United States- Mexico Border Health Commission

Transcription

1 United States- Mexico Border Health Commission

2 United States Mexico Border Health Commission The USMBHC is a bi-national organization created in July 2000 with the signing of an agreement between the governments of Mexico and the United States with the purpose of identifying and evaluating health problems affecting the border population, as well facilitating bi-national actions for the attention of the same through the exchange of resources and the sum of talents between both countries. Mission Provide international leadership to optimize health and quality of life along the United States - México border. Vision To be a leading binational border health agency that strengthens work with civil society agencies involved in improving the health of the population on both sides of the border

3 Functions Diagnose public health needs in the United States-Mexico border area, as well as conduct or support research or studies designed to identify and monitor health problems. Provide technical and administrative support to assist the efforts of public and private nonprofit entities to prevent and resolve health problems. Carry out or support actions of health promotion and disease prevention in the United States- Mexico border area. Accomplish or support the establishment of a coordinated and comprehensive system, using advanced technologies, to the extent possible, to gather health-related information and monitor health problems in the United States-Mexico border region. Consult and collaborate -where appropriate- with non-governmental organizations and other institutions related to public health activities in the United States-Mexico border area

4 Organizational Structure The USMBHC is made up of the two federal Secretaries of Health (Commissioned), the Secretaries of Health of the 10 border states and their respective Delegates; and 14 Members of the Community. In the Mexico Section, the Border Health Commission is headed by the Executive Secretary, there is a Coordinator for each Outreach Office as well as logistical and administrative support personnel. Members State Arizona California New Mexico Texas State Health Officers (SHOs) Cara M. Christ Karen Smith Lynn Gallagher John Hellerstedt United States Section Special Government Employees (SGEs) Emma Torres -- Horacio A. Rodiles Lawrence Kline Bruce San Filippo Susan Forster-Cox Manuel de la Rosa -- Delegates April Fernandez State Baja California State Health Officers (SHOs) México Section Community Members Delegates Guillermo Trejo Dozal Alfonso Valenzuela Héctor Zepeda Robert Guerrero Coahuila Jorge Verastegui Jaime Pineda Pineda Martha Romero Freida Adams Chihuahua Ernesto Ávila Valdez Beatriz Díaz -- Ronald J. Dutton Sonora Gilberto Ungsón Beltrán Filiberto Perez D. Nuevo León Tamaulipas Manuel Enrique de la O Cavazos Gloria de Jesús Molina Gamboa Dora Elia Cortes María de la Luz Vázquez Jaime León Varela Abelardo García

5 Committees Decision-making is centered on 2 committees: Planning Programming Outreach Offices, Mexico Section Tijuana, Baja California Hermosillo, Sonora Ciudad Juarez, Chihuahua Piedras Negras, Coahuila Monterrey, Nuevo León Ciudad Victoria, Tamaulipas Outreach Offices, United States Section San Diego, California Tucson, Arizona Las Cruces, New México Austin, Texas

6 Healthy Border 2020 A binational initiative of the U.S.-Mexico Border Health Commission aimed at promoting health and disease prevention in the border region. It focuses on public health problems that prevail in the populations that share their lives in this region. It addresses five public health problems that are bi-nationally relevant and whose goals and objectives are both measurable and evidence-based. Priorities Health Problems Cross-cutting principles o Obesity* o Diabetes Chronic and Degenerative Diseases o Heart Disease o Asthma o Cancer o Tuberculosis* o HIV/AIDS/STI* Infectious Diseases o Acute Respiratory Infections o Acute Diarrheal Disease o Access to health care o Vaccine Preventable Diseases o Research o Teen Pregnancy* o Strategic Planning Maternal & Child Health o Neural Tube Defects o Maternal Mortality* o Increase emergency care services o Disability Accidents o Mortality o Mental Health o Addictions* Mental Health Disorders o Depression o Violence (all types) *Definition of binational priorities to be developed during the period

7 Principal Initiatives México Section Initiatives Collaborative Agreement Projects S T R A T E G I C P R O J E C T S Health Promotion and Disease Prevention Research and Training Dissemination, collaboration and correlation

8 AA AA AA Collaborative Agreement Projects AA AA U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

9 U.S.-Mexico Border Binational Health Month Formerly know as Border Binational Health Week. Initiated in October 2004 with the purpose of celebrating and promoting healthy lifestyles through various activities aimed at the general population. Promotes numerous partnerships in collaboration with public and private organizations, academic institutes and NGOs. Focuses on health issues such as prevention of infectious diseases, chronic diseases, domestic violence, environmental health, adolescent health, women's health; as well as support training through workshops, forums and seminars through inter-agency collaboration. Web Page: U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

10 U.S.-Mexico Border Binational Health Month Mexico Section Results BINATIONAL HEALTH MONTH- OCTOBER 2016 ACTIVITIES BENEFITED POPULATION Chronic Degenerative Disease Prevention 9,698 Campaign, USMBHC Offices, Mexico Section Binational Border Conference on Substance Abuse 180 Prevention, Chihuahua 5 Health Fairs in municipal primary schools, Baja 1,250 California Mental Health Day, Tamaulipas 250 Labyrinth of Life, Chihuahua 250 Promotoras Binational Conference, Chihuahua 160 Infectious Diseases Forum, Chihuahua 45 Advances in México, Sonora 34 Intervention Guides mhgap Workshop, 35 Chihuahua Breast Cancer Month, Baja California Cross the Border! Baja California 158 Community Health Update, Chihuahua 30 Campaign for Breast Cancer Timely Detection, Baja 100 California I invite you for tea - let's talk about cancer, 300 Chihuahua Breast Cancer, Tamaulipas 1,228 Live! With Breast Cancer Walkathon th Annual Binational Walkathon, World Hug, 400 Chihuahua Total 14,847 U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

11 U.S.-Mexico Border Binational Health Month Mexico Section Results DEGENERATIVE CHRONIC DISEASE PREVENTION CAMPAIGN Detection Measurements taken Postive/High Values Prevalence (percentage) Measurement of blood glucose 8,795 4, % Overweight and obesity 8,935 6, % Blood pressure 9,929 2, % Total modules : 89 Population served : 9,698 U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

12 Leaders across Border Leadership D evelopment Program From 2010 to 2016 this leadership program was held for health professionals to improve leadership skills and health diplomacy as well as expand professional networks and improve understanding of binational public health resources, challenges and systems. In April 2017, an Advanced Leadership Program was held in Scottsdale Arizona where more than 110 graduates were invited to participate. The training consisted of a training group led by the Subdirector of Management of Health Training of the Ministry of Health of Mexico and the Director and consultant from Keisen Consultores. The focus group, led by the Associate Director of the Pima Prevention Partnership, was part of the program evaluation. In this course, 30 leaders were trained in border health, 15 of which hailed from Mexico and 15 from the United States. Web Page: U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

13 USMBHC Annual Meeting October 25 26, 2016 Tijuana, Baja California Participation from members, delegates, representatives and coordinators. U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

14 USMBHC Annual Meeting Definition of binational priorities to be developed during the period of Binational Priorities 2017 Obesity States will join efforts to align their programs and actions to address this epidemic by promoting a healthy lifestyle. Addictions and Mental Health With special attention to substance abuse, specifically opioids and alcohol, the latter, though a socially and legally acceptable substance, is the cause of many diseases and accidents. Infectious Diseases Vector derivatives (such as zika, dengue and chikungunya), as well as HIV / AIDS and Tuberculosis. The border states agreed to improve preparedness and contingency, as well as the response to these emerging, seasonal and unforeseen threats that threaten the health of the border population. Reproductive Health Through the USMBHC, the border states will focus on unifying their efforts to address maternal mortality and the prevention of pregnancy in adolescents. U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

15 Border Health Consortium of the Californias Project sponsored by the U.S.- México Border Health Commission Multidisciplinary group, formed by health professionals from Baja California and California, created to discuss border health issues and disseminate relevant information that affects the population of the region. Working groups: Obesity, Mental Health, HIV and Tuberculosis. Binational Border Health Meeting Tijuana, Baja California November 9, 2016 Objective: To discuss the sources of funding for the development of the work activities of the research groups. 50 attendees Binational Border Health Meeting Chula Vista, California May 18, 2017 Objective: To discuss the impact of recent socioeconomic and political changes on border health 60 attendees U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

16 Border Health Consortium of the Californias A logo was designed A video and a web page were developed: Progress of the Working Groups HIV/AIDS: o Binational telephone directory services o Tour and Integral HIV/TB Pacient Treatment symposium Obesity: o Implementation of 5210 program in elementary schools of Tecate, B. C. o 2nd Binacional Child Obesity Symposium Mental health: o Binational Week on Mental Health and Migration Tuberculosis: o Collaboration proposal for the care and accommodation of patients with tuberculosis in Baja California. P R O Y E C T O S D E L A C U E R D O C O L A B O R A T I V O M E X I C O - E S T A D O S U N I D O S

17 Binational epidemiological response exercise in the Paso del Norte Region May 9 and 12, 2017 El Paso, Texas Directed to those responsible for the epidemiological surveillance of Las Cruces, New Mexico; El Paso, Texas and Ciudad Juarez, Chihuahua Objective: Update the respective communication plans based on the document Operational Protocol of Binational Communication and Coordination of Notification of Diseases and Outbreaks of the United States - Mexico" U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

18 Binational Forum: Emerging vector - borne diseases along the US-Mexico border El Paso, Texas June 13-14, 2017 Objectives: To review and improve communication and cooperation mechanisms to detect, prevent and control outbreaks of mosquito-borne infectious diseases along both sides of the border. High-level technical meeting that addressed issues of surveillance, vector control and laboratories. Once the meeting report is finalized and its recommendations complete, concrete actions can be prioritized to work in a binational way. U N I T E D S T A T E S - M E X I C O C O L L A B O R A T I V E A G R E E M E N T P R O J E C T S

19 AA AA AA Mexico Section Initiatives AA AA

20 Modules of Integral Attention for the Health of the Migrant Objective: Contribute to the protection of the health of the migrant, promoting actions of health promotion and disease prevention at the time of repatriation and seeking to provide comprehensive health care. Currently there are modules in Tijuana, Baja California; Matamoros, Nuevo Laredo and Reynosa, Tamaulipas. Tijuana, Baja California January 1 June 30, 2017 Matamoros, Tamaulipas January 1 June 30, 2017 Nuevo Laredo, Tamaulipas January 1 June 30, 2017 Reynosa, Tamaulipas May 1 June 30, 2017 POPULATION SERVED 780 Orientations 2,730 Detections 1,061 Medical Consultations 455 Seguro Popular Affiliates 7,200 References to health services 10 In-crisis psychological 18 interventions TOTAL SERVICES 11,474 OFFERRED POPULATION SERVED 575 Orientations 2,013 Detections 2,180 Medical Consultations 114 In-crisis psychological interventions TOTAL SERVICES OFFERRED 119 4,426 POPULATION SERVED 2,374 Orientations 8,309 Detections 1,595 Medical Consultations 561 TOTAL SERVICES OFFERRED 10,465 POPULATION SERVED 425 Orientations 1,488 Detections 19 Medical Consultations 26 TOTAL SERVICES OFFERRED 1,533 Modules are set to begin September 1, 2017 in Nogales, Sonora. Web Page:

21 Modules of Integral Attention for the Health of the Migrant Crisis triggers in migrants, identified in the population served in the Modules of Attention to the Health of the Repatriated Migrant Family Separation Deportation Sexual Abuse Substance abuse Deprivation of Liberty Lack of access to health services

22 Love Your Heart Binational Campaign In 2015, the San Diego County Health and Human Services Agency partnered with the Mexico Section of the Border Health Commission to coordinate the first Binational Campaign. The Campaign aims to prevent cardiovascular diseases through the timely detection of hypertension and some comorbidities. Blood pressure screenings are offered free of charge in modules located throughout San Diego County, and in the Mexican border states of Baja California, Sonora, Chihuahua, Coahuila, Nuevo Leon, and Tamaulipas. As of 2017, 14 Ventanillas de Salud of the consular network of Mexico in the United States were open.

23 Love Your Heart Binational Campaign Results of the Love Your Heart Campaign in Mexico, ,098 13,700 2, Modules: Modules: Modules: 186

24 Love Your Heart Binational Campaign 14,000 12,000 10,000 8,000 6,000 Number of Screenings* by Blood Pressure Stage Reported for Mexico 11,871 Love Your Heart, ,934 Hypertension Stage % Percent of Screenings* by Blood Pressure Stage Reported for Mexico, Love Your Heart, 2017 Hypertension Stage 2 3.1% Hypertensive Urgency 0.8% Hypertensive 4,000 2,000 - Normal Pre Hypertension 3,096 Hypertension Stage Hypertension Stage Hypertensive Urgency Hypertensive Emergency Pre Hypertension 30.4% Normal 52.0% The detections were carried out in the six border states of northern Mexico and in 14 Ventanillas de Salud located in the four border states of the southern United States. Through May 2, 2017, 22,818 blood pressure shots have been captured in the Love Your Heart App. High blood pressure was detected in 1 in 2 participants participants had elevated blood pressure requiring urgent and emergency care who were referred to a physician.

25 Love Your Heart Binational Campaign Through collaboration, health education materials and lessons learned are shared increasing the reach of the Love Your Heart Campaign to improve the health of all residents of the binational region. This project will be part of the Collaborative Agreement Initiative approved at the San Diego Committee meeting last January.

26 Prevention of Chronic - degenerative Diseases P r o g r a m Program aimed at improving healthy habits in children. In may 2017 began the management of the implementation in 16 primary and secondary schools, which each will be certified as a healthy school. Tecate, Baja California. Participating Institutions: - Community Health Improvement Partners Agency - California Department of Public Health - Jurisdicción 2, ISESALUD - USMBHC Outreach Office, Baja California Starting September 2017, this project will be part of the Collaborative Agreement Initiative approved at the San Diego Committee meeting last January.

27 Prevention of Chronic - degenerative Diseases Promote the health benefits of physical activity and good eating habits in the population for the prevention of chronic noncommunicable diseases. World Day of Physical Activity April 21-22, 2017 Ciudad Juarez, Chihuahua 500 attendees First Yoga California-Baja California Event June 25, 2017 Tijuana, Baja California 75 attendees

28 Prevention of Chronic - degenerative Diseases S y m p o s i u m o n C h i l d h o o d O b e s i t y May 30, 2017 San Diego, California Objective: To present an overview of childhood obesity in the California-Baja California border region, presenting successful projects, alliances and practices. Participants: 80 representatives from health institutes, doctors and nutritionists from California and Baja California. Impact: Binational partnership between the US-Mexico Border Health Commission, the California Department of Public Health, and the San Diego County Department of Health and Human Services.

29 Campaign For a Border Free of Violence against Women Held in March 2017 by the US-Mexico Border Health Commission, the state of Sonora Secretariat of Public Health, the Agua Prieta-Cochise County Binational Health Council, civil society organizations and socially responsible companies in the border city Of Agua Prieta, Sonora. Activities 1. Campaign of dissemination through the distribution of diptychs in promotional stands. 2. Presentation of the theater work Sin mi No soy Nada held at the municipal auditorium. 3. Promotional dissemination by local means of communication. Impact Distribution of 3k diptychs 500 women attended the play Sensitization of the population on both sides of the border

30 Medical work day World Health Day April 7, 2017 Rosarito, Baja California Objective: commemorate the anniversary of the founding of the World Health Organization (WHO) Aimed at high school students Theme: Depression

31 Tuberculosis Activities Campaign: X Tijuana Curada de TB-VIH Objective: to raise public awareness about the high incidence of Tuberculosis in the region. Successful companies were convened in the city seeking to associate an image of prosperity and achievement toward the topic of a cure for tuberculosis. Health Fair: Held on March 24, 2017 to align with World Tuberculosis Day. 250 participants.

32 Tuberculosis Activities 1 st Binational Symposium on Tuberculosis California-Baja California March 22 and 24, 2017 Mexicali and Tijuana, Baja California Objective: to develop competencies in health personnel for the prevention, diagnosis and treatment of tuberculosis. More than 450 participants Annual Binational Tuberculosis Symposium March 29, 2017 Yuma, Arizona More tan 100 people participated

33 Border Binational Health Network (BBHN) An association of agents who are interested in the health of the population at the border, made up of experts from the 10 border states of Mexico and the United States. Objective Propose and evaluate guidelines, attention to health problems It is composed of researchers and academics (51), students (47) and non-academic Members (7) belonging to the 10 states that make up the US-Mexico border region. Contribute to the generation, scientific dissemination and transfer of knowledge Contribute to the development and training of human resources It is part of the Thematic Networks funded by CONACYT (2015). Promote collaboration Integrate capabilities Promote cross-cutting principles

34 Border Binational Health Network (BBHN) Six universities Three Conacyt Research Centers Border Health Commission BAJA CALIFORNIA CHIHUAHUA COAHUILA NUEVO LEÓN TAMAULIPAS SONORA Seven United States universities CALIFORNIA ARIZONA NEW MEXICO TEXAS

35 Border Binational Health Network (BBHN) Main achievements reached by being constituted in Network Establish the basis for the integration of the capacities of individuals and public and private institutions interested in border health. It has favored the articulation of the actions of its members through the use of information technologies. Dissemination of knowledge through a special edition article on border health in a specialized journal. Strengthening of human resources through the programming of technical visits, the incorporation of undergraduate and graduate students, a training program for members of the network, and the design of a masters program in public health focused on border health.

36 Border Binational Health Network (BBHN) The relevance of the results obtained to date It has been possible to open a space in which researchers interact on both sides of the border region, which allows for the exchange of ideas and strengthens academic cooperation between them; it has favored the integration of multiple individual efforts of academics, organizations and institutions that seek to have a favorable impact on the health of the region; It has contributed to the definition of the concept of border health through multidisciplinary and interinstitutional cooperation not only for the development of academic work, but also for its dissemination in relation to the topic of the Network. The creation of capacity building and human resource training opportunities that include researchers and students from the ten border states has been potentiate of the connections that can be had across the border region.

37 Mental Health Activities Training of the Program for Reducing Gaps in Mental Health (mhgap Guide) Objective: To strengthen mental health skills through basic training for the detection and referral of patients with mental health problems, directed at community physicians and promoters for the implementation of the mental health mhgap guide. CITY AND STATE OF TRAINING YEAR TYPE OF TRAINED PERSONNEL MD COMMUNITY PROMOTERS NUMBER OF TRAINED PERSONNEL Tijuana, Baja California 2015 X 64 Ciudad Juárez, Chihuahua 2016 X 100 Nogales, Sonora 2016 X 35 Agua Prieta, Sonora 2016 X 37 Matamoros, Tamaulipas 2016 X 37 Nuevo Laredo, Tamaulipas 2016 X 79 Nuevo Casas Grandes, Chihuahua 2016 X 33 Reynosa, Tamaulipas 2017 X 23 Tijuana, Baja California 2017 X 24 Miguel Alemán, Tamaulipas 2017 X 12 San Luis Río Colorado, Sonora 2017 X 47 Hermosillo, Sonora 2017 X 25 Reynosa, Tamaulipas 2017 X 35 Tijuana, Baja California 2017 X 22 TOTAL TRAINED PERSONNEL 573 Last Updated: Agosto, 2017

38 Mental Health Activities Project: Improvement plan for mental health care and reduction of stigma associated with mental health illnesses in Ciudad Juarez. Objectives: Provide training on WHO's "Program of Action to Overcome Health Gaps (mhgap)" (2008), and its corresponding "mhgap Intervention Guide". Offer trainings on Mental Health First Aid. Create a Mental Health Network. Integration of the Network of Organizations dedicated to the Care and Prevention of Mental, Neurological and Substance Abuse Disorders (ROTMENAS, as it is known in Spanish), in March Integrated by: - Civil society organizations - State Commission on Human Rights - Autonomous University of Ciudad Juarez - U.S.-Mexico Border Health Commission During the period of April-August, trainings have been carried out to doctors, nurses, psychologists and health promoters.

39 Mental Health Activities Presentation of the Book of Human Rights for Drug Users Ciudad Juárez June 30, 2017 Aimed at the media, decision makers and the community in general. Training on the mhgap Guide to Mobile Health Care Units (Together for Health Project) in Phoenix and Tucson, Arizona Videoconference May 30, 2017 Six health professionals were trained

40 Training on Vector - t ransmitted D i seases Binational Meeting on Migration and Vector-borne diseases Hermosillo, Sonora May 17, 2017 Objective: To address issues of mutual interest between states of the northern border of Mexico and the United States on issues of migrant health and vector-borne diseases. Emergency workshop on vector-borne diseases Tijuana, Baja California June 27, 2017 Objective: To train health promoters and community workers in California and Baja California on the problem of this issue in the region.

41 Mexico-Chile Binational Meeting: Finding answers to migratory dynamics Tijuana, Baja California February 27 28, de 2017 Objective: To announce and improve the governmental and social response to the migration and health dynamics at the Tijuana-San Diego border. Within the framework of the Mexico-Chile Technical Cooperation Project for Strengthening Public Health Policies for International Migrants. Participating Institutions: - Chile Ministry of Health - National Institute of Public Health - U.S.-Mexico Border Health Commission- General Directorate of International Relations/Ministry of Health - National Institute of Migration, Tijuana - National Commission for Human Rights-Tijuana Headquarters - Authorities of the Sanitary Jurisdiction of Tijuana, Baja California - Municipal Coordination of the Migration Network - The Colegio de la Frontera Norte A.C.

42 A l i gnment of the V entanillas de Salud-Frontera w i t h the BHC Strategic Planning and Reflection Workshop 2016 March 8 10, 2016 Tijuana, Baja California, México Activities aligned with the Healthy Border 2020 Initiative: Incorporation of the VDSF with the Love your Heart Campaign. U.S.-Mexico Border Health Month (October). Chronic-Degenerative Diseases Campaign

43 A l i gnment of the V entanillas de Salud-Frontera w i t h the BHC S t r a t e g i c M a p o f t h e V D S - F WORKING IN COLLABORATION WITH BINATIONAL INSTITUTIONS, IMPROVING ACCESS TO PRIMARY AND HEALTH PREVENTIVE SERVICES AND PROMOTING A PREVENTIVE CULTURE FOR MEXICANS WHO LIVE IN THE US ALONG THE BORDER, ACHIEVING ITS PHYSICAL AND MENTAL WELFARE A B C D E ALIGN STRATEGIES TO HB2020 STANDARDIZING PROCESSES AND SERVICES PROMOTE CONTACT WITH TARGET POPULATION WORK UNDER THE 4C'S (COMMUNICATE, COOPERATE, COORDINATE, COLLABORATE) MANAGE RESOURCES and BE "SUSTAINABLE" 1 Implement the Ventanilla de Salud en tu Corazón Standardize services, formats and basic processes / Operational manual Improve communication with community, dissemination of VDSF services Improve the Network of information and dissemination of contacts and events of the VDSF Search for and manage financial resources 2 Implementing the Nutrition Club Certify Promotoras Articulate USA-Mexico Medical Tourism Document and disseminate good practices Manage in-kind resources 3 Informa on and solve ven y te cuento Articulate the Seguro Popular F G MEASURE, RENDER ACCOUNTS, MONITOR. EVALUATE RESULTS STAFF DEVELOPMENT

44 Together for H ealth Project Objective: provide education, information and preventive health services to vulnerable populations in remote and difficult access areas where there is a high concentration of Mexicans..

45 Together for H ealth Project PREDIAGNOSTIC EXAMINATIONS HIV, glucose measurement, blood pressure, cholesterol, body mass index, skin cancer, among others. VACCINES Services Offerred In conjunction with local clinics and pharmacies, influenza vaccines are provided, in addition to others. EDUCATIONAL ACTIVITIES Health talks on key issues of diseases prevalent in the area. Participation in local health fairs and special events. TESTIMONIALS Interviews where success stories are captured, as well as testimonies about access to health services and impact of services.

46 Together for H ealth Project Results through July 2017 Total users 37,611 Total of services provided 196,631

47 Project: Together for H ealth Prevalence of the main causes of morbidity. April February 2017 Total de usuarios Total de servicios brindados Detection Guidance / Counseling Measurements taken Positives / high values Prevalence (percentage) Measurement of blood glucose 8,400 6,466 1, Overweight and obesity 7,646(2) 5,824 4, Blood pressure 8,278 8,619 2, Cholesterol 7,646(2) 2, HIV/AIDS 4463(3) 118 6(1) 5.08 (1) It includes those who refused to give their result (2) Includes counseling and guidance on obesity and cholesterol (3) Includes HIV / AIDS and other sexually transmitted infections Subject Mental health counseling /counseling through mobile units Orientation / Counseling With previous diagnosis of depression /anxiety Yes No In treatment Refused to answer Mental Health Source: Registration System for Together for Health from February 2016-February 2017 Did not specify I N I C I A T I V A S D E L A S E C C I O N M E X I C O

48 Disease prevention and health promotion Achievements of the USMBHC It has benefited the community in the development of health promotion and disease prevention activities with special attention in vulnerable populations (Meta Salud project, as part of the Healthy Communities 2020 project; Modules of Integral Health Care for Migrants). It has contributed to the health services of the states, municipalities and counties of the border to support in the prevention and promotion of the health of the populations with greater needs (Mexico-United States Border Health Month). With these activities, a great impact was achieved among different sectors of society, being addressed to various sectors and population groups such as students, seniors, health promoters, etc. Of these activities, the first Campaign for the Prevention of Chronic Degenerative Diseases was carried out in the six states of Mexico's northern border with the objective of raising awareness among the population in the prevention of chronic-degenerative diseases, through timely detection of systemic blood pressure, capillary glycemia, weight, height, muscle mass index and abdominal circumference. In total, 89 modules were installed, attended to about 10 thousand people and almost 28 thousand detections were carried out. Through the Love your Heart Campaign, in 2017 coverage was expanded with the installation of more modules compared to 2016, increasing the number of detections along the northern border of Mexico, including Mexicans living in the border states Of the southern United States. Another important achievement that stands out is the collaboration and alliance with institutions of the health sector (IMSS, ISSSTE and State Secretariats of Health) and Ventanillas de Salud. On a permanent basis, the Border Health Commission participates and supports both the health sector and civil society organizations to increase visibility and awareness in the prevention of the major diseases that occur along the northern border of Mexico and the South of the United States through alliances with their counterparts

49 Achievements of the USMBHC Research and Training It has contributed to strengthening of human resources in the region in relation to collaboration and binational work (Leaders across Borders, courses, training of health personnel [doctors, nurses, social workers, psychologists], promoters, municipal police of Tijuana, among others). It has contributed to health services of the states in the development of personnel capacities on specific and priority issues (mental health, HIV/AIDS, breast cancer, substance abuse and addiction, obesity, vector-borne diseases). It has contributed to the strengthening of ties between researchers and academic institutions in the region interested in border health through the formalization of their collaborative work. It has contributed to the dissemination of knowledge through a special edition article on border health in a specialized journal and to human resources through the programming of technical visits, the incorporation of undergraduate and graduate students, a training program for members of the network, and the design of a masters program in public health focused on border health. (Binational Thematic Network on Border Health)

50 Achievements of the USMBHC Dissemination, collaboration and connections It has succeeded in consolidating the dialogue and binational discussion to define the strategic priorities of the USMBHC (Annual Meeting and Meeting of Committees), taking as a frame of reference the priorities established in Healthy Border Support was provided to the Baja California Health Services to follow up on the actions established in the strategic plan for the prevention of tuberculosis developed in 2015 by the Mexico Section of the Border Health Commission, thus strengthening interagency collaboration. Has favored binational engagement and collaboration for the expansion of successful initiatives on both sides of the border, for example by participating in the San Diego County, California 'Love your Heart' hypertension prevention campaign. In this campaign, in 2016, five states of the northern border of Mexico as well as the Ventanilla de Salud of Eagle Pass participated, while in 2017, 6 border states of northern Mexico, the state of Arizona and all 14 Ventanillas de Salud located at the border participated