La reforma del sector salud en Colombia y sus efectos en los programas de control de tuberculosis e inmunización

Cadernos de Saúde Pública

Carlos Ayala Cerna¹  Axel Kroeger¹ 

[1] ,Liverpool School of Tropical Medicine

关键词: Health Sector Reform;    Tuberculosis;    Immunization Programs;    Reforma del Sector Salud;    Tuberculosis;    Programas de Inmunización;   

DOI  :  10.1590/S0102-311X2002000600032

来源: SciELO

【 摘 要 】

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.

【 授权许可】

CC BY   
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