Análisis político del Programa de Control del dengue en Morelos, México

Abstract

OBJECTIVE:To analyze municipal measures implemented to control the dengue epidemic, giving priority to the functions of intersectoral coordination, policy strengthening and community participation. METHODS:The observational study was performed in Morelos, Mexico in 2007. Data collected in interviews and direct observations were submitted to contents analysis and policy mapping. Policy Maker software was used to evaluate the values assigned to the stakeholders' performance (i.e., high, medium and low criteria) and to their role (actions undertaken for surveillance, control or management). A strategic analysis of opportunities and challenges regarding public policies and dengue control was conducted. RESULTS:The legal framework indicates that the approach to the dengue epidemic should be an intersectoral response. However, the burden of activities in terms of fi nancial and human resources tends to fall on local health services, which contrasts with the contribution of other sectors (e.g., water and sanitation) that do not recognize their responsibilities. A high degree of operational feasibility links, in terms of optimization of resources and objectives fulfi llment was detected, particularly among health authorities at state, jurisdictional and municipal levels. CONCLUSIONS:A multidisciplinary approach and strengthening of policy stewardship may allow a more efficient response to dengue outbreaks, sustained by intersectoral coordination and the active participation of the affected population.

Detecting and Responding to a Dengue Outbreak: Evaluation of Existing Strategies in Country Outbreak Response Planning

“…The literature highlights how the coordination of a diverse set of sectors and social groups has faced challenges. Often mechanisms do not exist to guarantee intersectoral compliance with a regulatory framework in terms of financial and operational participation, thus weakening the outbreak response, due to delegation to stakeholders with poor operational organisation [10]. Recognition of where capacity lies is thus far more important than encouraging universal sectors to be involved in an outbreak response.…”

Assessing capacities to strengthen intersectoral collaboration in Territorial Public Health Councils in the Republic of Moldova

“…The leading figures within the TPHC meetings were by no means immune from criticism as they provided no clear mechanism, direction or guidance for TPHC work. This perception was also assumed by stakeholders unaware of their legal responsibilities in an intersectoral dengue control programme in Mexico [ 11 , 25 ]. An explanation for this situation could be insufficient public health training that targets the objectives within the TPHC framework.…”

Participación social y calidad en los servicios de salud: la experiencia del aval ciudadano en México

“…Design and implementation of programs depend largely upon the social and political values of each country. 1,7,11,17 Over the last few years, the majority of reforms in the fi eld of health care have in reality encouraged the participation of covered populations as individual users rather than as a collective, negotiating entity, even when the promotion of social inclusion was included in the mission statement. 2 Some representative cases which can be compared to the Mexican model are those of Colombia, Brazil and Chile (Table 4).…”