La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización
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Data de Publicação: | 2002 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | spa |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1870 |
Resumo: | This paper analyzes the effects of health reform in Colombia on public health programs at the local level, particularly the Expanded Program of Immunization (EPI) and the tuberculosis control program. The research was developed in three health districts in two States by analysis of documents, direct observation, and longitudinal follow-up of the transition process. The health districts were unprepared for the change, resulting in insufficient technical skills among staff as well as lack of awareness of important elements in the new system, associated with a reduction in immunization coverage and tuberculosis case detection. Structural problems in the new system included loss of immunization opportunities and lack of examination of tuberculosis contacts. The potentialities of the new system were the local development of a new organizational structure and the improvement of the information system; a limiting factor was exposure of the health system to local political interests. The general conclusion is that the transition period takes far longer than anticipated and requires a much greater information flow to both the local level and the community. There are transitory but also structural maladjustments that require a political response. |
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La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunizaciónReforma del Sector SaludTuberculosisProgramas de InmunizaciónThis paper analyzes the effects of health reform in Colombia on public health programs at the local level, particularly the Expanded Program of Immunization (EPI) and the tuberculosis control program. The research was developed in three health districts in two States by analysis of documents, direct observation, and longitudinal follow-up of the transition process. The health districts were unprepared for the change, resulting in insufficient technical skills among staff as well as lack of awareness of important elements in the new system, associated with a reduction in immunization coverage and tuberculosis case detection. Structural problems in the new system included loss of immunization opportunities and lack of examination of tuberculosis contacts. The potentialities of the new system were the local development of a new organizational structure and the improvement of the information system; a limiting factor was exposure of the health system to local political interests. The general conclusion is that the transition period takes far longer than anticipated and requires a much greater information flow to both the local level and the community. There are transitory but also structural maladjustments that require a political response.Este trabajo analiza las consecuencias de la reforma de salud en Colombia para los programas de salud pública a nivel local, particularmente el programa ampliado de inmunizaciones (PAI) y de control de tuberculosis. La investigación se desarrolló en tres municipios de dos departamentos, utilizando como técnicas de recolección de información: análisis de documentos, entrevistas semi-abiertas con funcionarios del sistema, observaciones directas y el acompañamiento del proceso de cambio. Los resultados fueron: no hay preparación en los municipios para el cambio, llevando al desconocimento de elementos importantes en el nuevo sistema, lo que se asocia con la reducción de coberturas del PAI y con la disminución de la detección de casos de tuberculosis. Problemas estructurales del nuevo sistema fueron: oportunidades perdidas de inmunización y de análisis de contacto de pacientes con tuberculosis. Las potenciales del nuevo sistema fueron el desarrollo de una nueva estructura organizacional municipal y el mejoramiento del sistema de información y la debilidad de ser expuesto a intereses políticos del nivel local. Se concluye que el período de transición del sistema es mucho más largo de lo previsto y requiere un mayor flujo de información hacia el nivel municipal y comunitario. Hay desajustes pasajeros y desajustes estructurales los cuales requieren respuestas políticas.Reports in Public HealthCadernos de Saúde Pública2002-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1870Reports in Public Health; Vol. 18 No. 6 (2002): November/DecemberCadernos de Saúde Pública; v. 18 n. 6 (2002): Novembro/Dezembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZspahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1870/3728https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1870/3729Ayala Cerna, CarlosKroeger, Axelinfo:eu-repo/semantics/openAccess2024-03-06T15:26:41Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/1870Revistahttps://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:2024-03-06T13:02:13.479264Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización |
title |
La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización |
spellingShingle |
La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización Ayala Cerna, Carlos Reforma del Sector Salud Tuberculosis Programas de Inmunización |
title_short |
La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización |
title_full |
La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización |
title_fullStr |
La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización |
title_full_unstemmed |
La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización |
title_sort |
La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización |
author |
Ayala Cerna, Carlos |
author_facet |
Ayala Cerna, Carlos Kroeger, Axel |
author_role |
author |
author2 |
Kroeger, Axel |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Ayala Cerna, Carlos Kroeger, Axel |
dc.subject.por.fl_str_mv |
Reforma del Sector Salud Tuberculosis Programas de Inmunización |
topic |
Reforma del Sector Salud Tuberculosis Programas de Inmunización |
description |
This paper analyzes the effects of health reform in Colombia on public health programs at the local level, particularly the Expanded Program of Immunization (EPI) and the tuberculosis control program. The research was developed in three health districts in two States by analysis of documents, direct observation, and longitudinal follow-up of the transition process. The health districts were unprepared for the change, resulting in insufficient technical skills among staff as well as lack of awareness of important elements in the new system, associated with a reduction in immunization coverage and tuberculosis case detection. Structural problems in the new system included loss of immunization opportunities and lack of examination of tuberculosis contacts. The potentialities of the new system were the local development of a new organizational structure and the improvement of the information system; a limiting factor was exposure of the health system to local political interests. The general conclusion is that the transition period takes far longer than anticipated and requires a much greater information flow to both the local level and the community. There are transitory but also structural maladjustments that require a political response. |
publishDate |
2002 |
dc.date.none.fl_str_mv |
2002-12-01 |
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/1870 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1870 |
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/1870/3728 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1870/3729 |
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. 18 No. 6 (2002): November/December Cadernos de Saúde Pública; v. 18 n. 6 (2002): Novembro/Dezembro 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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