A wide-ranging analysis of what can be done, in the region of the Americas, to restructure health care within the context of a far-reaching economic crisis, deteriorating quality of services, glaring inefficiencies in health care, and growing inequalities. The book is the outgrowth of a PAHO project aimed at stimulating a fundamental rethinking of both the theory and practice of public health, particularly in view of a situation where most societies have proved unable to promote and protect the health of their populations, and where the majority of Latin American populations continue to experience excessive mortality rates in all age groups for most categories of public health problems, including many that are, in theory, easily preventable. The book has three parts. Contributions in the first part trace the evolution of concern about the crisis and of PAHOs commitment to stimulate a rethinking of the theory and practice of public health aimed at a revitalization and reorientation of services, research, and teaching. The second part consists of eleven invited papers from leading experts, who present their views of the current crisis, consider its roots, and explore a wide range of remedial actions that might be taken in response to the deteriorating health situation throughout the region. A central question explored is whether different and more complex public health theories and practices are needed to support the formulation of new guidelines or policy directives for public health. The final part summarizes the conclusions reached by a consultative group convened to consider the need for changes in the theory and practice of public health in the Americas.

DC.PAHO

eng.

WHODOC

WHO monograph

4