Frenz Patricia, Titelman Daniel
Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
División de Financiamiento para el Desarrollo, Comisión Económica de América Latina y el Caribe de Naciones Unidas, Santiago, Chile.
Rev Peru Med Exp Salud Publica. 2013 Oct-Dec;30(4):665-70.
Re-democratization has transformed the social agenda and the role of the state in Latin America with a growing commitment to health equity and social justice, yet these aspirations are strained by the region´s profound socioeconomic inequalities. Efforts to provide universal coverage to the right to health have led to the development of a variety of public policies, whose scope depends on how the concepts of health and equity are understood. In general, policy action has centered on health system reforms and only recently on integrated intersectorial action to address wider social determinants of health, particularly structural determinants. Furthermore, if the goal is health equity the predominant minimum standards approach cannot be the final answer, but only a step on the road to equality. Finally, realizing universal coverage of the right to health through public policy requires the strengthening of governmental institutional capacities with an intersectorial and participatory lens.
重新民主化改变了拉丁美洲的社会议程和国家角色,人们对健康公平和社会正义的承诺日益增强,但这些愿望因该地区深刻的社会经济不平等而受到制约。为实现健康权的全民覆盖所做的努力催生了各种公共政策,其范围取决于对健康和公平概念的理解方式。总体而言,政策行动主要集中在卫生系统改革上,直到最近才转向综合部门间行动,以应对更广泛的健康社会决定因素,特别是结构性决定因素。此外,如果目标是健康公平,占主导地位的最低标准方法不可能是最终答案,而只是通向平等道路上的一步。最后,通过公共政策实现健康权的全民覆盖需要从部门间和参与性角度加强政府机构能力。