No. 12 (1987): Public Health Administration

The Central American region is going through a social, economic and political crisis of considerable magnitude.

The international context of ideological and economic struggle largely conditions this crisis. On the other hand, the domestic scenario, characterized by limitations in the effectiveness and efficiency of the services provided by State institutions, has exacerbated the situation to extremes that seem very difficult to overcome.

The health sector is no stranger to the consequences of the convulsive situation in the isthmus, and thus we find a series of unsatisfactory indicators.

In some countries, life expectancy at birth does not reach 60 years, and infant mortality exceeds 80 deaths per thousand live births. Diseases of infectious origin coexist with those of chronic and degenerative evolution.

Within the above panorama, the population is growing rapidly, without the State being able to give an adequate response to the demands that this situation provokes. Added to this is a new social problem: massive migration within and between countries, caused mainly by the armed conflicts affecting some of the Central American nations.

The historical challenge that this situation poses for public administrations deserves to be addressed as a matter of priority and with concrete and adequate responses to the reality facing the region. Guided by this line of thought and aware of the mandate of the governments it represents, the Central American Institute of Public Administration, as part of its training programs, initiated in September 1986 a Postgraduate Program in Public Administration with emphasis on Health Administration. Likewise, within this strategy oriented to support the Public Health Sector in Central America, training, advisory and research programs have been initiated. In this issue of the Central American Journal of Public Administration, dedicated to the topic of Health Administration, we outline some questions and proposals to focus attention on the complex health problems of the Central American population. Thus, we want to emphasize initially the need for Central America to find its own concepts, design its own definitions and participate fully in the improvement of its health status from a global perspective and with an integral approach.