[Desperately seeking decentralisation: Mexican health policies in two periods of reform: the 1920s-30s and the 1980s].
This article compares public health policy reforms in Mexico during the 1920s and 1930s with subsequent reforms initiated in the 1980s. The attempts at decentralization in the 1920s-30s were supported by the Rockefeller Foundation, which was interested in the formation of local cooperative health units. In the 1980s, the aim of the Mexican government and international financial agencies, such as the Inter-American Development Bank, was to reduce public spending (as part of "structural adjustment" policies). One of the hypotheses of this article is that, in the end, the public health reforms were unable to overcome the limitations imposed by Mexico's political centralization and longstanding inequities in public spending. At the same time, one of the unforeseen achievements of these reforms was an increase in local capabilities to demand a better distribution of social services.
Birn
Anne-Emannuelle
AE
Department of Public Health Sciences, University of Toronto, Canadá. ae.birn@utoronto.ca
D035082:Federal Government / Q000266:history; D018166:Health Care Reform / Q000266:history* / Q000458:organization & administration; D005102:Health Expenditures / Q000266:history; D006291:Health Policy / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D008800:Mexico