medigraphic.com
Instituto Nacional de Salud Pública

2021, Number 5

salud publica mex 2021; 63 (5)

Governance in health system in the face of the Covid-19 pandemic in Mexico

Díaz-Castro L, Ramírez-Rojas MG, Cabello-Rangel H, Arredondo A, BáscoloEP

Language: Spanish
References: 26
Page: 672-681
PDF size: 412.16 Kb.


ABSTRACT

Objective. Analyze governance in the Mexican health system, with regards to policies to combat the Covid-19 pandemic. Materials and methods. Qualitative, analytic study carried out from June to November, 2020. Forty-one semi-structured interviews with key actors in the health system were analyzed and organized in ATLAS.ti-v.9 software. The analysis followed theoretical-methodological principles of the Governance Analytical Framework. Results. The problem: the policy-making was centralized; the actors: only high level actors participated in the decisions; decision-making: high level actors recognized power to propose modifications in the regulatory framework; nodes: federal policies were adapted at the state level in a differential manner. Conclusions. Centralized governance, differential levels of convocation of actors, decision-making power, level of agreements, as well as responsibility and leadership, all defined the reach of governance and, in turn, the level of response to the Covid-19 pandemic.


REFERENCES

  1. AlKhaldi M, Kaloti R, Shella D, Al Basuoni A, Meghari H. Health system’s response to the COVID-19 pandemic in conflict settings: Policy reflections from Palestine. Glob Public Health. 2020;15(8):1244-56. https://doi.org/10. 1080/17441692.2020.1781914

  2. Kickbusch Il, Gleicher D. Governance for health in the 21st century [Internet]. Copenhague: World Health Organization, Regional Office for Europe, 2012 [citado junio 9, 2021]. Disponible en: https://apps.who.int/ iris/handle/10665/326429

  3. Gale N, Dowswell G, Greenfield S, Marshall T. Street-level diplomacy? Communicative and adaptive work at the front line of implementing public health policies in primary care. Soc Sci Med. 2017;177:9-18. https://doi. org/10.1016/j.socscimed.2017.01.046

  4. Rai NK, Il-Kwang R, Wulandari EW, Subrata F, Sugihantono A, Sitohang V. Strengthening emergency preparedness and response systems: experience from Indonesia. WHO South-East Asia J Public Health. 2020;9(1):26-31. https://doi.org/10.4103/2224-3151.282992

  5. Duan T, Jiang H, Deng X, Zhang Q, Wang F. Government intervention, risk perception, and the adoption of protective action recommendations: Evidence from the COVID-19 prevention and control experience of China. Int J Environ Res Public Health. 2020;17(10):3387. https://doi. org/10.3390/ijerph17103387

  6. Khan Y, O’Sullivan T, Brown A, Tracey S, Gibson J, Généreux M, et al. Public health emergency preparedness: a framework to promote resilience. BMC Public Health. 2018;18(1):1-16. https://doi.org/10.1186/s12889-018- 6250-7

  7. Hsiang S, Allen D, Annan-Phan S, Bell K, Bolliger I, Chong T, et al. The effect of large-scale anti-contagion policies on the COVID-19 pandemic. Nature. 2020;584:262-7. https://doi.org/10.1038/s41586-020-2404-8

  8. Tabari P, Amini M, Moghadami M, Moosavi M. International public health responses to COVID-19 outbreak: A rapid review. Iran J Med Sci. 2020;45(3):157-69. https://doi.org/10.30476/ijms.2020.85810.1537

  9. Connolly J. The “wicked problems” of governing UK health security disaster prevention: The case of pandemic influenza. Disaster Prev Manag. 2015;24(3):369-82. https://doi.org/10.1108/DPM-09-2014-0196

  10. Cheng C, Barceló J, Hartnett AS, Kubinec R, Messerschmidt L. COVID- 19 Government Response Event Dataset (CoronaNet v.1.0). Nat Hum Behav. 2020;4(7):756-68. https://doi.org/10.1038/s41562-020-0909-7

  11. Hufty M. Governance in Public Health: Towards an analytical framework. Rev Salud Publica. 2010;12(supl 1):39-61.

  12. Prats J. Gobernabilidad democrática para el desarrollo humano. Marco conceptual y analítico. Madrid: Inter-American Development Bank, 2001.

  13. Goodin RE, Klingemann HD, eds. A new handbook of political science. Oxford: Oxford University Press, 1998.

  14. Hufty M, Báscolo E, Bazzani R. Gobernanza en salud: un aporte conceptual y analítico para la investigación. Cad Saude Publica. 2006;22(Supl):S35-S45.

  15. Díaz-Castro L, Arredondo A, Pelcastre-Villafuerte BE, Hufty M. Indicators of governance in mental health policies and programmes in Mexico: a perspective of key actors. Gac Sanit. 2017;31(4):305-12. https://doi. org/10.1016/j.gaceta.2016.08.001

  16. Secretaría de Gobernación. Manual de percepciones de los servidores públicos de las dependencias y entidades de la Administración Pública Federal. México: Diario Oficial de la Federación, 2020 [citado julio 9, 2020]. Disponible en: http://dof.gob.mx/nota_detalle.php?codigo=5594049 &fecha=29/05/2020

  17. Gómez-Dantés O, Sesma S, Becerril VM, Knaul FM, Arreola H, Frenk J. El Sistema de Salud de México. Salud Publica Mex. 2011;53(suppl 2):s220-32.

  18. Fouquet A. Diferencias regionales en México: una herencia geográfica y política. En: Guzmán N, ed. Sociedad y Desarrollo en México. Monterrey: Ediciones Castillo/ITESM, 2002:385-402.

  19. McMahon M, Nadigel J, Thompson E, Glazier R. Informing Canada’ s Health System Response to COVID-19?: Priorities for Health Services and Policy Research. Healthc Policy. 2020;16(1):112-24. https://doi. org/10.12927/hcpol.2020.26249

  20. Greer SL, Wismar M, Figueras J, eds. Strengthening Health System Governance. Better policies, stronger performance [Internet]. London: Open University Press, McGraw-Hill Education, 2016 [citado noviembre 30, 2020]. Disponible en: https://www.euro.who.int/__data/assets/pdf_ file/0004/307939/Strengthening-health-system-governance-better-policiesstronger- performance.pdf

  21. Shangguan Z, Wang MY, Sun W. What caused the outbreak of COVID-19 in China: From the perspective of crisis management. Int J Environ Res Public Health. 2020;17(9):3279. https://doi.org/10.3390/ijerph17093279

  22. Xu T, Yang R. COVID-19 Epidemic and Public Health Measures in China. J Epidemiol Glob Health. 2020;10(2):118-23. https://doi.org/10.2991/ jegh.k.200421.001

  23. Aquino EML, Silveira IH, Pescarini JM, Aquino R, de Souza-Filho JA, Rocha A, et al. Social distancing measures to control the COVID-19 pandemic: Potential impacts and challenges in Brazil. Cienc e Saude Coletiva. 2020;25(suppl 1):2423-46. https://doi.org/10.1590/1413- 81232020256.1.10502020

  24. Makuta I, O’Hare B. Quality of governance, public spending on health and health status in Sub Saharan Africa: a panel data regression analysis. BMC Public Health. 2015;15(932). https://doi.org/10.1186/s12889-015- 2287-z

  25. Plamondon KM, Pemberton J. Blending integrated knowledge translation with global health governance: An approach for advancing action on a wicked problem. Health Res Policy Sys. 2019;17(1):1-10. https://doi. org/10.1186/s12961-019-0424-3

  26. Siddiqi S, Masud TI, Nishtar S, Peters DH, Sabri B, Bile KM, et al. Framework for assessing governance of the health system in developing countries: Gateway to good governance. Health Policy. 2009;90(1):13-25. https://doi.org/10.1016/j.healthpol.2008.08.005




2020     |     www.medigraphic.com