[Health care reform, decentralization, prevention and control of vector-borne diseases].

Abstract:

: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.

journal_name

Cad Saude Publica

authors

Schmunis GA,Dias JC

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

117-23

eissn

0102-311X

issn

1678-4464

pii

S0102-311X2000000800016

journal_volume

16 Suppl 2

pub_type

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