Vision antropológica de la descentralización del sistema de salud en México

Abstract

OBJECTIVE: To analyze organizational, political economic changes resulting from the decentralization of the health system for those in Mexico without health insurance. METHODS: Three states, selected by considering the percentage of the population living in poverty, the political party in power their stage of decentralization (the fi rst was in 1984 the second in 1997) were included. Interviews were conducted during 2007 with key informants from the state health care services, users of health care services, community leaders. Data were analyzed from an anthropological economic perspective. RESULTS: Decentralization occurred in a heterogeneous way in each state, with responsibilities being transferred from federal to state level but without breaking the dependence on the central federal level. The reforms driven from the federal level to create a scheme based on a principle of fi nancial subsidies democratization of the health system face challenges for their political and organizational consolidation. CONCLUSIONS: The anthropological approach adopted in this analysis shows the relevance of considering organizational, economic political factors as key components of the decentralization process.