La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores

Cadernos de Saúde Pública

Gabriel A. Schmunis²  João Carlos Pinto Dias¹ 

[1],Organización Panamericana de la Salud Programa de Enfermedades Transmisibles Washington DC ,USA

关键词: Prevention and Control;    Health Care Reform;    Chagas Disease;    Prevención y Control;    Reforma Sanitária;    Doença de Chagas;   

DOI  :  10.1590/S0102-311X2000000800016

来源: SciELO

【 摘 要 】

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.

【 授权许可】

CC BY   
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