7 results
Search Results
2. How can a policy foster local pharmaceutical production and still protect public health? Lessons from the health–industry complex in Brazil.
- Author
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da Fonseca, Elize Massard
- Subjects
- *
DRUG development , *POLICY sciences , *PUBLIC health , *HEALTH services accessibility , *INTERVIEWING , *RESEARCH methodology , *HEALTH policy , *PHARMACEUTICAL industry , *PSYCHOLOGY - Abstract
The global health community is increasingly advocating for the local production of pharmaceuticals in developing countries as a way to promote technology transfer, capacity building and improve access to medicines. However, efforts to advance drug manufacturing in these countries revive an old dilemma of fostering technological development versus granting access to social services, such as healthcare. This paper explores the case of Brazil, a country that has developed large-scale health-inspired industrial policies, but is, yet, little understood. Brazil’s experience suggests that progressive healthcare bureaucrats can create innovative practices for technology and knowledge transfers. It also demonstrates that highly competitive pharmaceutical firms can collaborate with each other, if a government provides them the right incentives. Reforming regulatory policies is crucial for guaranteeing high-quality products in developing countries, but governments must play a crucial role in supporting local firms to adapt to these regulations. These findings send a strong message to global health policymakers and practitioners on the conditions to create a suitable environment for local production of medical products. [ABSTRACT FROM PUBLISHER]
- Published
- 2018
- Full Text
- View/download PDF
3. Infiltrating the State: The Evolution of Health Reforms Under Authoritarianism and Democracy in Brazil.
- Author
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Falleti, Tulia G.
- Subjects
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MEDICAL care , *PUBLIC health , *INTERORGANIZATIONAL relations , *INTERGROUP relations , *HEALTH policy - Abstract
This paper analyzes the institutional evolution of the health care system that led to the universalization of coverage and municipalization in the provision of basic health care in Brazil. I argue that a process of state-society transformation in the context of the authoritarian state facilitated the infiltration of the state bureaucracy by reformist groups of society. These activists reoriented the authoritarian health policies toward new goals. In analyzing this case of institutional change, the article advances a gradualist approach to institutional evolution and alerts scholars against the prioritization of critical junctures or locked-in effects in explanations of institutional change or stasis. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]
- Published
- 2008
4. Fundação Nacional de Saúde. A política brasileira de saúde indígena vista através de um museu.
- Author
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Teixeira, Carla Costa
- Subjects
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HEALTH policy , *SOCIAL policy , *PUBLIC health , *GOVERNMENT policy , *MEDICAL care - Abstract
This article analyses Brazilian state policy for indigenous health based on the inquiry of the recent historical, political and managerial process that resulted in the creation, in 1991, of the National Health Foundation (Funasa). I t attempts to bring together two lines of thought triggered by the examination of the Funasa Museum collection and by interviews with Funasa employees. T he threads thus woven should make possible, on the one hand, (i) to trace a genealogy of the National Health Foundation, and, on the other, (ii) to highlight its role in setting the hurdles that prevent the consolidation of a political field of respect for diversity in indigenous health policy. T he paper, therefore, consists of an approach which aims at pulling together biographic narratives with institutional memory. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
5. Meaning and Structure in Research in Medical Anthropology.
- Author
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Dressler, William W.
- Subjects
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PUBLIC health , *MEDICAL anthropology , *HEALTH policy , *SOCIAL structure - Abstract
In an earlier paper (Dressler, 2001), I suggested that medical anthropology as a research enterprise could not ignore either meaning or structure in human social life in the production of health. Rather, drawing on the early work of Bourdieu, I argued that we need to take into account both how the world is configured by the collective meanings we impose upon it, as well as the social structural (and physical) constraints on our behaviour that exist outside those meanings. Human health can be understood, in part, as the intersection of meaning and structure. Here, my aim is to extend this perspective in three ways. Firstly, I present an expanded theoretical framework within which collectivei meaning and social structure can be conceptualised. A useful theoretical framework must take into account paradoxical features of culture, including the seeming contradiction that it is a property both of social aggregates and of individuals, and that, ultimately, social structural constraints external to individuals depend on shared meaning. Secondly, I review recent research employing this perspective conducted in Brazil, the southern United States and Puerto Rico. These studies have all employed a 'structural-constructivist' theoretical orientation, using especially the concept of 'cultural consonance', or the degree to which individuals incorporate shared meaning into their own beliefs and behaviour. Where individual efforts to attain a higher cultural consonance are frustrated by structural constraints, poor health results. Thirdly, I consider some of the policy implications of this perspective. While much work in traditional public health focuses on a highly individualised notion of meaning (as in 'health beliefs'), it seems unlikely that the health of populations can be altered substantially without taking into account the structures that constrain individual action. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
6. Health priorities in Brazil in the 1990s: three policies, many lessons.
- Author
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Machado, Cristiani Vieira
- Subjects
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DECENTRALIZATION in government , *PUBLIC health , *PUBLIC welfare ,BRAZIL. Ministry of Health - Abstract
This paper, which focuses on the Brazilian Ministry of Health's agenda as the national health authority between 1990 and 2002, identifies and analyzes Ministry priorities. Three ,lain policies were identified for the period: decentralization, establishment of a family health program, and the policy to combat AIDS. In general, the initial design of these policies was consistent with the guidelines of the Brazilian public health system (SUS). Howitzer, discrepancies were found between the universalistic agenda of the Brazilian health reform carried out in the 1980s and the hegemonic agenda of state reform that prevailed in the country in the 1990s, which had liberal roots and did not favor the expansion of government actions and comprehensive social policies. Within this unfavorable political and economic context, the development of specific health policies prioritized by the Brazilian Ministry of Health revealed unsolved problems and gaps in the public health system and limitations in the Ministry's ability to exercise its role as national health authority. [ABSTRACT FROM AUTHOR]
- Published
- 2006
7. Discretion, power and the reproduction of inequality in health policy implementation: Practices, discursive styles and classifications of Brazil's community health workers.
- Author
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Nunes, João and Lotta, Gabriela
- Subjects
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HEALTH policy , *HEALTH care rationing , *HEALTH services accessibility , *HEALTH status indicators , *INTERVIEWING , *LABOR supply , *POWER (Social sciences) , *PUBLIC health , *DECISION making in clinical medicine , *SOCIAL support - Abstract
This article explores the mobilization of power by health workers during policy implementation, showing how in a context of discretion and resource scarcity they can reproduce inequalities in access to health services. The argument innovates theoretically by supplementing the 'street-level bureaucracy' literature, which emphasizes frontline worker discretion, with a conceptualization of power as domination encompassing the shaping of behavior, the constitution of subjects and the reproduction of inequality. Empirically, the article focuses on Brazilian community health workers (agentes comunitários de saúde , CHWs). CHWs are a neglected but highly important segment of the health workforce that traditionally functions as a link between the health system and disadvantaged groups. The article examines how Brazilian CHWs act as street-level bureaucrats mobilizing power in their interactions with users. They operate within a severely under-resourced public health system, the Sistema Único de Saúde , which places constraints upon their action and forces them to make allocation decisions with little training and support. The article highlights the ways in which inequalities in access to health services are reproduced (inadvertently or not) through the practices, discursive styles and classifications of CHWs. Methodologically, the paper is based on ethnography with 24 CHWs and interviews with 77 other CHWs in Brazil. • Develops a novel framework for analysing health worker discretion and power. • Supplements the street-level bureaucracy approach with the concept of domination. • Explores the mobilization of power by Brazilian community health workers. • Shows how policy implementation can reproduce inequality in access to healthcare. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
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