Regularización laboral de trabajadores de la salud pagados con recursos del Seguro Popular en México

Nígenda, Gustavo; Ruiz-Larios, José Arturo; Aguilar-Martínez, Matilde Elizabeth; Bejarano-Arias, Rosa

doi:10.1590/s0036-36342012000600010

Cited by 11 publications

(8 citation statements)

References 3 publications

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“…It formally represents the interests of the SSA permanent workers but not of temporary employees. The union became agile to participate in negotiations to provide better labor conditions for the new short-term non-permanent employees that escalated after the introduction of SP [ 42 , 47 ]. The negotiations resulted in setting a minimum period for short-term contracts of 12 months, with benefits included, and it provided the union with a 2 % salary contribution for each new contract as a union fee [ 42 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective

et al. 2015

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BackgroundIn 2003, Mexico’s Seguro Popular de Salud (SPS), was launched as an innovative financial mechanism implemented to channel new funds to provide health insurance to 50 million Mexicans and to reduce systemic financial inequities. The objective of this article is to understand the complexity and dynamics that contributed to the adaptation of the policy in the implementation stage, how these changes occurred, and why, from a complex and adaptive systems perspective.MethodsA complex adaptive systems (CAS) framework was used to carry out a secondary analysis of data obtained from four SPS’s implementation evaluations. We first identified key actors, their roles, incentives and power, and their responses to the policy and guidelines. We then developed a causal loop diagram to disentangle the feedback dynamics associated with the modifications of the policy implementation which we then analyzed using a CAS perspective.ResultsImplementation variations were identified in seven core design features during the first 10 years of implementation period, and in each case, the SPS’s central coordination introduced modifications in response to the reactions of the different actors. We identified several CAS phenomena associated with these changes including phase transitions, network emergence, resistance to change, history dependence, and feedback loops.ConclusionsOur findings generate valuable lessons to policy implementation processes, especially those involving a monetary component, where the emergence of coping mechanisms and other CAS phenomena inevitably lead to modifications of policies and their interpretation by those who implement them. These include the difficulty of implementing strategies that aim to pool funds through solidarity among beneficiaries where the rich support the poor when there are no incentives for the rich to do so. Also, how resistance to change and history dependence can pose significant challenges to implementing changes, where the local actors use their significant power to oppose or modify these changes.

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Section: Resultsmentioning

confidence: 99%

Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective

et al. 2015

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“…Short-term contracting also expanded to cover temporary absentees. It was not until 2003 when Seguro Popular was created that the Ministry of Health was able to offer full-time positions but under precarious conditions [4, 5]. These types of contracts were offered in all states following the advancement of Seguro Popular that, between 2003 and 2007, progressively financed all States Ministry of Health services.…”

Section: Discussionmentioning

confidence: 99%

“…Prior to the UHC declaration in 2012, the Mexican health system had achieved a significant increase in the availability of human resources including nurses. In fact, using SPS financial resources, by 2008, more than 55 000, mainly doctors and nurses, were hired to provide services in public health care units [4, 5]. However, availability was still far from the human resources of other countries with similar incomes, and Mexico had serious geographical distribution problems as well.…”

Section: Introductionmentioning

confidence: 99%

The precarization of the Mexican nursing labor market: a repeated cross-sectional analysis for the period 2005–2018

2019

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BackgroundPrecarization of labor conditions has been expanding over the last three decades as a consequence of global economic transformations. The health workforce labor market is exposed to these transformations as well. In Mexico, analyses of the nursing labor market have documented high levels of unemployment and underemployment; however, precarization has been not considered as a relevant indicator in these analyses. In this study, precarization is analyzed using a quantitative approach to show its prevalence and geographic distribution between 2005 and 2018.MethodsA repeated cross-sectional study was carried out with data from the population-based National Occupation and Employment Survey (ENOE in Spanish) which is administered quarterly to people 15 years or older in over 120 000 households. All individuals who reported having nursing training (technical or university level) were selected for this study. Our main variable was labor precariousness, which included three dimensions: (i) economic, (ii) regulatory, and (iii) occupational safety. We show the evolution of the relative weight of nursing activity between the years 2005 and 2018, the main socio-demographic characteristics of nurses as well as their main labor conditions, and the geographic distribution of precariousness for the 32 federal states in México.ResultsFour of the five indicators of labor precariousness increased among the group of nurses analyzed: (a) the percentage of people with no written contract, (b) the percentage of people with incomes lower than two times the minimum wage, (c) the percentage of nurses without social security, and (d) the percentage of nurses without social benefits. The percentage of nurses that work under some condition of work precariousness increased from 46% in 2005–2006 to 54% in 2018. Finally, the number of states with high precariousness level increased from seven in 2005–2006 to 17 in 2018.ConclusionsThroughout Mexico, nursing precariousness has expanded reaching 53% by 2018. The advancement of precarization of nursing jobs implies a reduction in the capacity of the Mexican health system to reach its coverage and care goals as nurses represent 52% of all available workers that provide direct services to the population.

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“…Un ejemplo de lo anterior lo representan no sólo médicos sino también enfermeras y personal contratado para atender el Seguro Popular, los cuales carecían de seguridad social, y otras prestaciones de ley (Muñoz, 2014). A los profesionales más jóvenes se les ofrecieron plazas como de 'base', cuando en realidad no lo eran; bajo la figura de ser formalizados y homologados tendrían acceso a prestaciones como estímulos económicos, descansos, fondo de auxilio por defunción y fondo nacional sin embargo no tendrían prestaciones como: escalafón, becas en tiempo con fines académicos, licencias de trabajo con y sin goce de sueldo y falta de estímulos por puntualidad (Nigenda et al, 2012;Leal, Ulloa, Sánchez-Pérez, & León-Cortés, 2017).…”

Section: Precarización Laboralunclassified

Flexibilización, precarización laboral y burocracia en salud: tres determinantes de desprofesionalización médica

Torres

Soto

Patiño³

2020

Acta Sci. Human Soc. Sci.

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En la conformación de la sociedad industrial, las profesiones surgieron como un movimiento fundamental de la división del trabajo, de estratificación ocupacional y de clases. Su mantenimiento e importancia a través del tiempo se ha sostenido mediante procesos de profesionalización para la producción de conocimiento especializado que le distinga de otras ocupaciones y al mismo tiempo le brinde autonomía y reconocimiento social para dar legitimidad y permanencia en función de la sociedad. La profesión médica, ha servido como aparato ideológico por parte del Estado para controlar y dominar a la sociedad basados en las necesidades de salud a través de profesionales que ejercen relaciones de poder reducidos a agentes secundarios perpetuando las diferencias de clases. Las profesiones en general han sufrido los estragos de las políticas neoliberales y la profesión médica no es la excepción. La realidad de los servicios de salud circula entre hospitales descuidados, falta de presupuesto, mala atención, falta de material, de recursos humanos y medicamentos, trámites burocráticos, y otros faltantes estructurales que subsumen a la práctica del profesional a indicadores y gestiones administrativas.

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Regularización laboral de trabajadores de la salud pagados con recursos del Seguro Popular en México

Abstract: It is important to consider the need to guarantee that this type of changes in the contractual conditions of workers benefit all actors, particularly the insured population.

Cited by 11 publications

References 3 publications

Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective

Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective

The precarization of the Mexican nursing labor market: a repeated cross-sectional analysis for the period 2005–2018

Flexibilización, precarización laboral y burocracia en salud: tres determinantes de desprofesionalización médica

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