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In the mid-1970s, several health reform projects were discussed in Spain for the purpose of changing the outdated health system inherited from Francoism. In all these proposals, but especially in those promoted by the left¬ist parties, a primary role was assigned to the health education of the general population. In a health system that sought to defend health rather than cure diseases, the behaviour of the population in relation to the social and eco¬nomic factors that generated diseases was crucial. Furthermore, health edu¬cation was conceived as a way for the population to participate in the plan¬ning, management, and evaluation of health services. These generic statements were, on many occasions, naive and classic versions of health education, similar to those proposed by the government. The role of health education in rationalizing the use of health services was frequently invoked. Health re¬form projects tended to establish the hegemony of health workers over teach¬ers. Some more specific proposals gave way to more concrete actions at a local level that led to the development of the model of health education that was carried out in the following decades. ; En España, a mediados de la década de los años setenta del pasado siglo, se discutieron diversos proyectos de reforma sanitaria que preten¬dían cambiar el desfasado sistema sanitario heredado del franquismo. En todas estas propuestas, pero en especial en las provenientes de los partidos de izquierda, se asignó un papel primordial a la educación sani¬taria de la población. En un sistema sanitario que pretendía defender la salud en vez de curar la enfermedad, las conductas de la población en relación con los factores sociales y económicos que generaban enferme¬dades resultaban cruciales. Asimismo, la educación sanitaria se concibió como un medio para que la población participase en la planificación, gestión y evaluación de los servicios sanitarios. Estas afirmaciones gené¬ricas supusieron, en muchas ocasiones, versiones ingenuas y clásicas de la educación sanitaria, similares a las propuestas por el gobierno. Fre¬cuentemente se defendió el papel de la educación sanitaria en la raciona¬lización del uso de los servicios sanitarios. Los proyectos de reforma sanitaria tendieron a establecer la hegemonía de lo sanitario frente a lo educativo. Algunas propuestas más diferenciadas dieron paso a acciones más concretas a nivel local que fueron desarrollando la educación para la salud que se llevaría a cabo en las décadas siguientes.

orcid.org/0000-0003-0870-3512. Departamento de Salud Pública, Historia de la Ciencia y Ginecología. Universidad Miguel Hernández de Elche. quique@umh.es ; This dossier focuses on some characteristics of the health reform processes in three southern European countries —Greece, Italy and Spain— over the second half of the twentieth century. We are interested in the proposals, projects and debates that sought to reorganise the health systems of these three countries. The paper on Italy analyses some aspects of the discussion that led to a national health service in 1978. In the cases of Greece and Spain, which both underwent a period of military dictatorship in the second half of the twentieth century, we describe attempts to restructure the system prior to the health reform laws (Greece, 1983, Spain, 1986). ; Project «Healthcare reform and promotion of health during the late Franco regime and the democratic transition: new cultures of health, sickness and care» funded by the Ministerio de Economía y Competitividad and the European Regional Development Fund (HAR2015-64150-C2-1-P)

orcid.org/0000-0003-0870-3512. Deapartamento de Salud Pública, Historia de la Ciencia y Ginecología. Universidad Miguel Hernández de Elche. quique@umh.es orcid.org/0000-0003-0064-364X. Medical Anthropology Research Center. Universitat Rovira i Virgili, Tarragona. josepmaria.comelles@urv.cat ; This paper analyses the discourses that addressed healthcare reform projects discussed in Spain during the 1970s, before the death of the dictator General Franco, and up to the declaration of healthcare as a right in the Spanish Constitution of 1978. The Spanish health system, which developed from the Compulsory Sickness Insurance launched in 1944, focused only on disease and made no provision for preventive activities. This shortcoming was one of the main aspects that required reform in the 1970s. We analyse the characteristics of the proposals to replace a treatment-centred health system with a new one based on a more holistic view and the defence of health. To contextualise these proposals, we review the development of the Francoist health system and regulations and plans that attempted to reform it before the death of Franco. The most interesting Spanish health system reform projects were written at the end of Francoism and the beginning of the Democratic Transition and were mainly drafted by medical doctors committed to the illegal left-wing parties. All shared the aim of universal healthcare financed by the State and the goal of placing the protection of health at the core of the health system by integrating preventive medicine and healthcare. Some proposals encouraged the study of social determinants of health and disease and emphasised the role of health education. Others were more concerned with the re-organisation of healthcare through planning and decentralisation, retaining the hospital for the treatment of diseases as the main goal. ; Project «Healthcare reform and promotion of health during the late Franco regime and the democratic transition: new cultures of health, sickness and care» funded by the Ministerio ...

This paper analyses the discourses that addressed healthcare reform projects discussed in Spain during the 1970s, before the death of the dictator General Franco, and up to the declaration of healthcare as a right in the Spanish Constitution of 1978. The Spanish health system, which developed from the Compulsory Sickness Insurance launched in 1944, focused only on disease and made no provision for preventive activities. This shortcoming was one of the main aspects that required reform in the 1970s. We analyse the characteristics of the proposals to replace a treatment-centred health system with a new one based on a more holistic view and the defence of health. To contextualise these proposals, we review the development of the Francoist health system and regulations and plans that attempted to reform it before the death of Franco. The most interesting Spanish health system reform projects were written at the end of Francoism and the beginning of the Democratic Transition and were mainly drafted by medical doctors committed to the illegal left-wing parties. All shared the aim of universal healthcare financed by the State and the goal of placing the protection of health at the core of the health system by integrating preventive medicine and healthcare. Some proposals encouraged the study of social determinants of health and disease and emphasised the role of health education. Others were more concerned with the re-organisation of healthcare through planning and decentralisation, retaining the hospital for the treatment of diseases as the main goal.

This paper analyses the discourses that addressed healthcare reform projects discussed in Spain during the 1970s, before the death of the dictator General Franco, and up to the declaration of healthcare as a right in the Spanish Constitution of 1978. The Spanish health system, which developed from the Compulsory Sickness Insurance launched in 1944, focused only on disease and made no provision for preventive activities. This shortcoming was one of the main aspects that required reform in the 1970s. We analyse the characteristics of the proposals to replace a treatment-centred health system with a new one based on a more holistic view and the defence of health. To contextualise these proposals, we review the development of the Francoist health system and regulations and plans that attempted to reform it before the death of Franco. The most interesting Spanish health system reform projects were written at the end of Francoism and the beginning of the Democratic Transition and were mainly drafted by medical doctors committed to the illegal left-wing parties. All shared the aim of universal healthcare financed by the State and the goal of placing the protection of health at the core of the health system by integrating preventive medicine and healthcare. Some proposals encouraged the study of social determinants of health and disease and emphasised the role of health education. Others were more concerned with the re-organisation of healthcare through planning and decentralisation, retaining the hospital for the treatment of diseases as the main goal.

This paper analyses the discourses that addressed healthcare reform projects discussed in Spain during the 1970s, before the death of the dictator General Franco, and up to the declaration of healthcare as a right in the Spanish Constitution of 1978. The Spanish health system, which developed from the Compulsory Sickness Insurance launched in 1944, focused only on disease and made no provision for preventive activities. This shortcoming was one of the main aspects that required reform in the 1970s. We analyse the characteristics of the proposals to replace a treatment-centred health system with a new one based on a more holistic view and the defence of health. To contextualise these proposals, we review the development of the Francoist health system and regulations and plans that attempted to reform it before the death of Franco. The most interesting Spanish health system reform projects were written at the end of Francoism and the beginning of the Democratic Transition and were mainly drafted by medical doctors committed to the illegal left-wing parties. All shared the aim of universal healthcare financed by the State and the goal of placing the protection of health at the core of the health system by integrating preventive medicine and healthcare. Some proposals encouraged the study of social determinants of health and disease and emphasised the role of health education. Others were more concerned with the re-organisation of healthcare through planning and decentralisation, retaining the hospital for the treatment of diseases as the main goal.

This paper analyses the role played by physicians in fighting the disease in the city of Alicante during the 18th century. The local government hired three physicians to take care of the population. The municipal hiring of these healers was a common practice, through which doctors acquired a series of responsibilities, being the main one the home care. However, the presence of these three titular doctors was not sufficient to attend the entire population, something that was reflected in the constant protests of the neighbours by the absence of the doctors. In addition to those hired, there were also other physicians who practised in the city on their own. In this paper, we compare the experiences and circumstances that characterised the case of the city of Alicante in the 18th century18th century with those of other populations that have been object of study and we find some differences that must be explained from the context of a specific socio-economic context. ; El presente trabajo analiza el papel que desempeñaron los médicos como agentes de lucha contra la enfermedad en la ciudad de Alicante durante el siglo XVIII. El ayuntamiento alicantino contaba con tres médicos asalariados para atender a la población. La contratación municipal de dicho personal sanitario era una práctica habitual, a través de la cual, los médicos adquirían una serie de responsabilidades, siendo la asistencia a domicilio la principal de ellas. Sin embargo, la presencia de estos tres médicos titulares no fue suficiente para atender a toda la población, algo que quedó reflejado en las constantes protestas de los vecinos por la ausencia de los facultativos. Además de los contratados, también existían otros médicos que ejercían en la ciudad por libre. En nuestro análisis, al comparar las experiencias y circunstancias que caracterizaron el caso de la ciudad de Alicante en esta centuria con el de otras poblaciones que han sido objeto de estudio, encontramos algunas diferencias que deben ser explicadas en el marco de un contexto socioeconómico concreto.

The aim of this article is to compare the development of health education in Italy and Spain from the point of view of the role played by medical anthropology in both countries. The context is provided by the changes in the concept of health education advocated by the UN technical agencies, especially the World Health Organization and Unesco, during the second half of the twentieth century. Despite their many similarities, Italy and Spain underwent different political evolutions over the last century. Therefore, it is interesting to compare both cases and the influence the social sciences had in health education initiatives. In order to assess the role of medical anthropology, the 1958 launch and the development of the Centro Sperimentale per l'Educazione Sanitaria (Perugia, Italy), which was at the forefront of health education in Europe until the 1990s, was reconstructed through oral sources. After a brief description of the scant initiatives regarding health education existing in the Spain of the dictatorship, the influence of the Perusine anthropologists on Spanish health education during the democratic transition is evaluated. ; El objetivo de este artículo es comparar el desarrollo de la educación sanitaria en Italia y España desde el punto de vista del papel jugado por la antropología médica en ambos países, en un contexto marcado por los cambios en el concepto de educación sanitaria que propugnaron los organismos técnicos de las Naciones Unidas, en especial la Organización Mundial de la Salud y la Unesco, durante la segunda mitad del siglo XX. A pesar de sus similitudes como países, Italia y España tuvieron evoluciones políticas muy diferentes durante el siglo pasado, por tanto, es interesante comparar ambos casos y la influencia que tuvieron las ciencias sociales en las iniciativas de educación sanitaria. Para valorar el papel de la antropología médica, mediante el uso de fuentes orales, hemos reconstruido la puesta en marcha, en 1958, y el desarrollo del Centro Sperimentale per l'Educazione Sanitaria (Perugia, Italia), que estuvo en la vanguardia de la educación sanitaria en Europa hasta los años noventa. Tras una breve descripción de las escasas iniciativas sobre educación sanitaria en la España de la dictadura, evaluamos la influencia de los antropólogos perusinos en la educación para la salud española durante la transición democrática.