El análisis de situación de salud poblacional en América Latina y el Caribe, entre 2000 y 2017. Reflexiones y desafíos

Abstract

Objective: To identify the methodological-theoretical evolution of the Health Situation Analysis (HAS) in Latin America and the Caribbean, and analyze the challenges to implement it. Methodology: A narrative review based on research studies, reflective articles and manuals published in databases as EBSCO, PubMed, Redalyc, Scielo and Lilacs, from 2000 to 2017, related to the analysis of the population’s health situation. 67 documents were chosen and analyzed and contents were compared with HAS conducted in the region. Results: The study found that the guidelines to direct the implementation of HAS reproduced an epidemiological/administrative health diagnosis model, many of which subscribe gender perspective, social determinants, intersectionality and social participation as their axis of analysis, which is demonstrated in 90 % of the 19 government reports recovered. 80 % of the 10 original research studies recovered were identified as descriptive, observational and cross-sectional studies, with little participation from first level Healthcare teams and minimum participation from populations and representatives of other sectors linked to health. The main sources used were official demographic and epidemiological statistics, and a very small part of the HSA result in producing action proposals. Conclusions: Implementing HSA represents challenges like transcending the pathological and sectorial notion of health, incorporating positive health indicators, as well as other health inequality indicators that allow a broader assessment of the population's health situation, their social determinants and the gradients of inequality expressed in diseases and access to health care services. Epidemiological methods with ethnographic and social participation techniques should be used in practice to support a comprehensive intersectional health analysis; and healthcare teams, particularly first level teams, should be trained to conduct effective studies to monitor and understand the trends and differentials in the health/diseases of population groups.

Keywords

• health situation diagnosis
• intersectoral collaboration
• social health determinants
• social participation
• health planning