Políticas e sistemas de saúde na América Latina: identidade regional e singularidades nacionais

Abstract

EDITORIAL EDITORIALLatin American societies are marked by profound socioeconomic inequalities that originated in the colonial period and were reiterated by the 20th-century processes of capitalist modernization, whose main characteristics were the countries' peripheral role in the global economy and limited social redistribution. Throughout the last century, various Latin American countries developed segmented social protection and health systems tied to the formal labor markets which excluded the majority of the population due to high levels of informality 1,2 .Latin American countries' historical and structural characteristics and development models influenced the paths and specificities of the national systems for social protection. The state was responsible for the reproduction of inequalities through regressive tax systems and stratified social policies. In some countries, it has subsidized the development of private sectors in the provision of social services, as in education and health 3 . In addition, contextual and political conditioning factors -economic cycles, government projects -influenced social policies at each historical moment. Finally, we highlight the importance of specificities in the different social policy areas -like health -which display singularities in the historical processes of societies given the different objects of intervention, backgrounds, and political stakeholders.In the 1980s and 1990s, Latin American states underwent important transformations amid processes of economic liberalization and democratization at different paces and with different intensities, with major implications for social policies. Various countries launched reforms in their health systems with differing orientations, depending on their structural, institutional, and political and contextual conditions.In the 2000s, the election of Center-Left governments in some countries 4 raised expectations for changes in the development models, with greater emphasis on social issues, while encouraging the debate on the relations between politics, democracy, and redistribution. The region witnessed positive experiences in the reduction of inequalities, associated with the redistributive effect of social policies and the increase in the workers' income 5,6,7 .However, the mid-2010s saw a new turnaround in various Latin American countries. The new scenario was characterized by economic and political instability, the rise of neo-

Las Políticas de Salud en Latinoamérica: El Camino Hacia la Cobertura Universal.

“…Las sociedades Latinoamericanas, desde el periodo colonial, han sido afectadas por profundas desigualdades económicas, que a lo largo del siglo XX se siguieron haciendo evidentes por la escasa redistribución social (Machado et al, 2017).…”

Persistent inequities in maternal mortality in Latin America and the Caribbean, 1990–2019

“…Despite the progress observed in these countries since the Millennium Development Goals (MDGs) went into effect in 2000, a blueprint agreed to by all the world's countries and leading development institutions, -by which all world countries agreed to improve maternal health by reducing the maternal mortality ratio (MMR) by 75% and achieve universal access to reproductive health by 2015, among other commitments-, health inequities persist among the most socially disadvantaged populations [5,6]. This occurs mainly in countries that have failed to achieve universality of health care, including some in the Latin American and Caribbean region (LAC) [7][8][9].…”

Implication of the training ad continuing education process for the interprofessional performance

“…At the national and world level, the experience initiated with the Sanitary Reform that culminated in the Unified Health System (Brazilian SUS) has aroused interest given the extent of changes and number of individuals and institutions involved. The decisive role of human resources is to broaden the access to services and transform the care model (1) .…”