Paradoxes of Decentralization in Health in Greater Buenos Aires, Argentina. Directions for the Construction of Health Policy in a Local Scenario

Abstract

The paths followed by the decentralization and its outcomes have varied according to contexts. In the health sector, the relationship between sub-sectors, the financing problem and the challenge of keeping the logic of “system”, were issues that challenged particularly to the experiences that resulted from the decentralization process. This article focuses on health policy in a municipality of Bue- Paradojas de la descentralización en salud en el Gran Buenos Aires... 236 nos Aires (Malvinas Argentinas) in the period from the start of the crisis 2001 to 2007, when it seems to have consolidated a local model based on the development of the second level health care and high complexity, which shows the margins of local-level action since decentralization. With features that approaches the nineties, the route taken by the municipal management shows flexibility and autonomy to adapt to changing contexts and skipping the local jurisdiction’s own borders in the public sector.