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Search Results: 1 - 10 of 32456 matches for " Antonio Ugalde "
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A Spatially Extended Model for Residential Segregation
Antonio Aguilera,Edgardo Ugalde
Discrete Dynamics in Nature and Society , 2007, DOI: 10.1155/2007/48589
Abstract: We analyze urban spatial segregation phenomenon in terms of the income distribution over a population, and an inflationary parameter weighting the evolution of housing prices. For this, we develop a discrete spatially extended model based on a multiagent approach. In our model, the mobility of socioeconomic agents is driven only by the housing prices. Agents exchange location in order to fit their status to the cost of their housing. On the other hand, the price of a particular house depends on the status of its tenant, and on the neighborhood mean lodging cost weighted by a control parameter. The agent's dynamics converges to a spatially organized configuration, whose regularity is measured by using an entropy-like indicator. This simple model provides a dynamical process organizing the virtual city, in a way that the population inequality and the inflationary parameter determine the degree of residential segregation in the final stage of the process, in agreement with the segregation-inequality thesis put forward by Douglas Massey.
Las reformas neoliberales del sector de la salud: déficit gerencial y alienación del recurso humano en América Latina
Ugalde,Antonio; Homedes,Nuria;
Revista Panamericana de Salud Pública , 2005, DOI: 10.1590/S1020-49892005000300011
Abstract: this work analyzes the neoliberal health sector reforms that have taken place in latin america, the preparation of health care workers for the reforms, the reforms' impacts on the workers, and the consequences that the reforms have had on efficiency and quality in the health sector. the piece also looks at the process of formulating and implementing the reforms. the piece utilizes secondary sources and in-depth interviews with health sector managers in bolivia, colombia, costa rica, the dominican republic, ecuador, el salvador, and mexico. neoliberal reforms have not solved the human resources problems that health sector evaluations and academic studies had identified as the leading causes of health system inefficiency and low-quality services that existed before the reforms. the reforms worsened the situation by putting new pressures on health personnel, in terms of both the lack of necessary training to face the challenges that came with the reforms and efforts to take away from workers the rights and benefits that they had gained during years of struggles by unions, and to replace them with temporary contracts, reduced job security, and lower benefits. the secrecy with which the reforms were developed and applied made workers even more unified. in response, unions opposed the reforms, and in some countries they were able to delay the reforms. the neoliberal reforms have not improved the efficiency or quality of health systems in latin america despite the resources that have been invested. nor have the neoliberal reforms supported specific changes that have been applied in the public sector and that have demonstrated their ability to solve important health problems. these specific changes have produced better results than the neoliberal reforms, and at a lower cost.
Las reformas de salud neoliberales en América Latina: una visión crítica a través de dos estudios de caso
Homedes,Nuria; Ugalde,Antonio;
Revista Panamericana de Salud Pública , 2005, DOI: 10.1590/S1020-49892005000300012
Abstract: neoliberal reforms have promoted privatization and decentralization as strategies to improve equity, efficiency, and the quality of health services. in this piece the impact of these reforms in latin america is critically analyzed, and the impacts of privatization in colombia and of decentralization in mexico are detailed. these two cases show that after 10 years of privatization in colombia and 20 years of decentralization in mexico the reforms have had the opposite of the desired effect: they have not improved equity, have increased health expenditures, have not increased efficiency, and have not shown a positive impact on quality. public health programs in colombia have deteriorated, while decentralization in mexico has had a very high cost, without achieving the proposed objectives. it is officially accepted that decentralization in mexico has increased inequity, and that new reforms implemented in 2003 promote vertical programs. health systems based on regulated competition are not the most suitable ones for latin america. latin american countries should improve their health systems in line with the principles stated in the declaration of alma ata and according to their own national experiences.
Descentralización de los servicios de salud: estudios de caso en seis estados mexicanos
Homedes,Nuria; Ugalde,Antonio;
Salud Pública de México , 2011, DOI: 10.1590/S0036-36342011000600005
Abstract: 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.
Twenty-Five Years of Convoluted Health Reforms in Mexico
Núria Homedes ,Antonio Ugalde
PLOS Medicine , 2009, DOI: 10.1371/journal.pmed.1000124
Human resources: the Cinderella of health sector reform in Latin America
Núria Homedes, Antonio Ugalde
Human Resources for Health , 2005, DOI: 10.1186/1478-4491-3-1
Abstract: This article is based on fieldwork and a review of the literature. It discusses the reasons that led health workers to oppose reform; the institutional and legal constraints to implementing reform as originally designed; the mismatch between the types of personnel needed for reform and the availability of professionals; the deficiencies of the reform implementation process; and the regulatory weaknesses of the region.The discussion presents workforce strategies that the reforms could have included to achieve the intended goals, and the need to take into account the values and political realities of the countries. The authors suggest that autochthonous solutions are more likely to succeed than solutions imported from the outside.Health reforms that aim at increasing efficiency, quality and users' satisfaction need to take into consideration human resource issues, because the health sector is labor-intensive and the performance of health systems depends on qualified and motivated workers [1-4]. At the same time, the support of the workforce is crucial to ensure successful implementation of reforms.In Latin America, the need to improve the performance of the workforce had been pointed out in many health sector assessments conducted in the 1970s and 1980s by the United States Agency for International Development (USAID), the World Bank (WB), other agencies and independent researchers. (See for Argentina [5-7], for Bolivia [8-10], for Brazil [11], for Chile [7,12], for Colombia [12-14], for Costa Rica [15], for the Dominican Republic [16-18], for Ecuador [19,20], for El Salvador [21], for Guatemala [22,23], for Mexico [12,24-26], for Nicaragua [27], for Panama [28,29], and for Uruguay [7].)From these reports and studies, and notwithstanding the differences among the countries in the region, we can summarize the problems present during the 1970s and 1980s as follows:? The skill mix of health personnel was often inadequate to meet the needs of the communities, and highly q
Multisource drug policies in Latin America: survey of 10 countries
Homedes,Núria; Ugalde,Antonio;
Bulletin of the World Health Organization , 2005, DOI: 10.1590/S0042-96862005000100016
Abstract: essential drug lists and generic drug policies have been promoted as strategies to improve access to pharmaceuticals and control their rapidly escalating costs. this article reports the results of a preliminary survey conducted in 10 latin american countries. the study aimed to document the experiences of different countries in defining and implementing generic drug policies, determine the cost of registering different types of pharmaceutical products and the time needed to register them, and uncover the incentives governments have developed to promote the use of multisource drugs. the survey instrument was administered in person in chile, ecuador and peru and by email in argentina, brazil, bolivia, colombia, costa rica, nicaragua and uruguay. there was a total of 22 respondents. survey responses indicated that countries use the terms generic and bioequivalence differently. we suggest there is a need to harmonize definitions and technical concepts.
La descentralización de los servicios de salud: de la teoría a la práctica
Ugalde,Antonio; Homedes,Núria;
Salud Colectiva , 2008, DOI: 10.1590/S1851-82652008000100003
Abstract: the current promoters of the decentralization of health services affirm that its implementation will improve the quality, equity and efficiency of health systems and at the same time will increase users' satisfaction. additionally, those who advocate decentralization believe that it will facilitate community participation in health decisionmaking, and as a result it will strengthen the democratic process. in this study we discuss first the lack of consensus regarding the meaning of decentralization and the difficulties of measuring the degree of decentralization of a health system. we also identify the actors who have formulated the above hypotheses, examine the reasons behind its formulation, and analyze if the outcome of the decentralization of the latin american health services confirm the hypotheses.
América Latina: la acumulación de capital, la salud y el papel de las instituciones internacionales
Ugalde,Antonio; Homedes,Núria;
Salud Colectiva , 2007, DOI: 10.1590/S1851-82652007000100003
Abstract: during the second half of the 20th century, there have been great transformations in the world's social and political organization. while the colonial system was being dismantled, international institutions were being built and the large multinational enterprises that took on the function of capital accumulation for the new transnational bourgeoisie began to emerge. this paper analyzes such transformation in the health sector and provides information on the role of international institutions in capital accumulation. the world bank, the international monetary fund and the world trade organization are used as examples, as well as international cooperation agencies. two major policies are addressed: health reforms and medicine-related policies. the analysis shows that reforms and medicine-related policies have not aimed at complying with the latin american countries' constitutional mandate requiring governments to provide health services to everyone but at accumulating capital. multinational enterprises have used international institutions to ensure their aim of accumulating capital, and the paper concludes by suggesting that they were created for that purpose.
Medicamentos para lucrar: la transformación de la industria farmacéutica
Ugalde,Antonio; Homedes,Núria;
Salud Colectiva , 2009, DOI: 10.1590/S1851-82652009000300002
Abstract: the article analyzes the case of merck and shows that this firm, considered during many decades to be the most innovative, highly scientific and profitable, the bluest of the blue chips, has in the last years transformed itself into a commercial enterprise. its main objective is to increase the sales of drugs regardless of their therapeutic value. the discovery of true innovative drugs that add new therapeutic value has decreased notably. in the second part, the authors present data indicating that merck's case is not unique. the innovative pharmaceutical industry, known as "big pharma", has followed the same trend. in the process, fundamental ethical principles are routinely violated. the paper discusses the health consequences of the industry's transformation.
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