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  1. "Popular" health and the state : Dialectics of the peace process in El Salvador.

    Article - En anglais

    The poor performance of large-scale « vertical » rural health programs tied to state Ministries of Health in Third World countries has often been attributed to a lack of « political will ».

    But that term tells little about the conditions that favor health reform and may obscure disparate power relations and struggles over development.

    This work explores such a struggle over community health that emerged as part of the peace process in a former war zone of El Salvador since the 1992 ceasefire.

    The formalized negotiations (and behind-the-scenes confrontations) over health in Chalatenango province took place between Ministry of Health administrators and proponents of a « popular » health system that has functioned in repopulated villages of rebel-controlled Chalatenango since 1987.

    The Ministry has set up its own national (U.S. AID-designed) community health worker program, and agreed in theory with the popular system's emphasis on village-based lay health promoters ; however, in negotiations and efforts at collaboration in Chalatenango the Ministry has been unwilling to support the promoters in the popular system, to accommodate local participation in health decision-making, or to restructure its own physician-centered practices around the need for more comprehensive approaches to health.

    Mots-clés Pascal : Système santé, Soin santé primaire, Agent santé, Politique sanitaire, Salvador, Amérique Centrale, Amérique, Homme, Milieu rural, Aspect politique, Réforme, Processus paix, Santé communautaire

    Mots-clés Pascal anglais : Health system, Primary health care, Health worker, Health policy, El Salvador, Central America, America, Human, Rural environment, Political aspect, Community health

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0239702

    Code Inist : 002B30A01B. Création : 11/06/1997.