Salud Colectiva最新文献

Ethics in qualitative social research has particular features that distinguish it from the model formulated in the Global North for the health sciences, which is characterized by a universalist, quantitative, clinical approach and a limited critical perspective on its role in power relations. In Latin American social anthropology-similarly to other social sciences-there are few institutionalized collective discussions about how ethics is being understood, excluded, and practiced in research processes. In this essay, I examine these issues in the Latin American context, along with some academic and community-based responses. I analyze key dimensions such as risk/benefit, social value, informed consent, confidentiality, validity of results, and the ethics proposed by communities themselves to protect against researchers. I also draw on two institutional experiences in which I participated, raising questions and possibilities through examples from the fields of anthropology and health.

In this essay, we propose that Mendes Gonçalves' theory of the labor process in health can contribute to a critical theory of digital health capable of deconstructing technological alienation within digital transformation processes in the health sector. First, we identify modes of care and models of technological organization of healthcare delivery. Second, we analyze the collective-informational mode of care oriented toward sociotechnical health networks, highlighting collaborative practices rooted in territories and local realities. Third, we propose a theoretical platform for understanding digital transformation in health, based on the articulation of the following concepts: sociotechnical appropriation, metapresence, critical technological competence, quality-equity, and eco-ethno-social sensitivity. Finally, we outline the epistemological and theoretical foundations necessary for a "digital epistemodiversity," understood as an ecology of knowledges in which technical objects, sociotechnical systems, human agents, and transhuman beings may coexist, interact, and produce systemic changes in the health field, with the protagonism of healthcare workers and broad popular participation.

This essay aims to critically reflect on the impacts of the technological escalation in medical practice, with particular attention to the transformations of professional practice. From a historical-social perspective grounded in the critical thought of collective health - particularly the work of Ricardo Bruno Mendes-Gonçalves - technology is examined as both a material and immaterial form that reconfigures healthcare work and reproduces the social order. Based on the analysis of previous studies drawing on the work-life narratives of physicians from different generations, three central axes are addressed: the construction and progressive dismantling of medical autonomy, the crisis of trust-based relationships in professional practice, and the transformation of clinical judgment in favor of standardized protocols. The essay concludes that the growing technification has reduced the reflexivity of medical action and transformed the clinical encounter into a depersonalized practice. In the face of this crisis, it argues for the need to recover the ethical-political dimension of medicine by promoting shared decision-making and spaces of mutual recognition between professionals and patients.

Tubal ligation access in the province of La Pampa is regulated by Provincial Law 2079 and National Law 26130. Although the only legal requirements are to be over 16 years of age and to sign an informed consent form, in practice there are barriers stemming from institutionalized heteronormativity. This normative framework privileges certain profiles of women while resisting the procedure for others, despite their status as rights-holders. This study aims to describe and analyze the trajectories and experiences of women who requested a tubal ligation - whether or not they ultimately obtained the procedure - in the public health subsector of the city of Santa Rosa, La Pampa. The research adopts a qualitative theoretical-methodological approach based on grounded theory. A total of 18 in-depth interviews were conducted between 2022 and 2023. The findings reveal the effects of the social valuation of motherhood within health services, which places women in a subordinate position regarding their autonomy and their right to make decisions about their reproductive functions in the face of medical authority.

In this speech, delivered at the inaugural class of the pre-medical course at the Faculty of Medicine of the Universidad Nacional y Popular de Buenos Aires, in 1973, Mario Testa presents a profound critique of the educational model inherited from the liberal oligarchic project, marked by individualism, superficiality, and detachment from the country's reality. He calls for a comprehensive transformation of the university, aimed at dismantling its feudal structure and building an institution committed to the social and political needs of the nation. Confronting the traditional medical model grounded in prestige, power, and competition, Testa advocates for a new conception of medicine as a collective and solidarity-based practice, embedded in a national and popular project. He emphasizes the need to form health teams integrated with the community, where physicians no longer occupy a central role but instead become one more worker in a collective process focused on solving the people's problems. Finally, he asserts that the Faculty of Medicine, transformed into a Faculty of Health Sciences, must be guided by social medicine, in order to train professionals committed to teamwork, critical thinking, and active participation in the construction of a more just country.

In Argentina, the so-called "green tide" fostered a process of politicization of women's and childbearing people's desire and sexuality, closely tied to the demand for the right to voluntary termination of pregnancy (VTP), which gave rise to new configurations of subjective meaning. This study aims to analyze the subjective implications for adult women who accessed a VTP in 2023. Drawing on a qualitative and interpretive approach, intersecting with feminist and affective epistemologies, seven in-depth interviews were conducted with cisgender women. The findings reveal the subjective impact of pregnancy as an unwanted experience and the persistence of affects such as guilt, fear, and shame. The women expressed a strong affirmative stance regarding their decision to have an abortion, grounded both in its legal status and in the support of peer-based sociability linked to feminist activism, as well as feelings of relief and happiness regarding the procedure. Barriers and facilitators within the healthcare system were also identified, in terms of ensuring access to VTP from a comprehensive care perspective.

The aim of this study was to understand the subjectivities promoted by food and nutrition policies in Comuna 1 Popular of Medellín. Based on a qualitative design grounded in constructivist grounded theory, 20 semi-structured interviews were conducted between 2022 and 2023 with program users, social leaders, and those who implement food and nutrition programs in the comuna. Among the main findings, it was identified that public food and nutrition policies shape precarious subjectivities through mechanisms such as the homogenization of food and nutrition care for users. The administrative aspects of the programs limit the development of effective actions, and participation has low political impact. It is concluded that the vision and alienation of individualized subjects restrict the possibilities for collective action; however, social leaders promote actions aimed at mobilizing adjustments in the functioning of these policies and programs.

In Argentina, Law 27610, which legalized voluntary termination of pregnancy, was the result of years of activism and political alliances. To monitor its implementation, between 2022 and 2024 an instrument was developed to assess the accessibility and quality of abortion services, considering users' experiences. We conducted a three-phase study that included expert panels, cognitive interviews, and a pilot test of the instrument with individuals who had undergone abortions. These efforts led to the creation of the questionnaire Measuring Accessibility and Quality in Abortion Services (MACA), which can be applied within the Argentine health system. This questionnaire can be used for monitoring purposes, to identify areas for improvement in health services, and to detect inequalities in access based on geographic and social characteristics.