title: [The absence of stewardship in the Chilean health authority after the 2004 health reform].
abstract: Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authoritys stewardship role.
authors.affiliation: Ministerio de Salud, Chile. Email: tshm17@hotmail.com. Address: Mac Iver #541, Santiago, Chile.
authors.forename: Tania
authors.initials: T
authors.lastname: Herrera
authors.affiliation: Presidente de Fundación Latinoamérica Reforma, Chile.
authors.forename: Sergio
authors.initials: S
authors.lastname: Sánchez
mesh_terms: D002677:Chile; D003695:Delivery of Health Care / Q000458:organization & administration*; D018166:Health Care Reform; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*
keywords: health system; stewardship