This study presents an assessment of the participation and training of nurses in public health areas in the Americas. Information was gathered through a literature review and interviews with key informants from Mexico, Colombia, and Paraguay. Results demonstrate that there is significant variation in definitions of public health nursing across the region and current systematized data about the workforce profile of public health nursing personnel is not available for many countries in the Americas. There are significant regional differences in the levels and types of training of nurses working in public health areas and an increasing number of nurses are pursuing training in public health at the master’s and doctoral levels. Many nurses carry out some or all of the essential functions of public health, but are not considered to be public health nurses. Generally, auxiliary and technical nurses have a broader presence in public health areas than professional nurses. In the future, regional health systems reforms should support increased recruitment and training of public health nurses, as well as stronger roles in public health research and health care at the individual, community, and population levels.

The health care options used by Mexican migrants and their families are defined according to events related to the migration process. The implementation of public policies to protect the health of migrants on both sides of the border is critical.

OBJECTIVE:This article describes the experience of the aval ciudadano "Citizens' Representative" (CR) in improving the Mexican health care system. METHODS:This is a qualitative study which took place in eight Mexican states in 2008. It evaluates different aspects of a nationwide program to increase the quality of health care services (National Crusade for Quality in Health Services). The Mexican strategy is compared with experiences in other Latin American countries. RESULTS:In this paper, there is the description of achievements and problems encountered by the CR in promoting social participation in the health of the population. CONCLUSIONS:The CR has great infl uence when representing health service users and passing on their demands for improvements to health care quality. Social participation in health services Nigenda-López GH et al DESCRIPTORS:

ResumenObjetivo. Analizar los factores asociados con la expectativa de migrar al extranjero en estudiantes de licenciatura en enfermería de escuelas públicas en México, Distrito Federal. Material y métodos. Se realizó un estudio transversal con una muestra no probabilística de 420 estudiantes. Se construyó un modelo logístico multivariado. Resultados. El 69% de los informantes expresó la intención de migrar para trabajar (65%) o estudiar (26%). El 50% elegiría como destino Canadá, seguido de España y Estados Unidos. Las variables asociadas con la expectativa de migrar fueron: edad, ingreso, tener familiares en el extranjero y percibir malas condiciones laborales/salarios en México. Conclusiones. Los resultados concuerdan con la literatura internacional. Los bajos salarios, malas condiciones laborales y escasas posibilidades de desarrollarse profesionalmente en México contribuyen a generar la expectativa de migrar en la población de estudio. Adicionalmente, la percepción optimista de los estudiantes sobre el mercado extranjero y la demanda laboral de países desarrollados coadyuvan a enfatizar dicho fenómeno. AbstractObjective. To analyze the factors associated with the expectations to migrate abroad among nursing students in Mexico City. Material and Methods. A cross-sectional study was conducted with a non-random sample of 420 students. A logistic regression model was estimated. Results. A total of 69% of the informants expressed their intention to move abroad, to look for employment (65%) and/or to continue their studies (26%). Of those, 50% would choose Canada as their destination, followed by Spain and the United States. The variables associated with migration expectations were: age, income, having relatives abroad, and perception of poor labor conditions and low wages in Mexico. Conclusions. Results are consistent with international literature. Low wages, poor labor conditions and the limited possibilities for professional development in Mexico are factors that contribute to generate migration expectations among nursing students. Additionally, optimistic perceptions about the job market and the labor demand in more developed countries heighten expectations to migrate.

It is important to consider the need to guarantee that this type of changes in the contractual conditions of workers benefit all actors, particularly the insured population.