Colombia - Health Services Integration Project

Document of The World Bak FOR OMCIAL USE ONLY Report No. 5532-CO STAFF APPPAISAL REPORT REPUBLIC OF COIOMBIA HEALTH SERVICES INTEGRATION PROJECT June 18, 1985 Population, Health and Nutrition Department DiJVision III This docuent has a rcstrited distribution and may be used by recipients only in the perfonnanee of thelir official dudes. Its contents way -not otherwise ber disclosed without World Bank anthoriztidoo.  CURREICY EOUIVhLUTS Currency Unit - Peso Colobiano (Col$) US$1.0 - Col.$135 (May 15, 1985 Actual) EIGHTS AND MEASURES Metric System FISCAL YEAR January 1 to December 31 PRINCIPAL ACROMS USED CUADS - Centro de Adiestramiento en Salud (Center fo- Realth Training) CI - Couitg Interseccional (Zonail Departmeatal Coordinating Units) DIP - Departasento Nacional de Planeaci6n (National Planning Departmoent) DSBR - Division de Sanesmiento BUsico Rural (Division of Basic Rural Sanitation) P1K - Foudo- acional Hospitalario (National Rospital Fund) ICEF - Instituto Colombiano de Bienestar Familiar (Colooiian Institute ef FAmily Welfare) INS - Instituto Racional de Salud (National Institute of Health) INSFOPAL - Instituto Raciona' de Fomento Municipal (Institute-for Municipal Development) ISS - instituto de Seguros Sociales (Social Security Institute) MOH - Miuisterio de Salud (Ministry of Health) SBR - Sauesmiento Bgsico Rural (Basic Rural Sanitation) SSS - Servicio Seecional de Salud (Departmental Health Services) UPA - Unidad Primaria de Atenci6n (Primary Care Unit) UR - Unidad Regional (Health Region)  FOR OMCUIL USE ONLY COLOMBIA MEALTH SERVICES INTEGRATION PROJECT STAFF APPRAISAL REPORT Table of Contents Pate Number SELECTED SOCIAL IINDICATORS .............................. ... iii GLOSS,M OF TCEM. ..........o............... - .......... o.... iv LOAW AND PROJECT SUOABY ....... - ..........................v I. Introduction .................. O-* ...... ....,...... l II. Sector Status ........ ......... .1 A. Population ............... I B. Health ........................ , ........ 3 C. NuEtrition ............................ ......... 4 D. The Health Care System . ........ . 5 E. Health Care Financing .......... ... ... ........... .8 F. Health Manpower ...............................10 G. Health Information Systems ,. ..... .. ........... 12 H. Research ........... III. Key Sector Issues ...............* ............ A. Lack of Coverage ............................ ...... 13 B. Sector Deficiencies .... 14 C. Management Weaknesses ......... ...... IV. The Bank-s Role ............................ . . ... 15 V. The Project .....................,........,........ 16 A. Project Summary ................ . 16 B. Sumary Project Composition ............................. .18 C. Detailed Project Description .... 9 This report is based on the findings of an appraisal and a post appraisal mission that visited Colombia from June 18 to July 6, 1984, and frca November 26 to December 7, 1984, respectively. The mission members yere Messrs. V. De Geyndt (Mission Leader), L. Vassiliou (Economist), B. Hubert (Architect), W. Stottman (Engineer), Mrs. P. Kleysteuber (Operations Assistant), and Consultants G. Herrera (Physician) and F. Unda (Engineer). This docume has a resicd ditbution and may be used by redpients ony in te poefonmane of thei offc duts ents may not otheie be ded witbout Wold Bank authobiaton  (ii) Pate