The local processes affecting variation in local implementation of policies for prevention and promotion in health care have not been studied in a developing country. This study does so by comparing two rural health systems with different levels of prevention and promotion activities in one of the poorest regions of Brazil, Ceará State in the northeast. The health system with greater activities of prevention and promotion also has a more advanced stage of decentralization, but this is in combination with many other, interacting influences that differentiate the two health systems' ability to adopt and implement new approaches.
Health Policy and Planning, 20 (2),: 69-79 pp.
Prevention and promotion in decentralised rural health systems: a comparative study from Northeast Brazil.