Operational definitions of health systems

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* Summary

* Medicine and Culture

* The health system

* Health systems modern and traditional

* Operational definitions of health systems

* Bibliography


They take the medicines as integrated systems for bureaucracies, training schools, health services, professional associations, research for the prevention, treatment, care and rehabilitation of the patient and includes the respective concepts of world health, illness, life, man, medicine, doctor. Each system has a common purpose in the case of health addresses the preservation of it, is made up of parts which are functions that must be in balance for the system to produce the common purpose.

This paper proposes conceptual and methodological criteria to distinguish operationally different practices and terms such as traditional medicine, folk medicine, naturopathy, folk medicine, official medicine, scientific medicine, Western medicine, alternative medicine, alternative medicine, among others.


There are more than 35 terms referring to various forms of medicine, especially when different practices referred to official scientific medicine. In many cases relate to health practices, to health systems or simply technical. This has led to confusion and difficulties in communication, but not just a matter of semantics or technical, but involves a conceptual background and even an ideological attitude.

At all times, companies created different ways to intervene in health and in some cases came to constitute real health systems, which contain a complex technical and structural attention, which persist and are related to other forms of medicine creating syncretism and assimilation, but also many forms of medicine have become extinct.

Some medical institutions such as the Ministry of Health official and Essalud have adopted some practices such as acupuncture, aromatherapy, the use of some medicinal plants. to which they call “complementary medicine” or “alternative medicine” and argues that it is integrating the contributions of other forms of medicine.

First, it is necessary to distinguish the concepts of “medicine”, “medical system” or “system health” and “health practices”.

Medicine is a cultural manifestation of health-related phenomena, such as concepts, norms, values, practices, materials, etc.; Arising in association with a society and a specific culture. The medical or health systems are social representation of closer links with the structural or organizational. The latter concept is a recent construct created from political or intellectual levels of health and narrowly bureaucratic comprises equipment, schools, health services, professional associations, research for the prevention, treatment, care and rehabilitation of the patient or population and includes the respective conceptions of health and medicine.

The confusion arises between multiple terms used for naming certain health practices, which sometimes causes some of them very legitimate as traditional medicine, is confused or reduced to practice as selling herbs, with the media spectacles charlatans and even some of scammers that offer solutions to all kinds of problems.

Even the Code of Medical Ethics of Peru and the respective Civil Code, do not make the distinction between traditional medicine and unsafe practices in health vain. These confusions and inaccuracies would not be casual and only product of misinformation, according to our assessment, from a cognitive and pragmatic position, interested in presenting scientific medicine as the only valid and delegitimize other.

For these reasons this paper is to propose a conceptual and a methodology to identify and specify the definitions associated with the medicine. So we’ve turned to the contributions of several investigations by the author which has validated this proposal.

1. Medicine and Culture

Medicine is a cultural expression, as humans through its social history, faced health problems and needs, as well as questions about the meaning of life and the world. Humans were developing explanations about the origin of diseases and ailments and thus ways to cope and healing agents structure, initially very close to the priests. The so-called modern day medicine, academic, scientific or Western, is a form of medicine, whose origin we usually identify with the ancient Greek culture, source of objective rationality and science. You can recognize that there were other medications or had other cultures indigenous medical systems, currently called traditional. The World Health Organization has officially recognized two traditional medicines: China and India.

In our country, after a long intellectual and ideological debate, most scholars have recognized that the ancient Peru built a traditional medical system, which highlights the concepts of balance warm-cold, animistic thinking, had a pharmacopoeia health workers specialized technology and naturopathic healing magic. This form of medicine is effective as currently thought and practice among large sections of the population, particularly in the southern Andean country. There are also cultural and social conditions that allow us to confirm the persistence of this medicine in the future.2. HEALTH SYSTEM

Health interventions can be explained as a system, but not all practices are sanitary systems, only then should compare those with the systemic form. Also one should not compare to a health system with parts of a system, for example, acupuncture is a technique or a method of Chinese health system, but acupuncture alone can not be called “medicine”, regardless of the cultural complex and conceptual containing it.

The systems approach as theory assumes that all reality is grouped into systems, which are cuts of reality constituted by the identification of a common goal, that make a whole, which is composed of elements or parts that are in equilibrium and interrelationship. Each part is functional at all, so the balance is one of its main features. When there is imbalance or anomie should fix to restore the one-way system. Each element has a role and status, if a party intends to do something different just becomes a problem. The latter denotes the theoretical and practical risks of believing that the systems approach can be to any reality or ideologically safe.

The system has exchanges with other systems through their incomes, outputs or products. Thus it can be seen a hospital where they could identify a common purpose or mission (recovery of the patient’s health) and therefore each hospital structure plays a certain role or function to fulfill that purpose well, administrative managers and provide resources, the doctors would do tests and appropriate indications, the nurses would support the treatment, the service develops diet and nutrition technicians deliver them, and feeding patients should follow medical, family morally support the patient; the product would be a recovered patient. If any level or structure does not fulfill its function becomes a hurdle that must be corrected.

A health system can be delimited, raised, described and analyzed in several ways. In its settings influence their goals and values. The health system is often one of the most complicated to have evolved in a while, from elements such as people’s beliefs, science, market factors and other social sources.


For this work we have proposed to distinguish, in general, to the modern and traditional medicines and other health expressions, as different systems, each characterized by having a worldview own conceptual baggage or to explain the world, man, life , health and disease.

From the above concepts would follow specific procedures or methods consistently to face health problems, and the structures and agents for health care and specifically, healing technologies.

We need to define further that all health systems are directed to seek the welfare of the population, the preservation of health and disease care, but where they differ is in the content of its components.

Not all health practices or ideas, constitute a system, they may be isolated events, casual or unique. An example of this are the ways popularly burns treated, putting toothpaste or edible oil or bleeding wounds with kerosene, lacquer, or burning cotton. These practices are not systemically because we can not identify in them the elements of the system that would contain.

The use of plants is not unique to traditional medicine, as in many cases this use can have a strictly scientific basis, when identified with biochemical fractions and the pharmacological support. The Andean traditional use of plants is based on the identification of the character “warm” or “cool” of disease and plants, which are used to restore the balance lost by disease. The use of medicinal plants can also be associated with a philosophy or ideology as naturism and they are not anything traditional. But in cases of people who sell plants called “medicinal”, but with the only interest of financial gain and repeated without further support the alleged “indications” of products (which are often of dubious and illegal), no nothing to do with traditional medicine and should be called only “herb sellers”.

In health systems can identify four levels in its structure, which can also be used for descriptive purposes or comparison of its elements. In the table below we compare the characteristics of traditional Andean and modern medical system.


In the field of public health there are several terms and concepts, whose use is varied and little sustained, particularly in relation to non-scientific forms of medicine. The renowned doctor and anthropologist Pedersen says “the concepts of health, culture, medicine and medical systems have no single model or paradigm for this very reason it becomes more difficult the task of understanding each public health specialists.” In local anthropology usually identify the herb vendors of malls as expressions of traditional medicine, when you really do not express or carry this medicine holistically as a system. The proposed definitions ordered the most common in practice and literature on the subject.


Definitions are answers to the questions as What is and seek the meaning of a term indicating establishing the essential properties of the object denoted by the term. The definitions also aim to clarify the essence of things, limits, differences with other objects, properties and changes. When do different definitions to classify objects, these classifications must be exhaustive (include all possible objects), exclusive (an object can only be located within a class) and proportional (the terms have a certain degree of generality and specificity equivalent between classes, one of which prevent or reduce them arbitrarily hypertrophy). Furthermore, the object must be defined not part of the definition, nor should define a noun with another noun.

The following are definitions that try to identify and distinguish different acts or practices. To make these definitions first start from a gold standard (culture, use or dissemination, formalization, cosmological and scientific thinking) that allows for a conceptual context and meaning to these practices or ideas, and then associate or distinguish. One can see that the same form of medicine or health system may have different names, depending on the criteria with which to analyze.


* Traditional Medicine: drugs are associated with ancient indigenous cultures of pre-Columbian societies in America or any other world society. In Latin America is also known by the terms of folk medicine, indigenous and ethnic Andean. Constitute health systems. Ex Peruvian Andean traditional medicine, the Pranic Ayurdeya and Medicine in India, Traditional Chinese Medicine.

* Modern Medicine: Medicine is linked to culture “western” or “modern”, one that began in Greece with the paradigm of objective rationality and empirical, which currently has a highly developed with emphasis biologist. Also called scientific or Western Medicine. It is a health system. Ex American Modern Medicine.


* Popular Medicine: Consists health practices are widespread and used by people and means a simplification or conversion of scientific concepts and popular health experiences, effective or not, which may include traditional features. Not having systemically identified therefore prefer to call “popular health practices.” Ex Cover burns with toothpaste, cotton burned in small wounds and burns oil.

* Academic Medicine: Associated modern culture and science is taught in Western universities formalizadamente and exercise is reserved for those who acquire a degree and mainly hospital settings. Ex Medicine is taught in medical schools of Peru.


* Official and Formal Medicine: The Medicine which has acquired social status of legality (with hegemonic or dominant culture) either by their academic as to meet current legal forms. Ex modern medicine, western or scientific physicians practicing in Peru, covered at the Medical College and Peruvian law.

* Informal Medicine: It is defined in relation to the illegal practice is exercised by midwives, bone setters, diviners, sorters, shamans, pseudo-medical and other non-physician, whose practice is blatantly illegal or semi-legal (protected by the right to work ). Ranging from authentic traditional healers to counterfeiters and scammers who advertise themselves as curators of everything and exploit popular beliefs or misinformation. Ex herbal vendors in markets, offices of the pseudo shamans.

* Alternative Medicine: Refers to the alternative to mainstream medicine, academic and scientific classic. Especially techniques derived from other oriental medicines whose effectiveness is recognized objectively and therefore no demand for and supply of it (even by medical scientists and people with non-traditional culture). Recently it has preferred to call it “complements” scientific medicine. Eg acupuncture, iridoterapia, aromatherapy, and many others.

* CRITERION cosmological

* Allopathic Medicine: Medical system whose treatments occur in the healthy state, the different phenomena that characterize the disease fighting. Emphasizes the biomedical approach to pharmacology and surgery, which cured eliminating or removing the aetiological agents. It is identified with classical or modern scientific medicine.

* Homeopathic Medicine: A medical system based on the relationship between total and individuality, used to practice the law of similarity, the drug boosted and unique, the law of cure and experimentation in healthy man. It is based on the principle that the disease can be cured by drugs, natural or biological elements that occur in a healthy person, the same pathological effects are symptomatic of the disease.


* Empirical Medicine: Are health practices or techniques created and used by the public, with some traits of effective symbolic or real, can collect elements of traditional medicine or scientific, rational and theoretical baseless. There is a health system.

* Scientific Medicine: The science associated with current force of character objective, positivist, formal and even academic. Excludes empiricists and magical practices of medicine.

* Medicine: Typically collecting ancient healing traditions, has as its foundation the reversal and harmony with nature, questions the current modernization and commercialization of medicine. Has a modern version (experimental testing involving the active principles, the definition of the average dose lethal dose, toxicity, clinical trials etc.), Which end in the production of commercial drugs based on laboratory plants or minerals and a traditional version of the herbalists, traditional or not. Plantain eg use of maca and the products sold in pharmacies naturists.


* BERTALANFYY, Ludwig Von: General Systems Theory. Fondo de Cultura Economica, 10th. Reprint. Mexico 1995.

* KLEEZKOWONSKI, B., Roermer, M. And Van der Worff, A.: The components of a national health system. Public Health Papers No. 77, WHO. Geneva 1982.

* PLAINS, Villajuan, Marino: A scientific definition of the concept of culture. In Proceedings of the Eighth National Congress of Arts and Multiculturalism, Lima in August 2000.

* PEDERSEN, Duncan: Health and Medical Traditional Cultures in Latin America and the Caribbean. In Arinsana, No. 4, 1986 Cuzco. (P. 5-21)

* VELA QUICO, Alejandro: Status of Traditional Medicine Andean Arequipa, Arequipa UNSA, 2000.

* VELA QUICO, Alejandro: Ethical Perspectives Political Relationship between Modern Medicine and Traditional Medicine Andean Arequipa UNSA, 2001.


Alejandro Vela Quico,

Medical, Anthropology graduate, Doctor of Medicine, Master in Public Health, Master in Philosophy, a senior lecturer in the Faculty of Medicine of the National University of San Agustin de Arequipa UNSA, Peru.

Arequipa – Peru

October 2007