Tamaño del Estado (gasto público) y salud en el mundo, 1990-2000

Franco, Álvaro; Gil, Diana Peña; Álvarez-Dardet, Carlos

doi:10.1157/13075951

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…During the first phase of health system reform, the SSA (Ministry of Health) began the consolidation of a national health system (México, 2013b;México, 2013a); the decentralization strategy was implemented in 12 of the 31 states in the country (México, 2010b;Franco;Gil;Álvarez, 2005). The legal and normative framework for decentralization included important guidelines for financing, equity and governance at the national, state and municipal levels.…”

Section: Introductionmentioning

confidence: 99%

Evidence on equity, governance and financing after health care reform in Mexico: lessons for Latin American countries

Arredondo¹,

Orozco²,

Avilés³

2015

Saude soc.

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This article includes evidence on equity, governance and health financing outcomes of the Mexican health system. An evaluative research with a cross-sectional design was oriented towards the qualitative and quantitative analysis of financing, governance and equity indicators. Taking into account feasibility, as well as political and technical criteria, seven Mexican states were selected as study populations and an evaluative research was conducted during [2002][2003][2004][2005][2006][2007][2008][2009][2010]. The data collection techniques were based on in-depth interviews with key personnel (providers, users and community leaders), consensus technique and document analysis. The qualitative analysis was done with ATLAS TI and POLICY MAKER softwares. The Mexican health system reform has modified dependence at the central level; there is a new equity equation for resources allocation, community leaders and users of services reported the need to improve an effective accountability system at both municipal and state levels. Strategies for equity, governance and financing do not have adequate mechanisms to promote participation from all social actors. Improving this situation is a very important goal in the Mexican health democratization process, in the context of health care reform. Inequality on resources allocation in some regions and catastrophic expenditure for users is unequal in all states, producing more negative effects on states with high social marginalization. Special emphasis is placed on the analysis of the main strengths and weaknesses, as relevant evidences for other Latin American countries which are designing, implementing and evaluating reform strategies in order to achieve equity, good governance and a greater financial protection in health.

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Section: Introductionmentioning

confidence: 99%

Evidence on equity, governance and financing after health care reform in Mexico: lessons for Latin American countries

Arredondo¹,

Orozco²,

Avilés³

2015

Saude soc.

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“…Por otro lado, algunos trabajos han encontrado asociaciones significativas entre indicadores de contexto e indicadores de salud 11 . En particular, en América Latina y el Caribe, durante la década de 1980, el ajuste de las políticas macroeconómicas tuvo un efecto negativo sobre los indicadores sociales, específicamente sobre los relacionados con la situación de salud 10 .…”

Section: Métodosunclassified

“…Éstos, también llamados factores contextuales, resultan de la combinación nociva de políti-cas injustas, situación económica precaria y mala gestión política 9 . Entre los factores estructurales o de contexto analizados en el estudio de la inequidad se encuentran el producto interior bruto (PIB), el gasto público y el gasto en salud, entre otros 10,11 .…”

Section: Introductionunclassified

“…Sin embargo, estos cambios no han sido iguales para todos los países y, por consiguiente, no alcanzan para lograr los objetivos de desarrollo del milenio en la región. Por lo tanto, la situación revela la necesidad ineludible de mejorar la equidad y de ampliar la protección social en materia de salud14 .El escaso avance en la disminución de las desigualdades injustas en la región puede deberse en parte a las reformas en el sector salud implementadas en algunos países, que han tenido un impacto negativo en términos de equidad, como lo demuestran diversos trabajos10,11,15,26 . Algunos autores afirman que los resultados positivos de estos procesos se diluyen por los nuevos problemas suscitados por las propias reformas27 .…”

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Inequidades en salud entre países de Latinoamérica y el Caribe (2005-2010)

2013

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Even today, there are wide health inequalities in Latin America and the Caribbean. The country with the most favorable health indicators was Cuba and that with the least favorable was Haiti. We recommend systematic evaluation of health inequalities in Latin America and the Caribbean through the Inequalities in Health Index and other indices, in order to analyze actions, policies and programs to reduce inequities in this region.

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“…El ajuste estructural ha implicado la reducción del gasto público global de los Estados (26,27), especialmente en América Latina y el Caribe, lo que ha permitido comparar los indicadores de salud y explorar las implicaciones negativas de la reducción del tamaño del Estado sobre la situación de la salud en los países del mundo, en general (28). Aunque en el decenio de 1990 empezó la recuperación económica, ella no se tradujo suficientemente en mejoras sociales.…”

Section: Forma De Citarunclassified