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Gobernanza de la salud a través de la seguridad en Filipinas: un análisis realista
Delaram Akhavein1, Lea Elora A Conda2, Sary Valenzuela2,3
1School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
Health policy and planning
|December 12, 2025
Resumen
El encuadre de la seguridad sanitaria en Filipinas refuerza la priorización de la salud de arriba hacia abajo, lo que afecta la toma de decisiones y la asignación de recursos. Este enfoque puede conducir a programas desalineados y a un aumento de las inequidades, a pesar de movilizar la atención.
Área de la Ciencia:
- Política de Salud Pública
- Seguridad Sanitaria Global
- Investigación de Sistemas de Salud
Sus antecedentes:
- Las agendas de salud global enmarcan cada vez más la salud como un problema de seguridad.
- Filipinas enfrenta presiones de donantes internacionales y de la política interna en el establecimiento de prioridades de salud.
Objetivo del estudio:
- Examinar cómo el encuadre de la seguridad sanitaria influye en la priorización en Filipinas.
- Identificar los resultados y factores contextuales del encuadre de la seguridad sanitaria en el sector de la salud filipino.
Principales métodos:
- Estudio cualitativo que emplea 25 entrevistas con actores gubernamentales y no gubernamentales.
- Se utilizó un enfoque realista para analizar el encuadre de la seguridad sanitaria y sus manifestaciones.
Principales resultados:
- El encuadre de la seguridad sanitaria refuerza la priorización centralizada y de arriba hacia abajo a nivel internacional y nacional.
- Los desafíos de implementación incluyen marcos desalineados, programas verticales y cargas de informes impulsadas por donantes.
- La participación de actores militares y de seguridad institucionaliza las normas de seguridad dentro de la salud.
Conclusiones:
- La seguridad sanitaria es un concepto dinámico moldeado por discursos globales, agendas de donantes y gobernanza interna.
- Si bien moviliza recursos, el encuadre de la seguridad sanitaria corre el riesgo de exacerbar las inequidades y descuidar los determinantes estructurales de la salud.
- Las relaciones de poder y el contexto histórico influyen significativamente en la co-construcción de la seguridad sanitaria.
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