The consequence of the simultaneous implementation of health reforms, and the re-establishment of democratic electoral regimes can create contrasting priorities with regard to reform implementation. Democratization and public sector reforms have forced Latin American governments to contend with both more political interests, and with political interests that are seeing their power and capacity diminished. As new governments respond to their ideological and political constituencies, governments have tended to modify reform priorities and have even reversed reform efforts. These factors increases the likelihood that health reform efforts remain unfinished.
This paper explores the implementation process of health reform projects in post-electoral periods. The paper applies a policy analysis and policy implementation framework for evaluating the potential impact of government transitions on the implementation and sustainability of health reform in two countries in Latin America - Guatemala and the Dominican Republic. The paper looks at the new actors, and the new context that emerge after elections and determine how these impact the following implementation criteria - i. The degree to which reform decisions are guided by a clear model or vision, ii. The number and variety of actors who must collaborate in order to design and implement major changes, iii. The length of time needed to implement reforms, iv. The kinds and amounts of resources required to implement the reforms, and v. The evident cost-benefit of postponing the reforms. The paper concludes by identifying the political factors that play a key role in engendering modifications to existing health reform efforts.
Learning Objectives: Participants will, 1) Learn about healthr eform programs in two Latin American countries, 2) Explore the impact of democratic elections on refrom efforts, 3) Learn about an analytic framework for exploring reform implementation.
Keywords: Health Care Reform, International
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