SciELO - Scientific Electronic Library Online

 
vol.12 suppl.1Notes for studying primary care within the context of segmented health systemsGovernance and Health: The rise of the managerialism in public sector reform author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Revista de Salud Pública

Print version ISSN 0124-0064

Abstract

BASCOLO, Ernesto  and  YAVICH, Natalia. Governance of PHC development in Rosario, Argentina. Rev. salud pública [online]. 2010, vol.12, suppl.1, pp.89-104. ISSN 0124-0064.

Objetive Describing the development of PHC policy as promoted by Rosario Municipality (Argentina). Methods A case-study was carried out during 2007 and 2008. Data was collected from secondary and primary sources (interviews, organisational census and observations). PHC development stages were identified by recognising the social norms which produced institutional change and transformation in municipal health services structure and health care and management models. The prevailing modes of governance in each stage were reconognised and characterised (clan, hierarchy and/or incentives). Results Four stages were identified between 1990 and 2008: 1990-1995/hierarchical mode: primary health care level organisation autonomied from hospitals. 1995-2000/ clan mode: developing of participatory managerial boards and community participation. 2000-2004/ clan mode: maturation of the "PHC movement" in competition with hospitals. 2004-2008/ clan-hierarchical mode: "movement’s" crisis and constructions of norms tending towards enhancing an integrated network. Discussion Strengthening and empowering first-level health-care produced innovation favouring: the consolidation of a "PHC movement" having strong social commitment and improved services performance. The clan governance mode (regulating collective action via voluntary adhesion to shared values) was crucial for developing PHC between 1995 and 2004. Later on, the movement’s fragmentation and the challenges of integrating the health system required developing hierarchical regulation mechanisms to complement the governance clan mode regulation.

Keywords : Governance; government; primary health care; health policy; decision making; organisational models; health management; organizational innovation.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )

 

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License