The role of priority programmes in the provision of health services in the state of Oaxaca, Mexico.

An assessment of the performance of five priority health programmes (basic sanitation, tuberculosis, vaccination, acute respiratory infections and acute diarrheal diseases) was carried out using ethnographic techniques in the region of La Cañada in the state of Oaxaca, Mexico. The region presents a large percentage of Indian and peasant population living in extreme poverty and health care is mainly provided by the Ministry of Health. Both characteristics of the population and the health services are used to analyze the performance of the programmes. With access to abundant resources, vaccination and diarrheal disease programmes have been highly successful in involving the population and achieving their operative targets. Consequently this capacity to concentrate resources results in a lack of resources for other programmes. Despite partial successes, all programmes face serious operational difficulties demonstrating, in turn, the lack of capacity of health services to respond to the specific demands of local populations. The information presented is relevant for the discussion of selective versus comprehensive PHC.

[Complementary health care models: a neglected component in the health care systems reform]. / Modelos complementarios de atención: un componente excluido en la reforma de los Sistemas de Salud.

Complementary health care models represent a neglected and scarcely studied area of the health services structure. Within them a myriad of medical therapies of various origins are included. Lately, their importance has grown by means of the increase in demand for such services, both in industrialized and developing countries. It is urgent to reinforce research in the area aiming at understanding the processes through which the population demands these services and the processes through which complementary practitioners are able to maintain their presence in a market environment where the forces of supply and demand are significant. The context created by the health services reform should be used to review the therapeutic value of these models, to promote its regulation, and to amplify the availability of therapeutic options for the population.

Cost of diseases in Brazil: breast cancer, enteritis, cardiac valve disease and bronchopneumonia.

The results from the need to develop methodologies for performing cost analysis in developing countries, principally in the region of Latin America, were studied. It, furthermore, serves to generate knowledge from an economic evaluation in order to support decision-making related to the organization of health systems, particularly in the efficient use of resources which are allocated for the provision of medical services. Two chronic diseases (breast cancer and cardiac valve disease) and two infections (enteritis and bronchopneumonia) were selected for the study. The results recommend the use of a valid methodology for economic cost analysis of any disease to be studied and the use of this information in the decision-making process.