Abstract

HOMEDES, Nuria  and  UGALDE, Antonio. Decentralization of health services: case studies in six Mexican states. Salud pública Méx [online]. 2011, vol.53, n.6, pp.493-503. ISSN 0036-3634.

OBJECTIVE: This article discusses the effects of the second decentralization of the Mexican Ministry of Health (1994-2000). MATERIAL AND METHODS: It is based on a review of official and archival documents, health and productivity statistics, observations in clinics and hospitals, and 232 in-depth interviews in the states of Baja California Sur, Colima, Guanajuato, Nuevo León, Sonora and Tamaulipas. The interviewees included high-level administrators of state and district health systems, leaders of workers unions, health providers and representatives of civil society. RESULTS: The article identifies the problems that offices of health at state level had to overcome to implement the decentralization. CONCLUSIONS: Descentralizacion failed to achieve the objectives stated by its promoters.

Keywords : decentralization; health; reform; Mexico.

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