Implementation of medical specialists brigades in the areas of Universal Health coverage: The peruvian Ministry of Health experience, 2009-2010

Peru has a high degree of inequity reflected in the distribution of morbidity and mortality, consistent with the inaccessibility to health care and human resource gap, especially in remote areas of the capital. The Peruvian Ministry of Health, recognizing the right of all people to quality health care, initiated the Universal Health Insurance (AUS), and in this context, increased access to specialized care in pilot AUS areas by brigades of specialist doctors. This article offers an approach to this strategy presents the management and implementation processes, a quantitative analysis with indicators of output / efficiency, and provides a qualitative look from the perspective of the members of the brigades. Its main findings reflect the lack of effective and efficient management, translated in the absence of: production goals, work plans, working partnerships with local stakeholders, monitoring and effective supervision, recurrent shortages of human and technological resources, and high costs.