Gestión local de salud : intervenciones en relación a desigualdades sociales. Revisión crítica de artículos científicos acerca de la Argentina y Brasil en el período 2005-2015

Abstract

The new century began with a renewed impulse to examine and develop strategies to address social inequalities. In addition, the importance attributed to them in the health status of the populations and in the so-called health disease care process (HDCP), contributing to inequity in health, has grown at this time. It is argued that the local level of health-often called Primary Health Care (PHC)-is the most appropriate for performing individual, family and collective interventions aimed at addressing these-also called social determinants in the literatura-. This implies changes in the model of care, community actions and intersectoral articulations. This thesis aimed to review and analyze scientific articles on social inequalities and local health services management, identifying the advances, obstacles and proposals observed in Argentina and Brazil in the period 2005-2015. Documents in the form of scientific articles from indexed magazines were studied. The corpus was characterized according to its location and identification. The articles were categorized in relation to the thematic content of their contributions. And finally an analysis and discussion of these categories was made taking into account the axes advances, obstacles and proposals. In the articles, a notable influence of structural properties, rules and resources on health equity and local level management was identified, as well as the importance of care production processes that include community action in PHC, work in territory and intersectoral articulation in order to adequately address the social inequalities that affect the HDCP, being central the construction of citizenship and the rights approach. In order to reduce inequity in health, we also detected the need to continue improving the accessibility and coverage of PHC and the counterreferral referral mechanisms.