Análisis de expertos y marco histórico normativo para la implementación de la estrategia de Atención Primaria de Salud, Paraguay 1978 - 2008

Abstract

Objective:To analyze the causes of the legal void to which the delay in the execution of the Primary Health Care strategy in Paraguay is attributed in the first two decades following the Alma Ata Declaration (1978), based on the review of the historical context, regulatory framework and expert opinion. Methodology: This is a descriptive, observational, retrospective historical, qualitative study, based on the review of documentation (the APS regulatory framework from 1978 to 2008) and primary sources gleaned from key informant interviews from a sample of restricted actors chosen for convenience (former ministers, former vice ministers, managers and experts), establishing the legal scope as categories of analysis. Results: Between 1978 and 1990, resolutions without legal effect have backed temporary projects for the development of a selective and partial APS strategy model, not yet interpreted as an entryway to the Health System, confirming the absence of laws or decrees that effectively permitted it. Conclusion: Only when a written norm is followed by the weight of the law it has been able to establish the relationship between the legal framework, the understanding of the conceptual definition of the APS strategy, as an entryway to the Health System in Paraguay, and its effective implementation as a state policy.