Modelos de regulación profesional de los médicos en América Latina: elementos teóricos para su análisis

Nígenda, Gustavo; Machado, Maria Helena

doi:10.1590/s0102-311x1997000400011

Cited by 7 publications

(7 citation statements)

References 2 publications

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“…Lack of resources, primarily due to fiscal and budgetary concerns, was a consistent theme among staff, an illustration of the scope of the overall lack of health care resources found generally in the Mexican health care system (20,22,23). Budget reductions have limited the staff necessary to carry out day-to-day tasks, including cleaning staff, and limited the availability of treatment necessities, such as medications.…”

Section: Discussionmentioning

confidence: 95%

“…Although financial barriers to the integration of mental health in primary care settings have generally been a concern, even among developed countries (21), these problems are further exacerbated in a developing nation. Providers also report other barriers associated with integration of mental health and primary care, including lack of training, role confusion, and burnout (22,23). In addition, primary care staff indicate lacking the necessary training to detect and make appropriate referrals for mental disorders (24).…”

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confidence: 99%

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Barriers to Integrating Mental Health Services in Community-Based Primary Care Settings in Mexico City: A Qualitative Analysis

Martínez

Galván

Saavedra

et al. 2017

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Objective Despite the high prevalence of mental disorders in Mexico, minimal mental health services are available and there are large gaps in mental health treatment. Community-based primary care settings are often the first contact between patients and the health system and thus could serve as important settings for assessing and treating mental disorders. However, no formal assessment has been undertaken regarding the feasibility of implementing these services in Mexico. Before tools are developed to undertake such an assessment, a more nuanced understanding of the microprocesses affecting mental health service delivery must be acquired. Methods A qualitative study used semistructured interviews to gather information from 25 staff in 19 community-based primary care clinics in Mexico City. Semistructured interviews were analyzed by using the meaning categorization method. In a second phase of coding, emerging themes were compared with an established typology of barriers to health care access. Results Primary care staff reported a number of significant barriers to implementing mental health services in primary care clinics, an already fragile and underfunded system. Barriers included the following broad thematic categories: service issues, language and cultural issues, care recipient characteristics, and issues with lack of knowledge. Conclusions Results indicate that the implementation of mental health services in primary care clinics in Mexico will be difficult. However, the information in this study can help inform the integration of mental health into community-based primary care in Mexico through the development of adequate evaluative tools to assess the feasibility and progress of integrating these services.

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Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 99%

Barriers to Integrating Mental Health Services in Community-Based Primary Care Settings in Mexico City: A Qualitative Analysis

Martínez

Galván

Saavedra

et al. 2017

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“…But in the last decades, society has become more critical of the claims of professional groups that they are primarily client/public-oriented. Professionals nevertheless continue to exercise considerable influence on the regulation of the provision of health care, through the definition of standards of practice and by participating formally or through lobbying in the process of defining the legal and administrative framework of the health sector [46,47]. …”

Section: Discussionmentioning

confidence: 99%

The interface between health sector reform and human resources in health

Rígoli

Dussault

2003

Hum Resour Health

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The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms.The impact of health sector reform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways – reacting to transformations, supporting, blocking and distorting the proposed ways of action.This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them.

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“…The participation of professionals in the production of health services can be studied through the regulation model proposed by Moran & Wood 9 , defined as "the mechanism used to establish the characteristics of the practice and the required technical standards." This model includes four dimensions: 1) market entry mechanisms; 2) professional competence control; 3) labor market structure; and 4) payment mechanisms 10 .…”

Section: The Professional Regulation Structure Modelmentioning

confidence: 99%

Regulación de la enfermería en México: actores, procesos y resultados

Aristizabal

Nígenda

Squires

et al. 2020

Ciênc. saúde coletiva

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Resumen El objetivo de este artículo es analizar la estructura regulatoria de la enfermería en México, a través de la normatividad y los actores involucrados. Se desarrolló un estudio de caso con uso de fuentes de información cualitativa, cuantitativa y revisión de documentación oficial. El análisis integró los datos obtenidos de las fuentes de acuerdo con cuatro dimensiones propuestas por Moran & Wood (1993). La dimensión con mayores avances es el ingreso al mercado ya que el Estado regula el ingreso a través de una licencia de práctica. La regulación de la competencia es débil y muestra áreas aisladas de práctica autónoma. El mercado laboral ofrece condiciones variadas de inserción con muestras claras de deterioro. El mecanismo de pago dominante es el salario de las instituciones públicas mostrando una estructura que incorpora un componente que no cotiza para la pensión al término del ciclo laboral. La regulación de la enfermería es un componente de su profesionalización y como tal se distingue como un proceso en marcha en vías de consolidación, particularmente aquellas dimensiones relacionadas con la regulación de la competencia, la estructura del mercado y los mecanismos de pago en el cual la enfermería y sus representantes deben jugar un papel más activo.

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Modelos de regulación profesional de los médicos en América Latina: elementos teóricos para su análisis

Cited by 7 publications

References 2 publications

Barriers to Integrating Mental Health Services in Community-Based Primary Care Settings in Mexico City: A Qualitative Analysis

Barriers to Integrating Mental Health Services in Community-Based Primary Care Settings in Mexico City: A Qualitative Analysis

The interface between health sector reform and human resources in health

Regulación de la enfermería en México: actores, procesos y resultados

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