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dc.contributor.advisorDeclercq, Eugene R.en_US
dc.contributor.authorGallego Perez, Daniel Felipeen_US
dc.date.accessioned2021-09-14T13:19:29Z
dc.date.issued2021
dc.identifier.urihttps://hdl.handle.net/2144/43004
dc.description.abstractBACKGROUND: All human societies have developed ways of maintaining health, dealing with illness and injury in ways that conform to their culture and environment. People worldwide draw upon a variety of healing systems, therapeutic methods, practices, and products, often referred to as Traditional and Complementary Medicine (T&CM). The World Health Organization (WHO) has encouraged member states to develop national policies that advance the integration of T&CM in national healthcare systems to harness their potential contribution to health, wellness, and people-centered health care. Yet, no global guidelines have been developed for assisting countries in structuring and developing such policies, and little is known about the characteristics of existing T&CM policies in Latin America and their level of implementation. METHODS: A qualitative research design was used to conduct a landscape analysis characterizing existing therapeutic pluralism policies in Latin American countries through a comprehensive literature review, a policy focused qualitative content analysis, key informant interviews and a case study analyzing the formulation process of Brazil's National Policy for Integrative and Complementary Health Practices (PNPICS). A technical cooperation tool to guide T&CM policy development and revision for Latin American countries was refined through face validation and an expert consensus method (Delphi process). Data categorization and analysis were performed in MS Excel and NVivo, using deductive and inductive coding. RESULTS: A total of 74 T&CM policy documents from the 16 Latin American countries were identified and characterized according to policy mechanisms. A typology of Latin American policy approaches identified policies as: health services-centered, model of care-based, participatory, and indigenous people-focused. Selection of T&CM practices for policy inclusion vary across countries; criteria change over time in Brazil might have compromised PNPICS’ political status. Lack of PNPICS financing jeopardized its implementation. A technical cooperation tool for T&CM policy development was structured on the policy cycle: national situation analysis, policy formulation, policy implementation, policy monitoring and evaluation, and policy re-formulation, re-prioritization for incremental policy developments. CONCLUSION: With a few exceptions, therapeutic pluralism policy implementation in Latin America seems to be a real challenge, often reducing policies to cultural and political symbols. Continued research is needed on assessing the various stages of the policy process in T&CM.en_US
dc.language.isoen_US
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 Internationalen_US
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subjectPublic healthen_US
dc.subjectComplementary medicineen_US
dc.subjectIntegrative medicineen_US
dc.subjectIntercultural healthen_US
dc.subjectInterculturalityen_US
dc.subjectMedical pluralismen_US
dc.subjectTraditional medicineen_US
dc.titleTherapeutic pluralism policies in Latin America: advances, gaps, and opportunities towards inclusive, people-centered health care systemsen_US
dc.typeThesis/Dissertationen_US
dc.date.updated2021-09-10T20:08:39Z
dc.description.embargo2023-09-10T00:00:00Z
etd.degree.nameDoctor of Public Healthen_US
etd.degree.leveldoctoralen_US
etd.degree.disciplinePublic Healthen_US
etd.degree.grantorBoston Universityen_US
dc.identifier.orcid0000-0002-0975-4349


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