Decentralization and Equity in the Chilean primary health care system
Basualto, Karen (2022)
2022
Master's Programme in Public and Global Health
Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences
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Hyväksymispäivämäärä
2022-05-16
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202204263606
https://urn.fi/URN:NBN:fi:tuni-202204263606
Tiivistelmä
Since the Pinochet dictatorship in the 1970s, the decentralization of Chile's primary health care system began for various reasons. However, as the years progressed, health in Chile did not seem to advance at the same pace as the general development of the country.
This study analyzes how the decentralization process of primary health care in Chile led to inequities between the different municipalities of the country.
To achieve this analysis, a methodology called triangulation was used, where sources of different origins are analyzed to conclude the results of the study. The different sources were: descriptive data from the participating municipalities, official documents and interviews with family health center managers.
As results, decentralization was implemented in official documents, but in practice, they are not adapted to local realities. In addition, in Chile there is a deconcentration of power rather than a deeper decentralization. Finally, decentralization generates inequity, since each commune must take care of the budgetary gap not covered by the central level. And not all communes can take charge of this gap.
The main reason and source of PHC inequality in Chile is that each commune depends on its own income and communes must cover the budget gaps left by the central level.
This study analyzes how the decentralization process of primary health care in Chile led to inequities between the different municipalities of the country.
To achieve this analysis, a methodology called triangulation was used, where sources of different origins are analyzed to conclude the results of the study. The different sources were: descriptive data from the participating municipalities, official documents and interviews with family health center managers.
As results, decentralization was implemented in official documents, but in practice, they are not adapted to local realities. In addition, in Chile there is a deconcentration of power rather than a deeper decentralization. Finally, decentralization generates inequity, since each commune must take care of the budgetary gap not covered by the central level. And not all communes can take charge of this gap.
The main reason and source of PHC inequality in Chile is that each commune depends on its own income and communes must cover the budget gaps left by the central level.