La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores
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Publication Date: | 2000 |
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Format: | Article |
Language: | spa |
Source: | Cadernos de Saúde Pública |
Download full: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1357 |
Summary: | Economic policies are changing Latin American health programs, particularly promoting decentralization. Numerous difficulties thus arise for the control of endemic diseases, since such activities traditionally depend on vertical, and centralized structures. Theoretical arguments in favor of decentralization notwithstanding, no such tradition exists at the county level. The lack of program expertise at peripheral levels, intensive staff turnover, and even corruption are additional difficulties. Hence, the simple bureaucratic transfer of activities from the Federal to county level is often irresponsible. The loss of priority for control of endemic diseases in Latin America may mean the inexorable extinction of traditional control services. Malaria, dengue fever, and Chagas disease programs are examples of the loss of expertise and effectiveness in Latin America. A better strategy for responsible decentralization is required. In particular, a shared transition involving all governmental levels is desirable to effectively modernize programs. Maintenance of regional reference centers to ensure supervision, surveillance, and training is suggested. |
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La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectoresPrevención y ControlReforma SanitáriaDoença de ChagasEconomic policies are changing Latin American health programs, particularly promoting decentralization. Numerous difficulties thus arise for the control of endemic diseases, since such activities traditionally depend on vertical, and centralized structures. Theoretical arguments in favor of decentralization notwithstanding, no such tradition exists at the county level. The lack of program expertise at peripheral levels, intensive staff turnover, and even corruption are additional difficulties. Hence, the simple bureaucratic transfer of activities from the Federal to county level is often irresponsible. The loss of priority for control of endemic diseases in Latin America may mean the inexorable extinction of traditional control services. Malaria, dengue fever, and Chagas disease programs are examples of the loss of expertise and effectiveness in Latin America. A better strategy for responsible decentralization is required. In particular, a shared transition involving all governmental levels is desirable to effectively modernize programs. Maintenance of regional reference centers to ensure supervision, surveillance, and training is suggested.Con las nuevas macropolíticas mundiales, la salud en América Latina ha sufrido importante transición en direción a la decentralización, sin compatibilizar la salud pública con la lógica de las economías de mercado. Con esto, el control decentralizado de las enfermedades endémicas presenta dificultades políticas y operativas. Aunque la decentralización se justifica por los presupuestos teóricos, no hay tradición de este control en los niveles municipales, lo que dificulta la simple o burocrática transferencia de encargos para estos niveles. La falta de expertise, el turn-over político y la corrupción son dificultades adicionales, conllevando a una extinción de varias instituiciones y programas. La falta de efectividad en el enfrentamiento del dengue, de la malaria y de la enfermedad de Chagas son algunos ejemplos. Requierese una modernización con responsabilidad, con una transición compartida entre los niveles y garantizada por acciones continuadas. Sugierese mantener estructuras regionales para referencia, consolidación epidemiológica, normatización, capacitación y supervisión, incluso con reserva técnica para acciones finalísticas supletivas.Reports in Public HealthCadernos de Saúde Pública2000-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1357Reports in Public Health; Vol. 16 No. 6 (2000): Supplement 2Cadernos de Saúde Pública; v. 16 n. 6 (2000): Suplemento 21678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZspahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1357/2702https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1357/2703Schmunis, Gabriel A.Dias, João Carlos Pintoinfo:eu-repo/semantics/openAccess2024-03-06T15:26:23Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/1357Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:01:37.906340Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores |
title |
La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores |
spellingShingle |
La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores Schmunis, Gabriel A. Prevención y Control Reforma Sanitária Doença de Chagas |
title_short |
La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores |
title_full |
La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores |
title_fullStr |
La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores |
title_full_unstemmed |
La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores |
title_sort |
La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores |
author |
Schmunis, Gabriel A. |
author_facet |
Schmunis, Gabriel A. Dias, João Carlos Pinto |
author_role |
author |
author2 |
Dias, João Carlos Pinto |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Schmunis, Gabriel A. Dias, João Carlos Pinto |
dc.subject.por.fl_str_mv |
Prevención y Control Reforma Sanitária Doença de Chagas |
topic |
Prevención y Control Reforma Sanitária Doença de Chagas |
description |
Economic policies are changing Latin American health programs, particularly promoting decentralization. Numerous difficulties thus arise for the control of endemic diseases, since such activities traditionally depend on vertical, and centralized structures. Theoretical arguments in favor of decentralization notwithstanding, no such tradition exists at the county level. The lack of program expertise at peripheral levels, intensive staff turnover, and even corruption are additional difficulties. Hence, the simple bureaucratic transfer of activities from the Federal to county level is often irresponsible. The loss of priority for control of endemic diseases in Latin America may mean the inexorable extinction of traditional control services. Malaria, dengue fever, and Chagas disease programs are examples of the loss of expertise and effectiveness in Latin America. A better strategy for responsible decentralization is required. In particular, a shared transition involving all governmental levels is desirable to effectively modernize programs. Maintenance of regional reference centers to ensure supervision, surveillance, and training is suggested. |
publishDate |
2000 |
dc.date.none.fl_str_mv |
2000-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1357 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1357 |
dc.language.iso.fl_str_mv |
spa |
language |
spa |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1357/2702 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1357/2703 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 16 No. 6 (2000): Supplement 2 Cadernos de Saúde Pública; v. 16 n. 6 (2000): Suplemento 2 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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