Determinantes sociopolíticos de las políticas internacionales de salud / Sociopolitical determinants of international health policies
Rev. peru. med. exp. salud publica
; 30(2): 288-298, abr.-jun. 2013.
Article
in Spanish
| LILACS, LIPECS
| ID: lil-681017
Responsible library:
BR1.1
RESUMEN
Desde hace décadas, dos lógicas opuestas dominan el debate político de la salud el enfoque de atención integral de salud, con la Declaración de Alma Ata de 1978 como piedra angular, y la lógica de la competencia privada, haciendo hincapié en el papel del sector privado. Presentamos este debate y su influencia en las políticas internacionales de salud en el contexto de las relaciones de poder económicas y sociopolíticas globales. Se ilustra el enfoque neoliberal de la reforma del sector salud de Chile en la década de 1980 y de la reforma colombiana desde 1993. La lógica pública integral se ilustra a través de los modelos de seguridad social en Costa Rica y en Brasil, y a través de los sistemas nacionales de salud pública en Cuba vigentes desde 1959, y en Nicaragua, durante la década de 1980. Estas experiencias ponen de relieve que los sistemas de salud no gravitan naturalmente hacia una mayor equidad y eficiencia, sino que requieren de decisiones políticas explícitas.
ABSTRACT
For decades, two opposing logics dominate the health policy debate A comprehensive health care approach, with the 1978 Alma Ata Declaration as its cornerstone, and private competition logic, emphasizing the role of the private sector. We present this debate and its influence on international health policies in the context of changing global economic and sociopolitical power relations. The neoliberal approach is illustrated with Chile’s health sector reform in the 1980s and the Colombian reform since 1993. The comprehensive ‘public logic’ is shown through the social insurance models in Costa Rica and in Brazil, and through the national public health systems in Cuba since 1959, and in Nicaragua -during the 1980s. These experiences emphasize that health (care) systems do not naturally gravitate towards greater fairness and efficiency, but that they require deliberate policy decisions.
Full text:
Available
Collection:
National databases
/
Peru
Health context:
SDG3 - Target 3.8 Achieve universal access to health
/
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
Health problem:
Governance Arrangements
/
Multisectoral Coordination
/
Goal 11: Inequalities and inequities in health
/
Target 3.8 Achieve universal access to health
Database:
LILACS
/
LIPECS
Main subject:
Health Policy
Type of study:
Prognostic study
Aspects:
Equity and inequality
Limits:
Humans
Language:
Spanish
Journal:
Rev. peru. med. exp. salud publica
Year:
2013
Document type:
Article
Institution/Affiliation country:
General Epidemiology and Disease Control Unit/BE