La décolonisation de la santé publique en Bolivie ou la fragmentation de tout un secteur.

IF 0.3 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sante Publique Pub Date : 2025-01-01 DOI:10.3917/spub.251.0043

Amélie Aubert Plard

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引用次数: 0

Abstract

Introduction: During its first ten years (2006-2016), the government of Evo Morales led Bolivia through a wave of reforms aimed at establishing a popular nationalism, free from what it calls "Western imperialism."

Purpose of the study: This article analyzes the implementation of the decolonization process, particularly in the reproductive health sector. It highlights the effects generated on those involved and the mechanisms of appropriation and/or rejection. To do this, it focuses on three measures: the My Health program, the professionalization of traditional midwives, and the cultural adaptation of delivery rooms.

Results: While the deployment of the My Health program is developing community medicine that is appreciated by users, it is also giving rise to deep rivalries among healthcare professionals and decision-makers alike. Furthermore, when it comes to intercultural childbirth, the study reveals a lack of both supply and demand.

Conclusion: Far from reforming it structurally, the decolonization process seems to have caused a deep ideological and organizational split within the health sector. The new measures have been implemented in the form of additional, competing programs, which has caused difficulties regarding their acceptance and integration within the established healthcare system. What's more, while in its discourse the government rejects Western colonization, in practice it remains heavily dependent on international aid.

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玻利维亚公共卫生的非殖民化或整个部门的分裂。

简介：在前十年（2006-2016年），埃沃·莫拉莱斯政府领导玻利维亚进行了一系列改革，旨在建立一个受欢迎的民族主义，摆脱所谓的“西方帝国主义”。研究的目的：本文分析非殖民化进程的执行情况，特别是在生殖健康部门。它突出了对有关人员产生的影响以及拨款和（或）拒绝的机制。为此，它将重点放在三项措施上：“我的健康”方案、传统助产士的专业化以及产房的文化适应。结果：虽然“我的健康”计划的部署正在发展社区医学，并受到用户的赞赏，但它也引起了医疗保健专业人员和决策者之间的激烈竞争。此外，当涉及到跨文化分娩时，该研究揭示了供应和需求的缺乏。结论：非殖民化进程非但没有在结构上进行改革，反而似乎在卫生部门内部造成了深刻的思想和组织分裂。新措施以附加的、相互竞争的方案的形式实施，这在接受和融入现有医疗保健系统方面造成了困难。更重要的是，虽然政府在口头上拒绝西方殖民，但实际上它仍然严重依赖国际援助。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sante Publique PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

0.40

自引率

33.30%

发文量

252

审稿时长

>12 weeks

期刊介绍： La revue Santé Publique s’adresse à l’ensemble des acteurs de santé publique qu’ils soient décideurs, professionnels de santé, acteurs de terrain, chercheurs, enseignants ou formateurs, etc. Elle publie des travaux de recherche, des évaluations, des analyses d’action, des réflexions sur des interventions de santé, des opinions, relevant des champs de la santé publique et de l’analyse des services de soins, des sciences sociales et de l’action sociale. Santé publique est une revue à comité de lecture, multidisciplinaire et généraliste, qui publie sur l’ensemble des thèmes de la santé publique parmi lesquels : accès et recours aux soins, déterminants et inégalités sociales de santé, prévention, éducation pour la santé, promotion de la santé, organisation des soins, environnement, formation des professionnels de santé, nutrition, politiques de santé, pratiques professionnelles, qualité des soins, gestion des risques sanitaires, représentation et santé perçue, santé scolaire, santé et travail, systèmes de santé, systèmes d’information, veille sanitaire, déterminants de la consommation de soins, organisation et économie des différents secteurs de production de soins (hôpital, médicament, etc.), évaluation médico-économique d’activités de soins ou de prévention et de programmes de santé, planification des ressources, politiques de régulation et de financement, etc