La reforma del sector salud, descentralización, prevención y control de enfermedades transmitidas por vectores

Abstract

Economic policies are changing Latin American health programs, particularly promoting decentralization. Numerous difficulties thus arise for the control of endemic diseases

Vigilância epidemiológica da doença de Chagas em programa descentralizado: avaliação de conhecimentos e práticas de agentes municipais em região endêmica de Minas Gerais, Brasil

“…Em particular, quanto ao PCDCh, cabe a GRS a preparação de recursos humanos a partir da realização de cursos de capacitação dos agentes municipais, além da supervisão e avaliação das ações de controle da endemia. Uma das dificuldades deste novo sistema é que embora a descentralização se justifique em pressupostos teóricos, não existe tradição deste controle em níveis municipais, o que dificulta a transferência de encargos e o cumprimento continuado do programa 17 .…”

Assessing options for an innovative malaria control program on the basis of experience with the new Colombian Health Social Security System

“…When a method or activity whose efficacy has been proved does not give the expected results, then the difficulties are attributed to isolated factors of control programme organisation and operation (administration, financing, personnel, etc.) or incontrollable processes within the context (5,33,76,77).…”

Evaluation of the Chagas Disease Control Program in Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil

“…Similar observations have been published by our team that verifi ed the same replacement (P. megistus by T. pseudomaculata) in Berilo, Jequitinhonha Valley 21 , a region previously associated with higher humidity and the presence of original vegetation, as a consequence of the intense deforestation for agropecuary activities and intense planting of eucalyptus, both of which increased the aridity of the region 32 . This situation is common, especially in MG where agropecuary is present with several siderurgic industries in vast areas as discussed in the study by Forattini 17 .…”

“…Although theoretical principles are decided by the SUS, the delegation of the responsibility for controlling endemics to the municipalities in 2000 caused new problems and consequences for the CDCP. In general, the municipalities do not have suffi cient knowledge for controlling endemics, which makes the transfer of responsibilities and the continuous success of the programs diffi cult 17,18 . These characteristics demonstrate that similar to other municipalities in Brazil, Açucena has not accepted its responsibility regarding the national CDCP.…”