Though the problems translating or applying research in policy-making are legion, solutions are rare. As developing countries increase their capacities to develop effective local solutions to their health problems, they confront the research/policy dilemma. Yet few descriptive studies of research-policy links can be found from developing countries, and the relevance of European and North American models and data is questionable. We report the results of a descriptive study from Mexico of the relationship between health research and policy in four vertical programmes (AIDS, cholera, family planning, immunization). We interviewed 67 researchers and policy-makers from different institutions and levels of responsibility. We analyzed interviewee responses looking for factors that promoted or impeded exchanges between researchers and policy-makers. These were, in turn, divided into emphases on content, actors, process, and context. Many of the promoting factors resembled findings from studies in industrialized countries. Some important differences across the four programmes, which also distinguish them from industrialized country programmes, included extent of reliance on formal communication channels, role of the mass media in building social consensus or creating discord, levels of social consensus, role of foreign donors, and extent of support for biomedical versus social research. We recommend various ways to increase the impact of research on health policy-making in Mexico. Some of the largest challenges include the fact that researchers are but one of many interest groups, and research but one input among many equally legitimate elements to be considered by policy-makers. Another important challenge in Mexico is the relatively small role played by the public in policy-making. Further democratic changes in Mexico may be the most important incentive to increase the use of research in policy-making.
Given the conditions that exist in these transit stations, interventions should be multisectoral, sustainable, and should defend the human rights of various groups, including women and people living with HIV/AIDS.
México, DF -México.
INTRODUÇÃOHá pelo menos vinte anos questiona-se o paradigma dominante da epidemiologia que conceitua a doença como um fenômeno biológico individual. Este questionamento implicou modificações conceituais e metodológicas. Entre as primeiras destacam-se os estudos que utilizam o conceito de classe social para explicar os fenômenos de saúde-doença, muitos dos quais realizados na América Latina 1,[3][4][5][6][7][8]14 . Segundo Bronfman e Tuirán 5 , "a inserção de classe determina, em última instância, o acesso diferencial, entre outros, à infra-estrutura de saúde, à quantidade e qualidade de alimentos, à habitação e ao vestuário".Uma primeira dificuldade na incorporação do conceito de classe social em estudos epidemiológicos é o fato de que o mesmo tem recebido diferentes interpretações. Uma dificuldade adicional é a operacionalização desse conceito, a fim de classificar os indivíduos ou famílias através de questionários padronizados.A definição de classe social na qual se baseou foi a seguinte: "Las clases son grandes grupos de hombres que se diferencian entre sí por el lugar que ocupan en un sistema de produción históricamente determinado, por las relaciones en que se encuentran con respecto a los medios de produción (relaciones que en gran parte quedan establecidas y formuladas por las leyes), por el papel que desempeñan en la organización social del trabajo y, consiguientemente, por el modo y la proporción en que perciben la parte de riqueza social de que disponen. Las clases son grupos humanos, uno de los quales puede apropiar-se del trabajo del otro, por ocupar puestos diferentes en un régimen determinado de economia social" (Lenin 9 ). O conceito de classe engloba, portanto, diferentes instâncias (econômica, jurídico-política e ideológica) que compõe o todo social 10 . As limi-
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