, funding, care models, and IHSDN management models. The books chapters describe the characteristics of IHSDN in the four studied countries, lessons are drawn from how these IHSDN have been designed and implemented, challenges for the future are identified and recommendations are provided on what will it take to consolidate the IHSDN model in Latin America. The hypothetical story of Dioselina, illustrates throughout the book the obstacles and difficulties that arise for a diabetic patient when using health services that are not people-centered. The results shed light on how prepared IHSDN in this region are to provide patient-centered care and where to focus efforts for improvement. The evidence found in this study will help develop and advance PHC in Latin America.

Most countries in Latin America and the Caribbean (LAC) seek to reform their health systems so they can achieve universal coverage and improve health expenditure efficiency, while meeting citizens’ ever-growing expectations about the quality of care. The role of primary health care (PHC) stands out as key to achieving these objectives in an integrated manner. With the aim of contributing to the design of evidence-based health policies in LAC, and giving special consideration to patient or health service user perspectives, between 2012 and 2014 the Inter-American Development Bank carried out the Primary Care Access, Experience and Coordination Survey in Latin America and the Caribbean, in adult populations in Colombia, Mexico, Brazil, El Salvador, Panama and Jamaica. The first two chapters of this book present the context and challenges of health systems in the region and describe the conceptual framework and methodology of the study. Chapters three through eight cover, separately, each of the six countries studied, presenting results on patients’ experiences with primary health care and its integration with other levels of care. Chapter nine concludes the book with a comparative analysis among the six LAC countries, and extends the comparison to 11 high-income OECD countries, showing persistent gaps in indicators regarding access, experience, and coordination in PHC between LAC and OECD countries. A multivariate analysis of these 17 countries shows that the main attributes observed in PHC are directly linked to patients’ perceptions on the need for fundamental changes in health systems and the quality of the services they use.