Snapshots of the Latin American Experience

Introduction: The Cartagena Declaration on Rural Health in Latin America, released by the XVII International Congress on Agricultural Medicine and Rural Health in 2009, called for concerted national and international efforts/actions to improving the coverage of primary health care that would better address the needs of rural working communities, and provide access to occupational and environmental health surveillance services in rural areas. A network of Latin American leaders willing to implement such agreements was organized. Although climatic, culture and social conditions vary within and between the countries of the region, several country experiences that have played an exemplary role in their respective countries were reviewed.

Methods: A systematic search and the review of several country and sub-regional reports were conducted to obtain information about different OH surveillance methods and systems that have been developed in several countries of the region.  

Results:  Several stakeholders from the health and the rural sectors, such as research groups, Universities, NGOs, indigenous, community and grassroots rural organizations, within others, have continued to promote local initiatives and develop services in many original ways to assure the access of rural people to healthcare services and OH surveillance systems. Regional programs such as PLAGSALUD and SALTRA have achieved to develop occupational surveillance programs, particularly for pesticides. Despite the efforts, coverage seems to remain limited.  

Discussion The common denominator found within countries was a strong participation of stakeholders at different levels. Community, grassroots, rural agricultural women, unions and indigenous organizations have proven to play a key role for their social and economical progress, for advancing towards local development, and to improving access to OH services and primary health care. Particular challenges seem to persist for indigenous working populations. Several successful case stories will be presented as examples worthy of replication.