Introduction and Relevance of the Program
Many individuals with access to private medical services often disregard and even mock programs like Salud Casa por Casa. While they may seem inadequate when measured against private hospital or well-equipped clinic standards, understanding these initiatives as public policies aimed at providing containment and dignity for those without resources changes the perspective. Criticize the design, but acknowledge the gap they aim to fill.
The Impact of Casa por Casa
Initiated by President Claudia Sheinbaum, Casa por Casa represents a genuine shift in public healthcare delivery. No previous Mexican government had designed a national strategy to bring doctors, nurses, and medications directly to the homes of elderly or disabled individuals on such a large scale, with this level of coverage and preventive ambition.
Historical Context
- Previous efforts, like IMSS-Coplamar in rural areas during the 1970s and some CDMX alcaldías, lacked the scope and preventive focus of Casa por Casa.
- The failure of Seguro Popular and INSABI exacerbated existing healthcare disparities.
Current Achievements
By July 1, Casa por Casa has censused over 9 million people and conducted more than 800,686 comprehensive clinical history home visits across all 32 states. However, progress varies, with Michoacán and Nayarit showing higher visit numbers (52,000 and 12,000, respectively) while most entities have not published clear figures, complicating real coverage assessment.
Preventive Logic and Challenges
The program’s preventive approach aims to detect diseases early, manage severe cases, and reduce unnecessary hospitalizations. It also functions as an epidemiological surveillance system, aiding in identifying outbreaks like the recent sarampión case in Chihuahua. Moreover, it offers continuous care for those unable to visit medical facilities.
Obstacles
- Overburdened staff: Nurses often handle up to ten visits daily without necessary supplies.
- Insufficient training in home care and geriatrics among some personnel.
- Hospital saturation or shortages render referrals for serious cases ineffective.
Resource Constraints
The 7,000 million-peso budget for 2025 may be inadequate to regularly serve 14 million people. Integration with Farmacias del Bienestar, intended to ensure medication access, remains incomplete.
Logistical Issues
- Inaccessible roads in certain areas.
- Security concerns hindering brigade access in others.
- Outdated Bienestar housing records limit program reach.
Conclusion
Casa por Casa is a serious intervention addressing decades of neglect, though it remains insufficient. Its success hinges on sustaining operations, adapting to challenges, and integrating with a still-fragmented hospital system. For now, it represents a promising step in the right direction.
