Constructing Healthy Municipalities: The Dogma And Dilemmas Of Decentralization In Mexico.

In recent years, anthropologists have grown increasingly concerned with the local impacts of global health policies as national governments restructure public health sectors throughout the developing world. Neoliberal development agendas that guide health reforms have privileged privatization and decentralized forms of management, shifting responsibility for health resource management from the state to municipal governments and local communities. The Healthy Municipalities program is one element of recent health reform efforts in Latin America. Advocated by the Pan American Health Organization to facilitate greater intersectoral collaboration and community participation, Healthy Municipalities seeks to assemble local participatory health management structures to help fill in the gaps left by a retracting state. Considering the case of Healthy Municipalities in Morelos, Mexico, this paper examines the micropolitics that guide the program's implementation and the extent to which it succeeds or fails to motivate participation in community health. The paper draws attention to a myriad of factors that limit the program's efficacy as it privileges a political agenda over local needs, despite the rhetoric of empowerment that places citizens at the center of health reforms. [ABSTRACT FROM AUTHOR]