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This paper analyzes the main advances in health coverage and health services demand in Colombia using the 1997 and 2003 living standards surveys. The study showed an increase in health coverage associated with expansion of the subsidized care system, although a large proportion of the population is still not entitled to health care. The type of entitlement also directly affects the demand for services. There was an increase in preventive medical consultations in 2003 and a decrease in the use medical care for acute illness, due mainly to lack of money. Access to medicines increased from 1997 to 2003, as reflected by a decrease in out-of-pocket expenditure on medicines.

This paper discusses the experiences and conceptual and theoretical lessons learned during interaction between researchers, policy-makers, program beneficiaries, and other actors in a research project on social protection, health, and forced displacement in Bogotá, Colombia. The article begins by presenting the methodological approach and a description of interaction between various actors. This experience provides the basis for a conceptual discussion on the factors and determinants of research use. The article also highlights the need for taking an epistemological view beyond the positivist and rationalist underpinnings of the dominant explanations concerning interaction between researchers and decision-makers.

This paper analyzes the effects of health reform in Colombia on public health programs at the local level, particularly the Expanded Program of Immunization (EPI) and the tuberculosis control program. The research was developed in three health districts in two States by analysis of documents, direct observation, and longitudinal follow-up of the transition process. The health districts were unprepared for the change, resulting in insufficient technical skills among staff as well as lack of awareness of important elements in the new system, associated with a reduction in immunization coverage and tuberculosis case detection. Structural problems in the new system included loss of immunization opportunities and lack of examination of tuberculosis contacts. The potentialities of the new system were the local development of a new organizational structure and the improvement of the information system; a limiting factor was exposure of the health system to local political interests. The general conclusion is that the transition period takes far longer than anticipated and requires a much greater information flow to both the local level and the community. There are transitory but also structural maladjustments that require a political response.

This article analyzes the relationship between population growth and ethical principles relating to poverty. The paper is a critical approach to the thesis presented by Peter Singer in his book Practical Ethics. The first part briefly examines the principal topics of his thesis. The author then analyzes the basis of Singer's theory with respect to the following questions: 1. Is overpopulation the main reason for poverty? Is it possible to establish an association between the poverty phenomenon and population growth? 2. Is Singer s demographic perspective valid? 3. Can problems of resource distribution be ignored when talking about poverty from an ethical perspective? 4. Is it true that birth control policy was successfully implemented in Mexico, Colombia, and Brazil? 5. Does Singer s position on population growth have a negative influence on the "collective imagination"? The paper concludes by suggesting some useful arguments for understanding an ethical perspective towards poverty.