Decentralization and Public Health: An Analysis of the Health System in Five Latin American Countries: Argentina, Brazil, Chile, Colombia and Mexico



This chapter will help you to have an overview of the health sector decentralization process in five Latin American countries, Argentina, Brazil, Chile, Colombia and Mexico, within the context of the wider international health sector reforms introduced in most of the developing countries, during the 1980s and 1990s. The chapter describes the main characteristics of the health systems, the health process and the main socioeconomic and public health indicators of these countries. It also presents a summary of the main findings of several studies focused on analysing the situation of health in these countries. It highlights the fact that decentralization was introduced simultaneously with privatisation, market economy and competition strategies, focalisation and labour flexibility policies, and therefore, it is not easy to conclude if the limitations and achievements of health systems come from it or from the other strategies. Data suggest that with these strategies, problems on accessibility, coverage, quality and inequity of services have not been solved; on the contrary, new barriers of accessibility have been created. The Colombian health system is an example, because the financial profitability interest of the private sector negatively affects efficiency, accessibility and quality, among others.


Health Sector Latin American Country Community Participation Social Security System Public Health Programme 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We are very grateful with Dr Krishna Regmi because he invited us to write this chapter for this book.


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© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Gloria Molina
    • 1
  • Julian Vargas
    • 1
  • Beatriz Londoño
    • 1
  1. 1.University of AntioquiaMedellinColombia

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