Keywords
Colombia
epidemiological studies
qualitative research
social determinants of health
collective health
dentistry
epidemiology
health policy
oral health
oral health policy
public health
social epidemiology
How to Cite
Abstract
Background: The Fourth National Study of Oral Health (ENSAB IV) represents a milestone in national health studies in Colombia because it arises from an alternative and critical theoretical approach called Social determination of the health disease process (DSSE). However, operationalizing this theoretical approach involved important challenges and generated some tensions that limited the critical and transformative perspective that guided this study. Purpose: To show the main tensions and challenges epistemological and practical in the process of design and execution of the ENSAB IV. Methods: A case study was conducted triangulating information from primary and secondary sources. Semi-structured interviews were conducted to key stakeholders who participated in the different phases of the study and a content analysis of the protocol and the final study report was made. Results: The main tensions and challenges highlighted were the change of institutions and actors responsible for the design and execution phases; the non-appropriation of the theoretical-methodological approach in the final results and recommendations and the lack of visibility and articulation of the qualitative component within the study. Conclusion: The fragmentation of the design process and implementation of the study and the change of actors responsible for each phase, created difficulties for the operationalization of the theoretical methodological approach proposed in the design of the ENSAB IV, both by the little methodological guidance of the approach in itself, as by the institutional resistance to show health outcomes from critical perspectives.
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