IV.ORGIV.

ORGANIZATION AND FUNCTIONING OF THE COMMUNITY HEALTH CARE NETWORK (RACS)

4.1. CONCEPTUALIZATION It is the set of establishments, services, and community actions that are intersectoral.
SPNS, aimed at guaranteeing the right to health for individuals, families, and communities with care.
Integral. The RACS has been established to provide 100% coverage to the population under the Care Model.
Integral; expanding access to health services, with the social approach that laid the foundations of
Barrio Adentro; more than 90% of the healthcare centers in the country are located there, which represents the
greater network of the National Public Health System.
4.2. CHARACTERISTICS OF THE COMMUNITY HEALTH CARE NETWORK • It constitutes the gateway and first
contact of the population with the SPNS. • Implements a comprehensive care model through strategies and
actions defined by the life cycle in all social territories under their responsibility. • It is organized to
through the ASICs with a work plan and a single direction. • It is articulated with the aggregation system.
communal from the Communal Councils, the Health Committees, and the Socialist Communes. • Manages
multisectoral actions with Social Missions, State Institutions, and community projects
focused on Good Living and Supreme Social Happiness. • The Basic Health Teams carry out their
functions according to 4 specific areas: Assistance, Teaching, Management, and Information System in
Health. 61 Guiding Principles for the Management of the Community Care Network in the Area of Comprehensive Health
Community
4.3. ESTABLISHMENTS OF THE COMMUNITY HEALTH CARE NETWORK THAT EXIST IN THE AREAS OF
COMMUNITY INTEGRAL HEALTH (ASIC) Resolution No. 400 establishes the Classification of the
establishments that make up the SPNS, in the first level of medical care, published in the Official Gazette
No. 40,723, dated August 13, 2015, explicitly describes the criteria for classification.
the services within the RACS, namely: 1. Type 1 Popular Clinics (C.P. T.1) 2. Popular Clinics
Type 2 (C.P. T.2)
Popular Optics (O.P) 6. Comprehensive Diagnosis Centers (C.D.I) 7. Comprehensive Rehabilitation Rooms (S.R.I) Their
geographical and population organization is referenced by the Community Comprehensive Health Areas (ASIC).
4.3.1. Popular Clinics The Popular Clinic (CP) is the establishment where the work of the EBS is
projects to the community. CP and community constitute the teaching-assistance stage for training of
human talent in the SPNS, including Community Integral Doctors (MIC), specialists in
Comprehensive General Medicine (CGM), Community Integral Nurses and other training programs. The
CP is assigned to the ASIC and is part of the Comprehensive Health Care Center (NAIS). From the CP, services are provided.
integral and intercultural health services for individual and collective life cycles through
promotion, prevention, restitution, and rehabilitation for the health of 100% of the enrolled population. It
resolves the Guiding Principles for the Management of the Community Attention Network in the Health Area
Community Integral 62 health problems identified with the active and leading participation of the
organized community in Health Committees. Its fundamental activity is the process of dispensing.
where Integrated Community Work (ICW) is included for comprehensive care for the person, the family and the
community; as well as the development and execution of the Action Plan for the Health Situation Analysis by
means of which it provides solutions to problems.
4.3.1.1. Popular Clinic Type 1 (CPT1) Characteristics: • It covers a population of up to one thousand (1,000) people or
two hundred (200) families, within the social territories under their responsibility. • Provides services of
health promotion, immunization, and disease prevention activities, as well as others
health actions properly protocolized by the Governing Body in Health. • They have a Promoter
of Health duly certified by the Regulatory Authority in Health, supervised by a doctor or a physician
responsible for the nearest Type 2 Popular Clinic.
4.3.1.2. Popular Clinic Type 2 (CPT2) Characteristics: • They have a population responsibility area between
1,000 and 2,500 people or 200 and 500 families, preferably 1,250 people or 250 families, within the
social territories under their responsibility. • Offers health promotion services, immunization and
other disease prevention activities, attention 63 Guidelines for Management of the
Community Care Network in the Area of Comprehensive Community Health, general and community medical care to the
person, family and community, basic nursing care and attention to the school and work environment
environmental. All health actions must be properly protocolized by the Regulatory Authority in
Health. • They have a Basic Health Group (BHG) made up of a doctor, a nurse, a
Health promoter(s) duly certified by the governing body in health.
4.3.1.3. Popular Clinic Type 3 (CPT3) Characteristics: • They have a population responsibility area of more
of 2,500 people and more than 500 families. •They offer the same services as a Type 2 Popular Clinic,
There is a community dentistry unit or service and basic diagnostic media within the center or in
its area of influence. Within its organization, other entities can coexist, either occasionally or permanently.
community health care services depending on the needs and characteristics of the community.
They have one to three Basic Health Groups duly certified by the Regulatory Body in Health.
 Depending on local health needs and the services and dimensions of the establishments,
another health staff can be incorporated.
4.3.2. Popular Dental Clinics (COP) are basic health units that are part of the Area of
Community Integral Health (ASIC), located in the community, that assumes responsibility for care
comprehensive dental care for the assigned population. They can consist of one to ten chairs or units.
Dental. Guiding Principles for the Management of the Community Care Network in the Health Area
Community Integral 64 The services can be located in a Comprehensive Diagnostic Center (CDI), Room
Comprehensive Rehabilitation (SRI), High Technology Center (CAT), Popular Consultation (CP), adapted facilities,
family houses, State health institutions, Military Units, Community Houses, Schools, Local premises
Of Municipalities and Governorships. Characteristics: • They serve a population corresponding between 4 and 8
Type 1 or 2 Popular Clinics; in case of being located within a Type 3 Popular Clinic or in its
influence area, can only additionally cover up to 3 Type 1 or 2 Popular Clinics. • They offer
comprehensive dental health services on an outpatient basis and free of charge to the general population and the environment
school. They operate in network with the Comprehensive Dental Care Centers. • They are attended by a Group
Basic Oral Health (GBSB) composed of a dentist and a dental health technician.
for each dental chair. Depending on the needs of the population responsibility area,
other members may be included in the Basic Oral Health Group (GBSB).
4.3.3. Popular Optics (OP) are basic health units that are part of the Comprehensive Health Area.
Community (ASIC), located in the community, which takes on the responsibility of comprehensive care for
population with uncomplicated visual disorders. Characteristics: • They serve a corresponding population
at least five Community Integral Health Areas (ASIC). • They offer comprehensive optical services and
free, timely, and adjusted to the needs of the 65 Guiding Principles for the
Management of the Community Care Network in the Comprehensive Community Health Area served population and
they operate in conjunction with the Specialized Ophthalmological Care Centers. • They are attended to by a Group
Basic Visual Health (GBSV) composed of an Optometrist and a technician in cutting and mounting
optical lenses, supervised by an ophthalmologist from the Community Integral Health Area (ASIC).
4.3.4. Comprehensive Diagnostic Centers (CDI) The Comprehensive Diagnostic Centers (CDI) are health institutions
that guarantee medical, surgical services, and complementary studies 24 hours a day to
the population that requires emergency attention or referrals from the Popular Clinics of an ASIC in
first intention. They have a team of professionals and technicians in the health field who in a way
integral ensure the quality of care and provide the necessary medications and supplies with the
appropriate technological equipment. Features: • They comprehensively serve the population of the territory.
social of the Community Comprehensive Health Area (ASIC), which is under their responsibility. • They offer services
Vital Support (Emergencies) 24 hours, Observation up to 72 hours, X-rays, Ultrasound, Endoscopy,
Ophthalmology, Intermediate Therapy, Nursing and others that are part of the complementary network of
diagnosis and treatment for girls, boys and adolescents; adults, pregnant women and care for
low-risk deliveries. • They have a Multidisciplinary Health Group (MSG), composed of:
Doctors, Specialists, Nurses, Ophthalmologists, Technicians, Pharmacists, Staff
Managerial and maintenance support. Depending on the Guidelines for Network Management
Community Attention in the Area of Comprehensive Community Health 66 local health needs and services
and dimensions of the establishments, other health personnel can be incorporated.
4.3.4.1. Services that operate in the Comprehensive Diagnostic Center (CDI) a) Services for the population
Urgencies and Emergencies
Emergency and screening electrocardiogram, Observation Room, Intensive Care Unit and Care
Intermediates, Surgical Activity (Only for Surgical CDIs), General Surgery, Orthopedics and Traumatology,
Minor Ambulatory Surgery, Delivery Room (only the authorized), Neonatal Care and Units
Pediatrics, according to the needs of the population. b) Diagnostic Services Clinical Laboratory,
Ultrasound, X-rays, Endoscopy, Ultra Micro Analytical System (SUMA) Laboratory (only the
enabled), Electrocardiography and others. c) Medical Consultations Ophthalmology, General Surgery, Traumatology
Orthopedics in Comprehensive Diagnostic Centers (CDI) surgical, Gynecology and pediatrics (in establishments
defined for such purposes). d) Support Services for the Care Coordination Office, Reception, and Room
Wait, Pharmacy and Pharmacy Warehouse, Sterilization Area and Statistics Department 67
Guidelines for the Management of the Community Care Network in the Area of Comprehensive Health
Community e) General Services and Assurance Electro medicine, Laundry, Kitchen – dining, Cleaning and
Cleaning, General Maintenance of the infrastructure, gardening, electricity, drinking water and wastewater,
Warehouses, Ambulance and/or medical transport and Non-medical transport. 4.3.5. Rehabilitation Rooms
Integral Rehabilitation Rooms (SRI) are health establishments that guarantee care.
to the people who require referred services from different nearby health care centers
home. Characteristics: • They serve the population of the social territory of the Integrated Community Health Area
(ASIC), which is under their responsibility. • They provide the following services: physical medicine and rehabilitation.
 medical including electrotherapy, thermotherapy, therapeutic gym, occupational therapy, massage therapy,
hydrotherapy, podiatry, natural and traditional medicine, psychoprophylaxis of pregnancy and others according to the
sociocultural needs; speech therapy and logopedia. • They are attended by a Multidisciplinary Health Group
(GMS), in the area of comprehensive rehabilitation composed of a physiatrist and a speech therapist.
licensed or higher technician in physical therapy, licensed or higher technician in occupational therapy
graduate or higher technician in speech therapy, graduate or higher technician in psychology,
bachelor or higher technician in social work, bachelor or higher technician in podiatry and others
according to the needs. Guidelines for the Management of the Community Care Network in the
Comprehensive Community Health Area 68 4.3.5.1. Services that operate in the Comprehensive Rehabilitation Room
(SRI): a) Services for population care: Physiotherapy consultation and complementary therapies. b) Services
therapeutic Natural and Traditional Medicine (NTM), Podiatry, Occupational Therapy, therapeutic gym,
Infrared Heat and Massage, Electrotherapy, Magnetotherapy, Logophoniatrics, Hydrotherapy, Rehabilitation
home care and physiotherapy, others according to the needs. c) Support Services for Care
Reception and Waiting Room General Services, Cleaning, Cleaning and Storage. ORGANIZATION AND FUNCTIONING
FROM THE COMMUNITY HEALTH CARE NETWORK (RACS)
4.1. CONCEPTUALIZATION It is the set of establishments, services, and intersectoral community actions of
SPNS, aimed at ensuring the right to health of individuals, families, and the community with care
Integral. The RACS has been established to provide 100% coverage to the population under the Care Model.
Integral; expanding access to health services, with the social approach that laid the foundations of
Barrio Adentro; more than 90% of the healthcare centers in the country are located there, which represents the
greater network of the National Public Health System.
4.2. CHARACTERISTICS OF THE COMMUNITY HEALTH CARE NETWORK • It constitutes the gateway and first
contact of the population with the SPNS. • It applies a comprehensive care model through strategies and
actions defined by the life cycle in all social territories under their responsibility. • It is organized to
through the ASICs with a work plan and a single direction. • It is articulated with the aggregation system
communal from the Communal Councils, the Health Committees, and the Socialist Communes. • Manages
multisectoral actions with the Social Missions, State Institutions, and community projects
focused on Good Living and Supreme Social Happiness. • The Basic Health Teams carry out their
functions according to 4 specific areas: Assistance, Teaching, Management, and Information System in
Health. 61 Guiding Principles for the Management of the Community Care Network in the Area of Integral Health
Community
4.3. ESTABLISHMENTS OF THE COMMUNITY HEALTH CARE NETWORK THAT OPERATE IN THE AREAS OF
COMMUNITY INTEGRAL HEALTH (ASIC) Resolution No. 400 that establishes the Classification of the
establishments that make up the SPNS, at the first level of medical care, published in the Official Gazette
No. 40.723, dated August 13, 2015, explicitly describes the criteria for classification of
the services within the RACS, namely: 1. Popular clinics type 1 (C.P. T.1) 2. Popular clinics
tipo 2 (C.P. T.2) 3. Consultorios Populares tipo 3 (C.P. T.3) 4. Consultorios Odontológicos Populares (C.O.P) 5.
Popular Optics (O.P) 6. Comprehensive Diagnosis Centers (C.D.I) 7. Comprehensive Rehabilitation Rooms (S.R.I) Their
geographical and population organization is referenced by the Community Comprehensive Health Areas (ASIC).
4.3.1. Popular Clinics The Popular Clinic (CP) is the establishment where the work of the EBS is
project to the community. CP and community constitute the teaching-assistive scenario for training of
human talent in the SPNS, including Community Integral Physicians (MIC), specialists in
Comprehensive General Medicine (CGM), Community Integral Nurses and other training programs. The
CP is attached to the ASIC and is part of the Comprehensive Health Care Center (NAIS). From the CP, services are provided.
comprehensive and intercultural health services by individual and collective life cycles through
promotion, prevention, restitution, and rehabilitation for the health of 100% of the assigned population. There
They resolve the Guiding Principles for the Management of the Community Care Network in the Health Area.
Community Integral 62 health problems identified with the active and leading participation of
organized community in Health Committees. Its fundamental activity is the process of dispensing.
where integrated community work (TCI) is included for comprehensive care of the person, the family and the
community; as well as the development and execution of the Action Plan for the Health Situation Analysis by
means by which it provides solutions to problems.
4.3.1.1. Type 1 Popular Clinic (CPT1) Characteristics: • Serves a population of up to one thousand (1,000) people or
two hundred (200) families, within the social territories under their responsibility. • Provides services of
promotion of health, immunization, and disease prevention activities, as well as others
health actions duly protocolized by the Governing Body in Health. • They have a Promoter.
of Health duly certified by the Health Regulatory Entity, supervised by a physician.
person in charge of the nearest Type 2 Community Clinic.
4.3.1.2. Popular Clinic Type 2 (CPT2) Characteristics: • They have a population responsibility area between
1,000 and 2,500 people or 200 and 500 families, preferably 1,250 people or 250 families, within the
 social territories under its responsibility. • Provides health promotion services, immunization and
other disease prevention activities, attention 63 Guiding Principles for Management of the
Community Care Network in the Area of Comprehensive Community Health, general integral and community medical care.
person, family and community, basic nursing care and attention to the school, work, and environmental context
environmental. All health actions must be properly protocolized by the Regulatory Entity in
Health. • They have a Basic Health Group (GBS) made up of a doctor, a nurse, a
Health promoter certified by the Health Regulatory Authority.
4.3.1.3. Popular Clinic Type 3 (CPT3) Characteristics: • They have a population responsibility area of more
of 2,500 people and more than 500 families. •They offer the same services as a Type 2 Popular Clinic,
Is there a community dentistry unit or service and basic diagnostic means within the center or in
its area of influence. Within its organization, other entities may coexist, either temporarily or permanently.
community health care services depending on the needs and characteristics of the community.
They have one to three Basic Health Groups duly certified by the Health Regulatory Authority.
Depending on local health needs and the services and dimensions of the establishments,
another health personnel can be incorporated.
4.3.2. Popular Dental Clinics (COP) are basic health units that are part of the Area of
Community Integral Health (ASIC), located in the community, that takes on the responsibility of care.
comprehensive dental care for the assigned population. They can consist of one to ten chairs or units
Dental. Guiding Principles for the Management of the Community Care Network in the Health Area
Community Integral 64 Services can be located in a Comprehensive Diagnostic Center (CDI), Room
Comprehensive Rehabilitation (SRI), High Technology Center (CAT), Popular Clinic (CP), adapted premises,
family homes, state health institutions, military units, community houses, schools, premises
From Mayoralties and Governorships. Characteristics: • They serve a population of between 4 and 8
Popular Clinics Type 1 or 2; in case they are located within a Popular Clinic Type 3 or in their
area of influence, can only additionally cover up to 3 Popular Consultancies Type 1 or 2. • They offer
comprehensive outpatient oral health services free of charge to the general population and the community
school. They operate in network with the Comprehensive Dental Care Centers. • They are attended by a Group
Basic Oral Health (GBSB) composed of a Dentist and a technician in the area of oral health
for each dental chair. Depending on the needs of the population responsibility area,
other members may be included in the Basic Oral Health Group (GBSB).
4.3.3. Popular Optics (OP) They are basic health units that are part of the Comprehensive Health Area.
Community (ASIC), located in the community, which assumes the responsibility for comprehensive care to the
population with uncomplicated visual disorders. Characteristics: • They serve a corresponding population
at least five Community Integrated Health Areas (ASIC). • They offer comprehensive optical services and
free, timely, and tailored optometry services to the needs of the 65 Guidelines for the
Management of the Community Care Network in the Area of Comprehensive Community Health attended population and
They operate in network with the Specialized Ophthalmological Care Centers. • They are attended by a Group
Basic Visual Health (GBSV) composed of an Optometrist and a technician in cutting and mounting
optical lenses, supervised by an ophthalmologist from the Comprehensive Community Health Area (ASIC).
4.3.4. Comprehensive Diagnostic Centers (CDI) The Comprehensive Diagnostic Centers (CDI) are health institutions
that guarantee medical services, surgical procedures, and complementary studies 24 hours a day to
the population that requires emergency attention or referrals from the Popular Clinics of an ASIC in
first intention. They have a team of professionals and technicians in the health field who in a
integral ensure the quality of care and provide the necessary medicines and supplies with the
adequate technological equipment. Characteristics: • They provide comprehensive care to the population of the territory
social of the Community Integral Health Area (ASIC), which is under its responsibility. • They offer the services
Vital Support (Emergencies) 24 hours, Observation up to 72 hours, X-rays, Ultrasound, Endoscopy,
Ophthalmology, Intermediate Therapy, Nursing, and others that are part of the complementary network of
diagnosis and treatment for girls, boys, and adolescents; adults, pregnant women, and care for
low-risk births. • They have a Multidisciplinary Health Group (GMS), composed of:
Doctors, Specialists, Nurses, Ophthalmologist, Technicians, Pharmacist, Staff
Management and maintenance support. Depending on the Guiding Principles for Network Management
Community Attention in the Area of Comprehensive Community Health 66 local health needs and services
and dimensions of the establishments, other health personnel can be incorporated.
4.3.4.1. Services that operate in the Comprehensive Diagnostic Center (CDI) a) Population care services
Urgencies and Emergencies: Vital Support, Urgent Consultation, Dressings, Injections, Nebulization
Emergency and screening electrocardiogram, Observation Room, Intensive Care Unit and Care
Intermediates, Surgical Activity (Only for Surgical CDIs), General Surgery, Orthopedics and Traumatology,
Minor Ambulatory Surgery, Delivery Room (only the authorized ones), Neonatal Care and Units of
Pediatrics, according to the needs of the population. b) Diagnostic Services Clinical Laboratory,
 Ultrasound, X-rays, Endoscopy, Ultra Micro Analytical System (SUMA) laboratory (only the
enabled), Electrocardiography and others. c) Medical Consultations Ophthalmology, General Surgery, Traumatology
Orthopedics in Comprehensive Diagnostic Centers (CDI) surgical, Gynecology and pediatrics (in establishments
defined for this purpose). d) Support Services for Care Coordination Office, Reception and Room
Wait, Pharmacy and Pharmacy Warehouse, Sterilization Area and Statistics Department 67
Guidelines for the Management of the Community Care Network in the Area of Comprehensive Health
Community e) General Services and Assurance Electro medicine, Laundry, Kitchen - dining, Cleaning and
Cleaning, General Maintenance of infrastructure, gardening, electricity, drinking water and sewage,
Warehouses, Ambulance and/or medical transport and non-medical transport.
4.3.5. Comprehensive Rehabilitation Rooms (SRI) The Comprehensive Rehabilitation Rooms (SRI) are health establishments
that guarantee attention to people who require their referred services from different centers
assistance services close to your home. Characteristics: • They serve the population in the social territory of the Area
Community Integral Health (ASIC), which is under your responsibility. • They provide the following services:
physical medicine and medical rehabilitation including electrotherapy, thermotherapy, therapeutic gym, therapy
occupational, massage therapy, hydrotherapy, podiatry, natural and traditional medicine, psychoprophylaxis of
pregnancy and others according to sociocultural needs; speech therapy and logopedics. • They are attended by a
Multidisciplinary Health Group (GMS), in the area of comprehensive rehabilitation composed of a physician
physiatrist, licensed speech therapist or physician, licensed or higher technical professional in physical therapy, licensed or
higher technician in occupational therapy, graduate or higher technician in speech therapy,
graduate or higher technician in psychology, graduate or higher technician in social work,
Graduate or higher technical specialist in podiatry and others according to needs. Guiding Principles
for the Management of the Community Care Network in the Area of Comprehensive Community Health 68
4.3.5.1. Services that operate in the Comprehensive Rehabilitation Room (SRI): a) Services for population care
Physiatry consultation and complementary therapies. b) Therapeutic services Natural and Traditional Medicine
(MNT), Podología, Terapia Ocupacional, Gimnasio terapéutico, Calor Infrarrojo y Masaje, Electroterapia,
Magnetotherapy, Logophoniatrics, Hydrotherapy, Home rehabilitation, and Kinesiotherapy, others according to
the needs. c) Support Services for Attention Reception and Waiting Room General Services,
Cleaning, Hygiene, and Storage.