Health Reform and Community Medicine Course in Chile

Program Dates: Monday, January 2, 2017 – Friday, January 20, 2017

Faculty: Thomas Bossert (tbossert@hsph.harvard.edu)

The Chile course this year offers a chance to learn about an innovative health system that has been a model for several countries around the world and to observe Chile’s initiatives in primary care including an important public private partnership and the development of a family medicine approach to community health care. During the first two weeks, we will interview key actors in the health system and visit clinics and hospitals to learn about:

  • their innovative health insurance system which involves both public and private insurance
  • their experiment in public private partnerships for delivery of primary care (the Ancora Clinics, written up as a Harvard Business School teaching case)
  • the challenges of implementing a “family medicine” approach in primary care clinics
  • how municipal governments manage the decentralized primary care systems in urban and rural settings.
  • the challenges of both public and private hospitals in Santiago
  • legislative initiatives of the Congress in Valparaiso

These two weeks involve interviews with key officials, including former President Lagos who initiated some of the innovations, as well as the association of physicians, association of private clinics and hospitals, and academic observers and researchers from key university programs as well as visits to municipal governments and to clinics and hospitals in urban and rural areas.

During the last week, students will have a chance to do independent work or a practicum on topics of their own interest. During the fall, Dr. Bossert can put students in touch with local academics and observers who can help develop the independent projects. Chilean residents in family medicine also attend the course and work with the Harvard students on projects. In recent years, students have done studies of tobacco legislation and of abortion that resulted in op-ed pieces in Chile's leading newspaper, other studies made impressive use of each student's special interests as applied to Chile. Open to all graduate degrees students; it offers a special opportunity for MPH students to do a practicum on specific issues in Chile before, during and after the winter term course.

The three week 1.25 credit course involves:

  • introductory lectures by HSPH faculty to orient students to the key issues of health reform and community medicine in Chile and to assist in the selection of MPH practicum topics
  • lectures by key participants in the health system - past and present
  • interviews with current and past stakeholders and observers of the health system innovations
  • lectures and field visits to public and private clinics and hospitals in urban and rural settings, including the Ancora public private partnership clinics
  • individual short research projects on various topics such as health reform, community medicine, innovations in obesity, tobacco control, and other public health topics.

One advantage of Chile is a significant Harvard presence to support the course. The David Rockefeller Center for Latin American Studies has an office in Santiago and provides active support for this course. Two recent graduates from HSPH will be able to assist in the program: Dr. Thomas Leisewitz, formerly the leading health expert in the Ministry of Finance, is on the faculty at the Catholic University in the Department of Community Medicine working on the Ancora clincis ; and Dr. Marco Nunez, currently the President of the Chamber of Deputies in Chilean Congress and former Director of the decentralized Northern Metropolitan Santiago regional health office.

In addition, the faculty director of the course, Thomas Bossert, Senior Lecturer in Global Health and Population and Director of the International Health Systems Program, has had years of experience in Chile and direct involvement in some of the health reform programs.

The course will be for 1.25 credits and will require a presentation on individual research into one of the topics of the course. Some students gain additional credit through an independent study in the spring term following the course. The course dates are January 4 to 22 - a beautiful summer time period in Santiago, the safest city in the Americas. Housing arrangements can be made at a reasonable price at an apart-hotel near the David Rockefeller Center. Spanish will be helpful but not essential. One student will be selected as TA for the course.

For cost and budget information, please click here.

Course Note: Enrollment is limited to 15 students; pass/fail grading option only, although students who want more credit for their individual research are encouraged to follow up the course with an independent study in the spring with Dr. Bossert. Two or three seminars on Chile will be held during Fall 2 in preparation for the course. MPH students interested in using this course for their practicum will have special sessions in the fall to organize their projects, and will have follow up sessions in the spring.