Birn Anne-Emannuelle
Department of Public Health Sciences, University of Toronto, Canadá.
Dynamis. 2005;25:279-311, table of contents.
This article compares public health policy reforms in Mexico during the 1920s and 1930s with subsequent reforms initiated in the 1980s. The attempts at decentralization in the 1920s-30s were supported by the Rockefeller Foundation, which was interested in the formation of local cooperative health units. In the 1980s, the aim of the Mexican government and international financial agencies, such as the Inter-American Development Bank, was to reduce public spending (as part of "structural adjustment" policies). One of the hypotheses of this article is that, in the end, the public health reforms were unable to overcome the limitations imposed by Mexico's political centralization and longstanding inequities in public spending. At the same time, one of the unforeseen achievements of these reforms was an increase in local capabilities to demand a better distribution of social services.
本文将20世纪20年代和30年代墨西哥的公共卫生政策改革与80年代启动的后续改革进行了比较。20世纪20年代至30年代的权力下放尝试得到了洛克菲勒基金会的支持，该基金会对地方合作卫生单位的组建感兴趣。在20世纪80年代，墨西哥政府和美洲开发银行等国际金融机构的目标是减少公共开支（作为“结构调整”政策的一部分）。本文的一个假设是，最终，公共卫生改革未能克服墨西哥政治集权和长期存在的公共开支不平等所带来的限制。与此同时，这些改革一项意外的成果是地方要求更好地分配社会服务的能力有所增强。
