Abstract
This study analyzes the conduction patterns of implementing Primary Health Care (PHC) in Paraguay in three government periods (2008-2012, 2012-2013 and 2013-2017) and three management levels (national, regional and local). This is a qualitative study based on grounded theory. A priori categories on PHC stewardship and governance in Paraguay were analyzed. An open-ended questionnaire was applied to a sample of social, political and technical stakeholders: ministers, coordinators, managers, consultants, and international organizations' experts. Data were processed combining the use of Atlas Ti software and sorting findings in a structured Excel matrix. Gaps in leadership, regulatory mechanisms, technical capacities for health planning and management and financial implementation methods have affected PHC continuous expansion and strengthening process. The findings show limitations and possibilities for the implementation of this health policy in Paraguay, evidencing the need for greater qualification of management and political stability in its conduction.
Highlights
Expanded freedom in democratic contexts and access to information through new technologies has increased the participation and expectations of society vis-à-vis its health authorities, including the internal health public
This study proposes the analysis of Primary Health Care (PHC) stewardship and governance
This study mainly aims to analyze the influence exerted by conduction methods in the process of implementing the renewed Primary Health Care model within the framework of government changes in the last nine years, through a systemic approach to the different issues that emerge in settings of political instability that influence and affect health outcomes[13,14]
Summary
Expanded freedom in democratic contexts and access to information through new technologies has increased the participation and expectations of society vis-à-vis its health authorities, including the internal health public (professionals and health staff). This setting exposes and makes visible the conduction methods and stewardship competences of managers responsible for the management and implementation of public health policies. Paraguay is a unitary and decentralized republic with a political and administrative distribution organized into departments and health regions, including capital Asunción and 249 municipalities. The Human Development Index (HDI) holds the 110th spot (0.693) and the Gini index places the country at 48.3, Paraguay stopped being among the most inequitable countries in Latin America[1,2,3,4,5]
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