Resumen

GRANDA, Edmundo. What do we call community health nowadays. Rev Cubana Salud Pública [online]. 2004, vol.30, n.2. ISSN 0864-3466.

The article begins with the analysis of the advances and restrictions in the field of public health; later it deals with the debate on community health. It is recognized that public health care prevailing in Ecuador and in Latin America is based on a metaphor derived from the philosophical-theoretical assumption of disease and death, the positivist method, the structural functionalism and the recognition to the state’s power as a privileged force to assure the prevention of disease. These categories made it possible for health providers to behave as technical-normative interventors. Changes occurred in the last decades of globalization compels public health care to find its new path by which it can understand and act upon health and life and not only upon disease, interpret population’s culture and its forms of power exercise and give more strength to social action and to the new identities that fight for health. In this way, the health provided should play the role of interpreter-mediator of several proposals in the process of health construction. The improvement of the concept of conventional public health care lies in looking and interpreting the process of health-disease in a different way, that is, to see population’s health within its historical realities, its context matrix, its vital substantiation rather than seeing it as mere elimination of disease. It is also required to shift those practice only seeking technical success to the compromise of attaining practical achievements. In doing so, we should develop that quadruple movement of construction of sense, construction of meaning, constitution and determination that Mario Testa recommends. Being Community Health an articulate set of technical, ideological, political and economic practices, always open to incorporation of innovating proposals, it constitutes a high valuable source for reflection and advance of alternative public health

Palabras clave : Community health; Public health; Alternative health; Public health care services.