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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Alberto Jose Cardelle, PhD, MPH, Public Health Program, East Stroudsburg University, 200 Prospect Street, East Stroudsburg, PA 18301, 570-422-3401, acardelle@po-box.esu.edu
In Latin America, popular protests, public demonstrations and organized civil actions have shaped, timed and even ceased economic, political and social reform efforts. Recent events in Argentina, and previously in Peru and Venezuela show the power the public retains in influencing reform policies. However, health care reform efforts have not generated broad popular actions and have lacked channels of articulation between civil society and policymakers. This paper reviews the health reform process in four countries in Latin America – Guatemala, Dominican Republic, Chile and Costa Rica. Using a political economic framework the results will demonstrate the quality and quantity of civil society participation in the health reform process. The paper will show that the public’s input in the area of health policy is more likely to be articulated by labor unions (Gremios), and not by other more traditional integrators of civil society such as NGOs. Doctors, hospital workers and civil servants and not those covered by government services have been the most active and successful in effecting change. The role of NGOs in this area has been curtailed because of their new role as state contractors under the new health systems. The findings are important because they identify the political actors in the reform process, and help to isolate the channels of articulation between health policy makers and civil society in a systematic fashion. This is critical to understand in countries that have a fragmented civil society, and in which the channels of communication between government and civil society are constrained.
Learning Objectives:
Keywords: Health Reform, Latin American
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.