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Objetivo: La acción de tutela es un instrumento creado con la Constitución de 1991 y constituye un indicador de fallo en el sistema de salud. En 2015 se promulgó la Ley Estatutaria, con la cual se regula el derecho a la salud. Este trabajo analiza los efectos de dicha ley sobre el comportamiento de las tutelas en salud entre 2008 y 2019. Metodología: Se realizó un estudio cuantitativo, con un diseño cuasiexperimental de series de tiempo interrumpidas de las acciones de tutelas en Colombia, a partir de datos provistos por la Defensoría del Pueblo. Resultados: Entre 2008 y 2019, se instauraron 1 719 584 tutelas en salud; estas incrementaron en el 41 % después de la sanción de la Ley. El número de tutelas mensuales pasó de 8714 antes de la Ley, a 12 295 después de su sanción; la diferencia fue de 3581,37 95% (IC 5938,12; 1224,62), con una pendiente positiva de 96,13 cambios que son estadísticamente significativos. Conclusiones: Las medidas adoptadas a partir de la Ley Estatutaria han sido insuficientes para corregir la tendencia creciente de las tutelas de salud en Colombia; contrario a lo esperado, estas han aumentado desde su promulgación. A pesar del cambio en los valores e ideas impulsados por el poder judicial, esta ley no logró una transformación del arreglo institucional, lo que se manifiesta en la persistencia de la tutela como mecanismo para lograr el acceso y goce efectivo a la atención sanitaria. Este análisis aporta un conjunto de elementos --una combinación de aspectos estructurales, funcionales y de la cultura producida-- que podrían explicar dicho comportamiento. [ABSTRACT FROM AUTHOR]

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In 1956 the first health promotion agencies were founded in Colombia and were intended to enhance the health condition in the populations in the most alienated territories. The promoters, especially women, became leading actors in the rural community when their role transcended the public health endeavors. This study seeks to critically understand both the social and public-health roles of the health promoters in the town of Andes, Antioquia during 1976-2015. A study case was conducted using interviews and document reviews. Female promoters with a wide track record, public servants and community leaders took part in the study. The institutionalization of the promoters emerged as the main health alternative for the rural communities in our country. The transformations in the health system have brought about some pressure on this social practice, even though they still prevail. The promoters have had a role with an impact beyond the public-health care as they perform an important function in the construction of the social fabric and the management for a social cultural change in the Colombian rural life. [ABSTRACT FROM AUTHOR]

Background: In Colombia, oral health was incorporated as content of care in the health system, starting with Law 100 of 1993. This change modified the liberal form of professional practice that prevailed since the origin of the dental profession in the country. Purpose: characterize and critically analyze oral health policies in Colombia in the period 1994-2017, with respect to universality, integrality and equity. Policy analysis: A descriptive review was carried out that included standards, technical documents, scientific and opinion articles. A historical hermeneutic approach and a critical reading were used to interpret the policies, classified in relation to individual attention, public health, and professional training and practice. Conclusions: The contents of dental care in the health system include a broad set of procedures and technologies; however, coverage of care is low, and investment is insufficient to guarantee universality. We identified policies related to preventive population measures, epidemiological surveillance, the development of population studies, the implementation of collective actions in everyday life environments and, more recently, the formulation of territorial public policies; however, these policies do not have a clear articulation with each other, and of these with the processes of individual attention. The policies related to the training and work practice of dentistry are market oriented, with a weak regulatory capacity of the State. The development of public policies in oral health is incipient and disarticulated. A greater boost to research in this field is necessary. [ABSTRACT FROM AUTHOR]