In 2006, the release of the document The Future of Children is Always Today highlighted widespread conditions of poverty in Chile and its detrimental effects of childhood development. The Presidential Advisory Council for Child Policy Reform, a multidisciplinary political body established in 2006, drew at length from this foundational document to design and implement Chile Creece Contingo (ChCC), a multisectoral public policy addressing the comprehensive nature of childhood development.1 Through vertical and horizontal coordination mechanisms at the national, local, and communal level, ChCC synergizes the existing structures of Chile’s health, education, and social development sectors to expand the reach of the system and scope of activities. What emerged has evolved into a comprehensive, intersectoral, and multicomponent system of social development to help individuals reach their full potential, regardless of socioeconomic status.

ChCC coordinates existing interdependent services and resources across sectors to deliver services at the local level in each of Chile’s 345 communes. The implementation of ChCC is flexible based on the characteristics of the local context, exercising local priority-setting strategies to best meet the complex needs of individuals and communities. To make use of the usual points of contact and minimize the creation of new institutions, ChCC established the local health system as the public’s gateway to services and support, where over 80% of children were already being treated and born. Support is provided by a network of intersectoral teams with clearly defined roles, who can leverage upon the expanded referral network of regional and national agencies for additional support and resources. Teams are supported by an information system that captures the developmental history of a child from birth to allow for intersectoral communication and collaboration regarding the use of relevant services and support across sectors.1

The successes of ChCC serve as an important demonstration of the value of leveraging intersectoral action and community engagement to achieve the delivery of high-quality comprehensive person-centered services and the realization of the Sustainable Development Goals. Four major contributors to the ongoing success of ChCC hold important lessons for strengthening primary care systems: 1) person-centered design, demonstrated by the focus on the local delivery of services and the social determinants of health, 2) sustainability, exhibiting through the emphasis on leveraging the strengths of existing frameworks and institutions to reduce service overlap and consolidate resources, 3) high-level political commitment, demonstrated by the establishment of a governing body to coordinate and the implement performance assessment measures (including monitoring and evaluation systems), and 4) the creation of a state budget established by law, to reinforce the continuity of the policy through ongoing financial commitment.

References:

  1. Torres A, Lopez Boo F, Parra V, Vazquez C, Segura-Pérez S, Cetin Z, et al. Chile Crece Contigo: Implementation, results, and scaling-up lessons. Child Care Health Dev. 2018;44(1):4–11.