Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study

Autores
Báscolo, Ernesto Pablo; Yavich, Natalia; Jean-Louis Denis
Año de publicación
2016
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Primary health care (PHC)-based reforms have had different results in Latin America. Little attention has been paid to the enablers of collective action capacities required to produce a comprehensive PHC approach. Objective: To analyse the enablers of collective action capacities to transform health systems towards a comprehensive PHC approach in Latin American PHC-based reforms. Methods: We conducted a longitudinal, retrospective case study of three municipal PHC-based reforms in Bolivia and Argentina. We used multiple data sources and methodologies: Document review; interviews with policymakers, managers and practitioners; and household and services surveys. We used temporal bracketing to analyse how the dynamic of interaction between the institutional reform process and the collective action characteristics enabled or hindered the enablers of collective action capacities required to produce the envisioned changes. Results: The institutional structuring dynamics and collective action capacities were different in each case. In Cochabamba, there was an 'interrupted' structuring process that achieved the establishment of a primary level with a selective PHC approach. In Vicente López, there was a 'path-dependency' structuring process that permitted the consolidation of a 'primary care' approach, but with limited influence in hospitals. In Rosario, there was a 'dialectic' structuring process that favoured the development of the capacities needed to consolidate a comprehensive PHC approach that permeates the entire system. Conclusion: The institutional change processes achieved the development of a primary health care level with different degrees of consolidation and system-wide influence given how the characteristics of each collective action enabled or hindered the 'structuring' processes.
Fil: Báscolo, Ernesto Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
Fil: Yavich, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
Fil: Jean-Louis Denis. École Nationale d’Administration Publique; Canadá
Materia
ACCESS
AND EVALUATION
HEALTH CARE QUALITY
HEALTH CARE REFORM
LEADERSHIP
ORGANIZATIONAL INNOVATION
POLITICS
PRIMARY HEALTH CARE
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/52631
Acceder
id CONICETDig_400ecd7582f92ebbed9b4d6e24be592b
oai_identifier_str oai:ri.conicet.gov.ar:11336/52631
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case studyBáscolo, Ernesto PabloYavich, NataliaJean-Louis DenisACCESSAND EVALUATIONHEALTH CARE QUALITYHEALTH CARE REFORMLEADERSHIPORGANIZATIONAL INNOVATIONPOLITICSPRIMARY HEALTH CAREhttps://purl.org/becyt/ford/5.9https://purl.org/becyt/ford/5Background: Primary health care (PHC)-based reforms have had different results in Latin America. Little attention has been paid to the enablers of collective action capacities required to produce a comprehensive PHC approach. Objective: To analyse the enablers of collective action capacities to transform health systems towards a comprehensive PHC approach in Latin American PHC-based reforms. Methods: We conducted a longitudinal, retrospective case study of three municipal PHC-based reforms in Bolivia and Argentina. We used multiple data sources and methodologies: Document review; interviews with policymakers, managers and practitioners; and household and services surveys. We used temporal bracketing to analyse how the dynamic of interaction between the institutional reform process and the collective action characteristics enabled or hindered the enablers of collective action capacities required to produce the envisioned changes. Results: The institutional structuring dynamics and collective action capacities were different in each case. In Cochabamba, there was an 'interrupted' structuring process that achieved the establishment of a primary level with a selective PHC approach. In Vicente López, there was a 'path-dependency' structuring process that permitted the consolidation of a 'primary care' approach, but with limited influence in hospitals. In Rosario, there was a 'dialectic' structuring process that favoured the development of the capacities needed to consolidate a comprehensive PHC approach that permeates the entire system. Conclusion: The institutional change processes achieved the development of a primary health care level with different degrees of consolidation and system-wide influence given how the characteristics of each collective action enabled or hindered the 'structuring' processes.Fil: Báscolo, Ernesto Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; ArgentinaFil: Yavich, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; ArgentinaFil: Jean-Louis Denis. École Nationale d’Administration Publique; CanadáOxford University Press2016-06info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/52631Báscolo, Ernesto Pablo; Yavich, Natalia; Jean-Louis Denis; Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study; Oxford University Press; Family Practice; 33; 3; 6-2016; 207-2180263-21361460-2229CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/fampra/article/33/3/207/1749908info:eu-repo/semantics/altIdentifier/doi/10.1093/fampra/cmw038info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439347/info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:19:36Zoai:ri.conicet.gov.ar:11336/52631instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:19:36.745CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study
title Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study
spellingShingle Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study
Báscolo, Ernesto Pablo
ACCESS
AND EVALUATION
HEALTH CARE QUALITY
HEALTH CARE REFORM
LEADERSHIP
ORGANIZATIONAL INNOVATION
POLITICS
PRIMARY HEALTH CARE
title_short Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study
title_full Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study
title_fullStr Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study
title_full_unstemmed Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study
title_sort Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study
dc.creator.none.fl_str_mv Báscolo, Ernesto Pablo
Yavich, Natalia
Jean-Louis Denis
author Báscolo, Ernesto Pablo
author_facet Báscolo, Ernesto Pablo
Yavich, Natalia
Jean-Louis Denis
author_role author
author2 Yavich, Natalia
Jean-Louis Denis
author2_role author
author
dc.subject.none.fl_str_mv ACCESS
AND EVALUATION
HEALTH CARE QUALITY
HEALTH CARE REFORM
LEADERSHIP
ORGANIZATIONAL INNOVATION
POLITICS
PRIMARY HEALTH CARE
topic ACCESS
AND EVALUATION
HEALTH CARE QUALITY
HEALTH CARE REFORM
LEADERSHIP
ORGANIZATIONAL INNOVATION
POLITICS
PRIMARY HEALTH CARE
purl_subject.fl_str_mv https://purl.org/becyt/ford/5.9
https://purl.org/becyt/ford/5
dc.description.none.fl_txt_mv Background: Primary health care (PHC)-based reforms have had different results in Latin America. Little attention has been paid to the enablers of collective action capacities required to produce a comprehensive PHC approach. Objective: To analyse the enablers of collective action capacities to transform health systems towards a comprehensive PHC approach in Latin American PHC-based reforms. Methods: We conducted a longitudinal, retrospective case study of three municipal PHC-based reforms in Bolivia and Argentina. We used multiple data sources and methodologies: Document review; interviews with policymakers, managers and practitioners; and household and services surveys. We used temporal bracketing to analyse how the dynamic of interaction between the institutional reform process and the collective action characteristics enabled or hindered the enablers of collective action capacities required to produce the envisioned changes. Results: The institutional structuring dynamics and collective action capacities were different in each case. In Cochabamba, there was an 'interrupted' structuring process that achieved the establishment of a primary level with a selective PHC approach. In Vicente López, there was a 'path-dependency' structuring process that permitted the consolidation of a 'primary care' approach, but with limited influence in hospitals. In Rosario, there was a 'dialectic' structuring process that favoured the development of the capacities needed to consolidate a comprehensive PHC approach that permeates the entire system. Conclusion: The institutional change processes achieved the development of a primary health care level with different degrees of consolidation and system-wide influence given how the characteristics of each collective action enabled or hindered the 'structuring' processes.
Fil: Báscolo, Ernesto Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
Fil: Yavich, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
Fil: Jean-Louis Denis. École Nationale d’Administration Publique; Canadá
description Background: Primary health care (PHC)-based reforms have had different results in Latin America. Little attention has been paid to the enablers of collective action capacities required to produce a comprehensive PHC approach. Objective: To analyse the enablers of collective action capacities to transform health systems towards a comprehensive PHC approach in Latin American PHC-based reforms. Methods: We conducted a longitudinal, retrospective case study of three municipal PHC-based reforms in Bolivia and Argentina. We used multiple data sources and methodologies: Document review; interviews with policymakers, managers and practitioners; and household and services surveys. We used temporal bracketing to analyse how the dynamic of interaction between the institutional reform process and the collective action characteristics enabled or hindered the enablers of collective action capacities required to produce the envisioned changes. Results: The institutional structuring dynamics and collective action capacities were different in each case. In Cochabamba, there was an 'interrupted' structuring process that achieved the establishment of a primary level with a selective PHC approach. In Vicente López, there was a 'path-dependency' structuring process that permitted the consolidation of a 'primary care' approach, but with limited influence in hospitals. In Rosario, there was a 'dialectic' structuring process that favoured the development of the capacities needed to consolidate a comprehensive PHC approach that permeates the entire system. Conclusion: The institutional change processes achieved the development of a primary health care level with different degrees of consolidation and system-wide influence given how the characteristics of each collective action enabled or hindered the 'structuring' processes.
publishDate 2016
dc.date.none.fl_str_mv 2016-06
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/52631
Báscolo, Ernesto Pablo; Yavich, Natalia; Jean-Louis Denis; Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study; Oxford University Press; Family Practice; 33; 3; 6-2016; 207-218
0263-2136
1460-2229
CONICET Digital
CONICET
url http://hdl.handle.net/11336/52631
identifier_str_mv Báscolo, Ernesto Pablo; Yavich, Natalia; Jean-Louis Denis; Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: A multiple case study; Oxford University Press; Family Practice; 33; 3; 6-2016; 207-218
0263-2136
1460-2229
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/fampra/article/33/3/207/1749908
info:eu-repo/semantics/altIdentifier/doi/10.1093/fampra/cmw038
info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439347/
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1844614169244991488
score 13.070432

Publicaciones similares