• Lorena Rodríguez Osiac, Ricardo Cerda, Rodrigo Retamal, Daniela Nicoletti, and Marcela Araya Bannout.
• Escuela de Salud Pública Dr. Salvador Allende G., Universidad de Chile, Chile.
• Rev Med Chil. 2023 May 1; 151 (5): 591599591-599.

BackgroundChile faced the Sars-Cov-2 pandemic, which coexisted with food-nutritional problems related to non-communicable diseases (NCDs). Due to this context, individuals with chronic conditions had less chance to receive medical attention due to the restructuring of the public health system.ObjectiveThe present study aimed to identify strategies that integrate the individual, community, and structural levels to improve health control in habitual and critical situations.MethodsThe study included individuals attending the Cardiovascular Health Program (Programa de Salud Cardiovascular) at the primary care level in the capital city of Santiago during the COVID-19 pandemic. Nine hundred forty individuals attending the Cardiovascular Health Program answered a 40-question telephonic interview. With the results of the analysis (convergence analyses, the complement of quantitative and qualitative results), we performed a seminar with key stakeholders from the Ministry of Health and the primary care level.ResultsOur study describes integrative strategies that include the individual level, the community level, and structural aspects. These strategies may improve healthcare management among people with NCDs and could be helpful to face interruptions of health benefits and improve health control in everyday and critical situations. The strategies include three levels: 1) Cardiovascular Health Program redesign; 2) facing health attendance discontinuities, and 3) structural measures.ConclusionIt is necessary to re-evaluate primary care policies in light of these proposed strategies for sharing responsibility and empowering users about their abilities.

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