Center for Health Market Innovations (CHMI)

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Overview

Implementing organization: 
Ministry of Health of Jalisco
Legal Status: 
Year Launched: 
1997
Stage: 
Existing/expansion stage

Funding

Primary Source of Funding: 
Government
Summary: 

In 1997, the state government earmarked budgetary funds that would finance and permit the operation of the new programme to contract health teams and hospitals to provide services to the population not covered by a social security institution.

Key program components: 

As a requisite for contracting, two types of services were selected: a basic health unit that consisted of a physician, nurse and health technician who worked as a team to provide health services in rural areas. General hospitals that offered basic specialties (surgery, pediatrics, gynecology/obstetrics and internal medicine) made up the second provider type.

The basic health unit contracted personnel for a defined period of time (usually three months) through renewable contracts. Payment varies by job category. For example, physicians receive a fixed salary equivalent to 50% of the permanent MOH physician salary. The remainder is variable and calculated based on monthly productivity (defined primarily as the number of consultations). The other categories of health personnel also receive a fixed salary complemented by productivity payments, based on indicators related to their activities (e.g. number of home visits, immunizations administered).

By 2002, MOH bureaucrats looked for a budgetary increase to incorporate more basic units and hospitals into the contracting model.

The basic health units are distributed throughout Jalisco, primarily in localities that lack a public health centre. The specific criteria are that these units be located in localities with a population of no more than 2500, without local public health services and with the nearest public health clinic more than one hour away via public transportation.

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