En la actualidad somos testigos de vertiginosos cambios producto de las tecnologías de la información y comunicación. El Estado no es ajeno a estos cambios, tal es el caso que el concepto de Gobierno Electrónico El Gobierno Electrónico promueve el desarrollo de las entidades del Estado bajo un enfoque sistémico con un crecimiento integral de sus componentes, proporcionando no sólo ahorro de costos, sino también cambiando la percepción del Estado, como un Estado transparente, eficiente, eficaz y accesible. Siguiendo la misma línea surge el modelo de ETRADE que toma como base los modelos de Gobierno Electrónico, comercio electrónico y el comercio exterior, y se basa en los lineamientos de estos, para facilitar y promover la eficiencia del proceso de Comercio Exterior haciendo llegar los beneficios a todos los miembros de la comunidad. El modelo de ETRADE plantea que la modernización del Comercio Exterior se realice con enfoque sistémico donde se aproveche la sinergia de todos los componentes del Comercio Exterior, permitiendo la simplificación de procesos, con ahorro de costos para todas las comunidades, con el uso intensivo de la tecnología de la información y comunicación con la participación conjunta de las entidades del Estado, el sector privado y la sociedad civil. Este proyecto propone un "MODELO PARA LA GESTION DE ETRADE EN EL SISTEMA DE COMERCIO EXTERIOR EN EL PERU", cuya finalidad es proponer ejes estratégicos para la modernización del Comercio Exterior, a través del análisis de los modelos ETRADE implementados satisfactoriamente en Corea y Singapur. ; Nowadays, we witness the amazing changes resulting from the communication and information technology. The State is not outside of these changes, as a clear example is the Electronic Government concept case. The Electronic Government encourages the state institutions development under a systematic approach with an integral growth of its components, providing costs saving, and also changing the state perception, as a transparent, effective, affordable and efficient state. Following the same line comes up the ETRADE model which is based on Electronic Government models, electronic and foreign trade lt is based on their guide lines to facilitate and promote the foreign trade process efficiency by bringing the benefits all members of the community. ETRADE model propases that the foreign trade modernization be conducted with systematic approach which takes advantage of the synergy of all components of foreign trade, allowing process simplification, with costs saving for all type of communities, with intensive use of information and communication technology, and also with government entities participation, prívate sector and civil society. This project suggest a "MODELO PARA LA GESTION DE ETRADE EN EL SISTEMA DE COMERCIO EXTERIOR EN EL PERU", whose objective is to propase strategic priorities for the Foreign Trade modernization, trough the analysis of ETRADE models successfully implemented in Korea and Singapore. ; Tesis
The labor agreements contained in the Free Trade Agreement between the United States of America and Colombia, Ecuador and Perú (pre AFTA) are similar to those already signed with Jordan, Singapore and Chile and near replicas of those in the Central America Free Trade Agreement (CAFTA) currently pending ratification by the U.S. Congress. This FTA model, however, differs clearly from the treaty signed more than a decade ago with Mexico and Canada (NAFTA), particularly in its notable reduction of the protective labor regulations that safeguard commerce. This article grew out of questions concerning the strength of our own labor legislation and practices in the face of a treaty which allows FTA counterparts to question them whenever they feel commerce is affected. The answer to this question is, in part, comforting —the Colombian legal system has withstood attacks throughout its 200-year old history and the equal footing ensured all treaty participants will allow us to defend this system— but we cannot ignore the risks inherent in a country where decisions are most often made underthe duress of poverty.This article highlights questions that emerged following the presentation of information to Colombian society by Colombian labor negotiators between August of 2004 and May of 2005. ; El capítulo laboral del Tratado de Libre Comercio entre Estados Unidos de América del Norte, Colombia, Ecuador y Perú —futuro AFTA—, sigue la línea de los tratados de libre comercio ya firmados con Jordania, Singapur, Chile y es básicamente exacto al proyecto con Centroamérica —CAFTA—, en vía de ratificación por parte del Congreso de Estados Unidos de América. Este modelo presenta eso sí, claras diferencias con el suscrito hace más de una década con México y Canadá —NAFTA—, sobre todo porque reduce ostensiblemente los estándares laborales protegidos como salvaguarda del comercio. La génesis de este artículo se encuentra enmarcada en la pregunta de ¿hasta qué punto nuestra cultura laboral constituye una herramienta sólida para enfrentar el reto de un tratado que contiene los medios para ponerla en tela de juicio, cada vez que nuestra contraparte considere que afecta el comercio? Parte de la respuesta es tranquilizante, poseemos una trayectoria jurídica de más de 200 años capaz de enfrentar cualquier embate y estaríamos en condiciones de igualdad dentro del tratado para defenderla, pero aquí como siempre, ¿qué papel jugará nuestra endémica situación de país pobre? El artículo hace un seguimiento a los informes presentados a la sociedad civil por los negociadores o coordinadores de la mesa laboral del tratado desde el 11 de agosto de 2004 hasta el 11 de mayo de 2005, es decir, desde la primera a la segunda rondas de Lima y a partir de ellos, plantean una serie de inquietudes que invitan a la reflexión y a la actuación.
RESUMEN: En la actualidad, numerosas naciones en el mundo se encuentran embarcadas en profundas reformas de sus sistemas educativos. Existe un acuerdo generalizado entre políticos educativos, académicos y educadores en que una de las claves para el éxito de dichas reformas es fomentar el desarrollo profesional docente (DPD). Cada año, los gobiernos invierten cantidades astronómicas de dinero en el aprendizaje continuo de los profesores. Sin embargo, la literatura indica que buena parte del DPD ofrecido a los profesores es ineficaz, teniendo un efecto reducido o incluso nulo sobre sus prácticas y/o sobre el aprendizaje de los alumnos. Este monográfico describe las perspectivas y enfoques de DPD en cinco naciones altamente comprometidas con la investigación y/o la práctica en este campo. Conocer cómo el DPD se estructura en tales naciones puede ayudar a otras a diseñar oportunidades de aprendizaje más favorables para sus profesores. El artículo de Estados Unidos ofrece un marco general respecto a las características del DPD de alta calidad y ofrece ejemplos de recientes iniciativas eficaces. Los cuatro artículos siguientes describen los modelos de DPD en Australia, Hong Kong, Finlandia y Singapur, algunos de los países con sistemas educativos más exitosos. Dado que el aprendizaje continuo del profesorado se considera una prioridad, estas naciones han desarrollado sólidas infraestructuras de DPD para responder a las necesidades e intereses de los profesores. El monográfico concluye con una contribución de España, el país donde se edita la revista Psychology, Society and Education. La autora discute los cinco artículos anteriores y reflexiona sobre cómo las ideas presentadas podrían mejorar el DPD ofrecido actualmente a los profesores de otras naciones, en particular de España.Teacher Professional Development: International Perspectives and ApproachesABSTRACT: Nations around the world are currently embarked in deep reforms of their education systems. There is widespread agreement among policymakers, scholars, and educators that one of the keys for success during these reforms is promoting the professional development (PD) of in-service teachers. Every year, governments invest astronomical amounts of money on teacher continuous learning. However, the literature shows that much of the PD offered to teachers is inefficient, having small or no effect on teaching practices and/or student learning. This monograph describes the perspectives and approaches to teacher PD of five nations heavily committed to research and/or practice in this field. Understanding how PD is structured in these nations may guide others in designing more favorable learning opportunities for their teachers. The article from United States provides a general framework regarding the features of high-quality PD and offers examples of recent effective initiatives. The four following articles describe the PD models of Australia, Hong Kong, Finland, and Singapore, among the highest-achievers in education presently. Because teacher continuous learning is a high priority in these nations, strong infrastructures for high-quality PD have been built to meet teachers' needs and interests. The monograph closes with a contribution from Spain, the country where the journal Psychology, Society and Education is edited. The author discusses the five prior articles and reflects on how the ideas presented could improve the PD currently offered to teachers in other nations, particularly Spain.
90p. ; Based on the regulations of the Colombian Educational Legislation and some of the highest standards for higher education in countries such as Finland and Singapore, a Lean Manufacturing tool is designed and proposed for the diagnosis of certain administrative, academic and pedagogical processes carried out by a higher education entity. This work intends to be useful to support the quality of service verification processes provided by Colombian HEIs, since it allows the identification of frequent "wastes" in the procedures executed by their dependencies. Lean Manufacturing tools allow us to identify and reduce activities that do not add value to the product (waste) and thus generate clean manufacturing which leads us to reduce customer costs and be able to include continuous improvement processes The Education system in countries such as Finland and Singapore have shown that through the correct administration of the different processes, taking into account where they come from and which process they will impact, it has been possible to generate continuous improvement in education, guaranteeing the highest quality standards. Additionally, according to the article published on the BBC on May 13, 2015, ―Five Lessons for Latin America of the highest global ranking of education‖ (Martins, 2015) Education should focus (…) on the correct development of learning (… ) and, according to Erick Hanushek, professor at Stanford University ―It is no longer enough to know how to read and write‖, but also "to have the ability to understand and use information critically, develop the ability to reason with concepts (…) and drawing conclusions based on evidence "thus allows us to keep in mind that deeper learning must be guaranteed in a more competitive and sustainable development environment away from all those elements (procedures) of little or no educational significance. The Colombian Educational System and the quality assessment of Higher Education Institutions (HEI) is carried out under the result of each procedure, often without taking into account 13 the next stage, evaluating them as independent entities and not as a system relationship. The countries that lead the quality ranking apply successful strategies that can be thought of to be implemented in Colombia and thus strive to achieve better levels of quality and competitiveness for the Institution and for the country. Consequently, a characterization of Lean tools applicable to the educational industry as a joint body in all its areas is carried out, at the same time that the different Colombian standards for the creation and certification of high quality of higher education institutions are reviewed ( IES) and take into account certain aspects of quality in the education of two countries that head the list of the best (Finland and Singapore) to develop and propose a Benchmark for the evaluation of the processes of the IES in Colombia and a matrix of applicability of tools read in front of the person in charge of the process. ; Bibliografía Alvarez, V. (s.d.). Polilibros Portal. Recuperado el 09 de Octubre de 2016, de Metodología para Planeación estratégica: http://148.204.211.134/polilibros/portal/Polilibros/P_proceso/Bases_de_datos_vers22_Victor_Alvarez/POLILIBRO/UNIDAD3/BASE%20DE%20DATOS-80.htm Araújo, P. (Oct-Dic de 2011). "Universidades Lean": Contribución para la reflexión. 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Acuerdo por lo Superior 2034: Propuesta de Política Pública para la Excelencia. Bogotá, Colombia: CESU. Cooper, R. (2008). Perspective: The stagegate idea-to-launch process - update, what's new and NexGen Systems. Journal of Product Innovation Management, 25(3), 213-232. Recuperado el 9 de Octubre de 2016, de Metodología Stage-Gate de Robert Cooper. Departamento Administrativo Nacional de Estadística de Colombia. (16 de Marzo de 2016). DANE: Fuerza Laboral y Educación. Recuperado el 27 de Junio de 2016, de http://www.dane.gov.co/index.php/mercado-laboral/fuerza-laboral-y-educacion Dinas, G. J., & Franco, C. P. (03 de Agosto de 2009). Aplicación de herramientas de pensamiento sistémico para el aprendizaje de Lean Manufacturing. Cali, Colombia: Universidad ICESI. Earley, T. (1 de Enero de 2016). Lean Manufacturing Tools. Obtenido de Lean Manufacturing Tools: http://leanmanufacturingtools.org Emiliani, B. (2015). Universidad Lean: Una guía para la renovación y la prosperidad. The center for lean business management. Escuela Colombiana de Carreras Industriales - ECCI. (28 de Septiembre de 2012). Guía de presentación y entrega de trabajos de grado (Tesis, Monografía, Seminario de Investigación, Pasantía). Bogotá, Colombia. Escuela de Estudios Superiores de Administracion y Empresa (EESAE). (2016). Sistemas de Producción. Recuperado el 12 de Octubre de 2016, de http://aula1.escuela-online.net/dwaula1/19DIROPERAC/19TEMA3_6758.pdf Fundación Universia. (20 de 11 de 2015). www.fundacionuniversia.net. Obtenido de http://internacional.universia.net/asia-pacifico/singapur/sistema-educativo/introduccion/index.htm Fundación Universia-es. (2015). Estudiar en Singapur. Recuperado el 9 de Octubre de 2016, de http://www.universia.es/estudiar-extranjero/singapur/sistema-educativo/1700 García, D. S. (2009). Diccionario de logística. Barcelona, España: Marge Books. Gómez, G. S. (2008). Cuantificación y generación de valor en la cadena de suministro extendida. Madrid, España: Del Blanco editores. Gómez-Zorrilla, S. J. (2015). La cultura del Marketing. Recuperado el 9 de Agosto de 2016, de http://laculturadelmarketing.com/que-es-un-kpi-en-marketing/ González Córdova, M. L. (2013). Factores que influyen en la aceptación de Materiales de Aprendizaje Multimedia en programas de capacitación. Estado de Mexico, Mexico: UNIVERSIDAD TECVIRTUAL ESCUELA DE GRADUADOS EN EDUCACIÓN . González, B. F., & Plazzotta, F. (s.d.). Organización Panamericana de la Salud (OPS). Recuperado el 9 de Octubre de 2016, de Management en Salud: www.managementensalud.com.ar/OPS./Estrategias_de_Implementacion.docx Hay, E. J. (26 de Marzo de 1989). Justo a Tiempo. Series en Desarrollo gerencial. Bogotá: Norma. Hernandez, J., & Vizán, A. (2013). Lean Manufacturing: Conceptos, técnicas e implantación. Madrid, España: Escuela de Organización Industrial, es. Maram, L. (28 de Agosto de 2013). Cómo hacer benchmarking en sustentabilidad. 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Recuperado el 20 de Junio de 2016, de http://www.mineducacion.gov.co/sistemasdeinformacion/1735/w3-article-343463.html Ministerio de Educación y Cultura de Finlandia. (2015). Sistema de educación en Finlandia. Recuperado el 9 de Octubre de 2016, de http://www.minedu.fi/OPM/Koulutus/koulutusjaerjestelmae/index.html?lang=en Normas9000.com. (1 de enero de 2011). Normas ISO-9000. Obtenido de Herramientas para sistemas de calidad: http://www.normas9000.com/iso-9000-59.html Organización para la Cooperación y el Desarrollo Económicos (OCDE). (2016). La educación en Colombia: Revisión de políticas nacionales. Bogotà: Ministerio de Educaciòn Nacional. Parasmal, Y. R. (2009). La aplicación del Lean Thinking en la Educación Superior. Strategum Eduserve Private Limited. Bangalore, India. Pérez Porto, J., & Merino, M. (2013). Definición.DE. Recuperado el 09 de Octubre de 2016, de http://definicion.de/herramienta/ Pérez-Fajardo, V. A. (16 de Mayo de 2016). Centro de Capacitación de Tudela. Equipo de Mejora. Tudela, Navarra, España: Ayuntamiento de Tudela. Polo, V. P. (Junio de 1999). El sistema Colombiano de acreditación. (C. Ascun, Ed.) Cuadernos ASCUN(7), 9. Salazar, L. B. (2012). Ingenieria Industrial Online: Diseño y distribución en planta. Recuperado el 7 de Agosto de 2016, de http://www.ingenieriaindustrialonline.com/herramientas-para-el-ingeniero-industrial/dise%C3%B1o-y-distribuci%C3%B3n-en-planta/ Structuralia: Formación Especializada. (2016). Manufacturing Terms. Definition at a click away. Santiago, Chile. Recuperado el 12 de Octubre de 2016, de Nivelación de la producción. Turmero, A. I., Alcocer, I., Perdomo, R., Muñoz, D., & Orta, B. (junio de 2010). Supply Chain Management. Maestria de Ingeniería Industrial. Puerto Ordaz, Bolivar, Venezuela. Universidad de Salamanca. (sf). OpenCourseWare de la Universidad de Salamanca. (Servicio de innovación y producción digital, Ed.) Recuperado el 01 de Octubre de 2016, de OCW-MIT: http://ocw.usal.es/ciencias-sociales-1/investigacion-evaluativa-en-educacion/contenidos/Calidad.pdf Villagomez Montero, P. D. (2009). Modelo de gestion para la ejecucion de proyectos de instalaciones de superficie en el sector petrolero del ecuador. Quito: Escuela Politecnica Nacional. Web Finance INC. (2016). Diccionario de negocios. Recuperado el 6 de Octubre de 2016, de http://www.businessdictionary.com/definition/key-performance-indicators-KPI.html ; Con base en la normatividad de la Legislación Educativa Colombiana y algunos de los más altos estándares para la educación superior de países como Finlandia y Singapur, se diseña y propone una herramienta de Lean Manufacturing para el diagnóstico de determinados procesos administrativos, académicos y pedagógicos adelantados por una entidad de educación superior. Este trabajo pretende ser de utilidad para apoyar los procesos de verificación de la calidad del servicio prestado por las IES de Colombia ya que permite la identificación de los ―desperdicios‖ frecuentes en los procedimientos ejecutados por las dependencias de éstas. Las herramientas de Lean Manufacturing nos permiten hacer una identificación y reducción de las actividades que no agregan valor al producto (los desperdicios) y así generar una manufactura limpia la cual nos lleva a reducir costos al cliente y poder incluir procesos continuos de mejora El sistema Educativo en países como Finlandia y Singapur han demostrado que a través de una correcta administración de los diferentes procesos, teniendo en cuenta de donde provienen y a que proceso van a impactar, se ha podido generar una mejora continua de la educación garantizando los más altos estándares de calidad. Adicionalmente, de acuerdo al artículo publicado en la BBC el 13 de Mayo 2015, ―Cinco Lecciones para América Latina del mayor ranking global de educación‖ (Martins, 2015) Se debe enfocar la educación (…) en el correcto desarrollo de aprendizaje (…) y al decir de Erick Hanushek profesor de la universidad de Stanford ―Ya no basta saber leer y escribir‖, sino además "tener la capacidad de comprender y usar con reflexión crítica la información, desarrollar la capacidad de razonar con conceptos (…) y extraer conclusiones basadas en evidencia" permite entonces tener en mente que se debe garantizar un aprendizaje más profundo en un ambiente más competitivo y de desarrollo sostenible alejado de todos aquellos elementos (procedimientos) de poca o nula significación educativa. El Sistema Educativo Colombiano y la evaluación de calidad de las Instituciones de Educación Superior (IES) se realiza bajo el resultado de cada procedimiento, muchas veces sin tener en cuenta 13 la siguiente etapa, evaluándolos como entes independientes y no como una relación del sistema. Los países que encabezan el ranking de calidad aplican estrategias exitosas que pueden ser pensadas para ser implementadas en Colombia y de esta manera propender por alcanzar mejores niveles de calidad y competitividad para la Institución y para el país. En consecuencia, se lleva a cabo una caracterización de herramientas Lean aplicables a la industria educativa como organismo conjunto en todas sus áreas, al mismo tiempo que se revisan las diferentes normas colombianas para la creación y certificación de alta calidad de las Instituciones de educación superior (IES) y se tienen en cuenta ciertos aspectos de calidad en la educación de dos países que encabezan la lista de los mejores (Finlandia y Singapur) para desarrollar y proponer un Benchmark para la evaluación de los procesos propios de las IES en Colombia y una matriz de aplicabilidad de herramientas lean frente al responsable del proceso.
The SARS-Cov-2 (COVID-19) pandemic outnumbered the spread of the virus 10 times more than the SARS-Cov-1 DEL 2002. It caused a major economic recession brought with it the pandemic that added to the 2019 economic crisis. The public and private systems of developed countries collapsed, which underestimated the aggressiveness of the viral agent, such as Italy and Spain, resulting in 372,756 confirmed cases and 16,231 deaths (4.3% of total cases) globally. Countries like Singapore and Taiwan, developed their protocols with the SARS-Cov-1 epidemic, and demonstrated to the world as efficient at a global biological threat. Currently, their strategies allowed to flatten the viral propagation curve of COVID-19, and were global benchmarks for tackling the pandemic locally. However, Mainland China, without staying on the sidelines, competes with the US. for the economic and political power of the regions and currently for the discovery of the vaccine against COVID-19. Aims: To determine the strategies and indicators associated with COVID-19 and its political impact on health and on the world and local economy. Determine country-based public health strategies efficient in emerging biological responses to minimize or flatten the epidemiological curve of COVID-19. Results: Ecuador, in South America, with 17 million inhabitants, with a GDP of 9.5% invested in public health, became the second country with the highest prevalence of COVID-19 cases (n=981) and ranked 26th in the world. The partial strategies taken at the national level, added to the lack of preventive culture in Ecuadorian society, quickly spread COVID-19. The lack of management of medical supplies, and the shortage of medical personnel (15 doctors per 10,000 inhabitants), as well as deficits in hospital beds (rate=1.4/1,000 inhabitants / national level [0.8 of the public sector], below Cuba with 5.4) and PCR-RT tests, it puts the health system at risk of collapse, due to the exponential increase of COVID 19 cases until the 6th week of local impact. However, the analysis of GDP% between Ecuador (GDP = 9.5%) and Taiwan (GDP = 6.3%), and the strategic measures used, rectify that the universal health system of Taiwan is very efficient in strategies and responses to the COVID-19 emergency. Taiwan's strategies have been reflected in our environment to flatten the epidemiological curve and reduce local public spending. ; La pandemia del SARS-CoV-2 (COVID-19) superó a 10 veces más la propagación del virus que el SARS-CoV-1 del 2002. Causó una gran recesión económica que se sumó a la crisis económica del 2020. Colapsó los sistemas públicos y privados de los países desarrollados que subestimaron la virulencia y mutación viral, especialmente en Italia y España, resultando en 372.756 casos confirmados y 16231 muertes (4.3% de casos totales) a nivel global. Países como Singapur y Taiwán, desarrollaron sus protocolos con la epidemia del SARS-Cov-1, y demostraron al mundo como ser eficientes a una amenaza biológica mundial. Actualmente, sus estrategias permiten aplanar la curva de propagación del COVID-19, y fueron referentes mundiales para afrontar la pandemia localmente. Por otro lado, China Continental, compite con EE.UU. por el poder económico y político de las regiones, así como el desarrollo de una vacuna para finales del 2020. En cuanto a las estrategias e indicadores asociados al COVID-19 y su impacto político en salud y en la economía local, Ecuador, localizado en Sudamérica, con 17 millones de habitantes, y un PIB de 9.5% destinado a la salud pública, se convirtió en el segundo país con mayor prevalencia de casos (n=981) y se ubicó en el puesto 26º en el mundo. Las estrategias parciales tomadas a nivel nacional, sumado a la falta de cultura preventiva de la sociedad ecuatoriana, propagaron rápidamente el COVID-19. La falta de gestión de insumos médicos, y la escasez del personal médico (15 médicos por cada 10.000 habitantes), así como déficit de camas hospitalarias (tasa=1.4/1.000 habitantes/nivel nacional [0.8 del sector público], por debajo de Cuba con 5.4) y pruebas de PCR-RT, pone en peligro el sistema de salud de colapsarse, por el aumento exponencial del virus COVID-19 analizado hasta la 6ta semana del impacto local. Sin embargo, el análisis de PIB% entre Ecuador (PIB=9.5%) y Taiwán (PIB=6.3%), y las medidas estratégicas empleadas, rectifican que el sistema universal de salud de Taiwán, es muy eficiente en estrategias y respuestas a la emergencia del COVID-19. Estrategias de Taiwán han sido reflejadas en nuestro entorno para aplanar la curva epidemiológica y reducir el gasto público local.
Advanced Practice Nursing (APN) emerged as a response to the need for professionals capable of giving care to patients, thereby improving the quality of healthcare; the results obtained by implementing APNs in healthcare teams confirm that APNs can be implemented in the healthcare of patients of all ages and with varied health situations (1). Levels of development in APN are very diverse in distinct countries, in the legal aspect as well as in the roles that a nurse with this level of training can fulfill. The International Council of Nurses (ICN) counts around seventy countries as being preoccupied with introducing clear function for APNs (20); nonetheless, literature describes the main progress in this sense occurring in Canada, Australia, Ireland, Finland, the United Kingdom, and the United States, although in the last ten years significant advances have been identifies in Belgium, Germany, Switzerland, Thailand, Singapore, Korea, and Africa (3, 4). In Latin-American, progress in this initiative is embryonic: the role that a APN can fulfill has not been sufficiently disseminated and the implementation of this strategy has been limited by healthcare policies in many countries or by the opposition to APNs by professionals in other areas who are reacting to misinformation or to fear of usurpation of certain functions by APNs. However, in primary care, APNs have been incorporated into healthcare teams, and research shows positive results for the expansion of coverage and reduction of healthcare costs, in both rural areas and urban centers (1, 5). Thanks to these advances, in 2000 the ICN supported the creation of the International Nurse Practitioner/Advanced Practice Nursing Network (INP/APNN) with the objective of favoring dialogue, advancing the installation of APNs in the countries, facilitating the interchange of knowledge, determining the limits in the expansion of the role of nurses, and defining the guidelines for the formation of human resources at this level. Likewise, the World Health Organization and the Pan-American Health Organization (PAHO) have worked with universities and nursing associations in Latin America and the Caribbean to, through context analyses, propose implementation of APNs (5). During August 2018, the 10th Conference of the International Nursing Council convened in Rotterdam with the goal of exploring the role of APNs in the transformation of healthcare (6). With the participation of more than fifty countries, the council established a global panorama of the situation and of the challenges nursing faces as an active participant and agent for achieving universal health coverage. An important conclusion drawn from the event is the recognition given by all participating countries to APNs for allowing significant advancement of strategies for primary healthcare and the achievement of goals related with universal health coverage and sustainable development: the guarantee of a healthy life and the promotion of wellness for everyone at every age (4, 5). These propositions imply a process and the need for countries to work towards the expansion of nursing roles, which requires the promotion of a collective project that unites different sectors involved in the formation of human talent, on one hand, that the offering of health services on the other. Likewise, administrators of education and health policy along with associations involved in the nursing discipline need to contribute to the analyses of strategies for implementing a sustainable and efficient health system that allows universal access to health (1, 4, 7). In this context, APNs are understood to have undergone master or doctorate level training that develops scientific knowledge, clinical expertise, leadership, political formation, communicational capacity, and education for the patient, family, and community groups. Therefore, the professional is enabled to take ethical decisions, work autonomously, interact in intra- and interdisciplinary groups, and understand that ANP's work will be determined by the unique environment, healthcare structure, and legislation of different countries. In accord with Morán-Peña (8), the International Nursing Council states that APNs are characterized by an autonomous practice that allows the implementation of tools like: valuation, diagnostic reasoning, decision making for the handling of cases, plan development, implementation and evaluation of programs as part of consultation services, and being the first point of contact in the healthcare system. This implies that an ANP will have competencies to participate in the elaboration of public policy as well as on teams dedicated to care for individuals, families, groups, and communities in disease prevention, health promotion, treatment, recuperation, and palliative care (7, 9, 10). Consequently, working on the implementation of the EPA can possibly lead to transformation of healthcare systems in the clinical area, improvement in the access to primary healthcare, and in the design and development of investigation projects whose results can be applied in practice; in short, it would affect the quality and effectiveness of healthcare at different levels and allow the urgent and much needed evolution of healthcare systems (11). With this perspective, the fundamental question is whether sufficient political interest exist for the development of APN's roles, the definition of APN's limits, the adaption of the existing structure, the establishment of guidelines for educational programs, and the application of expert knowledge, among other aspects, in benefit of health coverage, healthcare quality, and the establishment of a sustainable healthcare system. ; Advanced Practice Nursing (APN) emerged as a response to the need for professionals capable of giving care to patients, thereby improving the quality of healthcare; the results obtained by implementing APNs in healthcare teams confirm that APNs can be implemented in the healthcare of patients of all ages and with varied health situations (1). Levels of development in APN are very diverse in distinct countries, in the legal aspect as well as in the roles that a nurse with this level of training can fulfill. The International Council of Nurses (ICN) counts around seventy countries as being preoccupied with introducing clear function for APNs (20); nonetheless, literature describes the main progress in this sense occurring in Canada, Australia, Ireland, Finland, the United Kingdom, and the United States, although in the last ten years significant advances have been identifies in Belgium, Germany, Switzerland, Thailand, Singapore, Korea, and Africa (3, 4). In Latin-American, progress in this initiative is embryonic: the role that a APN can fulfill has not been sufficiently disseminated and the implementation of this strategy has been limited by healthcare policies in many countries or by the opposition to APNs by professionals in other areas who are reacting to misinformation or to fear of usurpation of certain functions by APNs. However, in primary care, APNs have been incorporated into healthcare teams, and research shows positive results for the expansion of coverage and reduction of healthcare costs, in both rural areas and urban centers (1, 5). Thanks to these advances, in 2000 the ICN supported the creation of the International Nurse Practitioner/Advanced Practice Nursing Network (INP/APNN) with the objective of favoring dialogue, advancing the installation of APNs in the countries, facilitating the interchange of knowledge, determining the limits in the expansion of the role of nurses, and defining the guidelines for the formation of human resources at this level. Likewise, the World Health Organization and the Pan-American Health Organization (PAHO) have worked with universities and nursing associations in Latin America and the Caribbean to, through context analyses, propose implementation of APNs (5). During August 2018, the 10th Conference of the International Nursing Council convened in Rotterdam with the goal of exploring the role of APNs in the transformation of healthcare (6). With the participation of more than fifty countries, the council established a global panorama of the situation and of the challenges nursing faces as an active participant and agent for achieving universal health coverage. An important conclusion drawn from the event is the recognition given by all participating countries to APNs for allowing significant advancement of strategies for primary healthcare and the achievement of goals related with universal health coverage and sustainable development: the guarantee of a healthy life and the promotion of wellness for everyone at every age (4, 5). These propositions imply a process and the need for countries to work towards the expansion of nursing roles, which requires the promotion of a collective project that unites different sectors involved in the formation of human talent, on one hand, that the offering of health services on the other. Likewise, administrators of education and health policy along with associations involved in the nursing discipline need to contribute to the analyses of strategies for implementing a sustainable and efficient health system that allows universal access to health (1, 4, 7). In this context, APNs are understood to have undergone master or doctorate level training that develops scientific knowledge, clinical expertise, leadership, political formation, communicational capacity, and education for the patient, family, and community groups. Therefore, the professional is enabled to take ethical decisions, work autonomously, interact in intra- and interdisciplinary groups, and understand that ANP's work will be determined by the unique environment, healthcare structure, and legislation of different countries. In accord with Morán-Peña (8), the International Nursing Council states that APNs are characterized by an autonomous practice that allows the implementation of tools like: valuation, diagnostic reasoning, decision making for the handling of cases, plan development, implementation and evaluation of programs as part of consultation services, and being the first point of contact in the healthcare system. This implies that an ANP will have competencies to participate in the elaboration of public policy as well as on teams dedicated to care for individuals, families, groups, and communities in disease prevention, health promotion, treatment, recuperation, and palliative care (7, 9, 10). Consequently, working on the implementation of the EPA can possibly lead to transformation of healthcare systems in the clinical area, improvement in the access to primary healthcare, and in the design and development of investigation projects whose results can be applied in practice; in short, it would affect the quality and effectiveness of healthcare at different levels and allow the urgent and much needed evolution of healthcare systems (11). With this perspective, the fundamental question is whether sufficient political interest exist for the development of APN's roles, the definition of APN's limits, the adaption of the existing structure, the establishment of guidelines for educational programs, and the application of expert knowledge, among other aspects, in benefit of health coverage, healthcare quality, and the establishment of a sustainable healthcare system. ; Advanced Practice Nursing (APN) emerged as a response to the need for professionals capable of giving care to patients, thereby improving the quality of healthcare; the results obtained by implementing APNs in healthcare teams confirm that APNs can be implemented in the healthcare of patients of all ages and with varied health situations (1). Levels of development in APN are very diverse in distinct countries, in the legal aspect as well as in the roles that a nurse with this level of training can fulfill. The International Council of Nurses (ICN) counts around seventy countries as being preoccupied with introducing clear function for APNs (20); nonetheless, literature describes the main progress in this sense occurring in Canada, Australia, Ireland, Finland, the United Kingdom, and the United States, although in the last ten years significant advances have been identifies in Belgium, Germany, Switzerland, Thailand, Singapore, Korea, and Africa (3, 4). In Latin-American, progress in this initiative is embryonic: the role that a APN can fulfill has not been sufficiently disseminated and the implementation of this strategy has been limited by healthcare policies in many countries or by the opposition to APNs by professionals in other areas who are reacting to misinformation or to fear of usurpation of certain functions by APNs. However, in primary care, APNs have been incorporated into healthcare teams, and research shows positive results for the expansion of coverage and reduction of healthcare costs, in both rural areas and urban centers (1, 5). Thanks to these advances, in 2000 the ICN supported the creation of the International Nurse Practitioner/Advanced Practice Nursing Network (INP/APNN) with the objective of favoring dialogue, advancing the installation of APNs in the countries, facilitating the interchange of knowledge, determining the limits in the expansion of the role of nurses, and defining the guidelines for the formation of human resources at this level. Likewise, the World Health Organization and the Pan-American Health Organization (PAHO) have worked with universities and nursing associations in Latin America and the Caribbean to, through context analyses, propose implementation of APNs (5). During August 2018, the 10th Conference of the International Nursing Council convened in Rotterdam with the goal of exploring the role of APNs in the transformation of healthcare (6). With the participation of more than fifty countries, the council established a global panorama of the situation and of the challenges nursing faces as an active participant and agent for achieving universal health coverage. An important conclusion drawn from the event is the recognition given by all participating countries to APNs for allowing significant advancement of strategies for primary healthcare and the achievement of goals related with universal health coverage and sustainable development: the guarantee of a healthy life and the promotion of wellness for everyone at every age (4, 5). These propositions imply a process and the need for countries to work towards the expansion of nursing roles, which requires the promotion of a collective project that unites different sectors involved in the formation of human talent, on one hand, that the offering of health services on the other. Likewise, administrators of education and health policy along with associations involved in the nursing discipline need to contribute to the analyses of strategies for implementing a sustainable and efficient health system that allows universal access to health (1, 4, 7). In this context, APNs are understood to have undergone master or doctorate level training that develops scientific knowledge, clinical expertise, leadership, political formation, communicational capacity, and education for the patient, family, and community groups. Therefore, the professional is enabled to take ethical decisions, work autonomously, interact in intra- and interdisciplinary groups, and understand that ANP's work will be determined by the unique environment, healthcare structure, and legislation of different countries. In accord with Morán-Peña (8), the International Nursing Council states that APNs are characterized by an autonomous practice that allows the implementation of tools like: valuation, diagnostic reasoning, decision making for the handling of cases, plan development, implementation and evaluation of programs as part of consultation services, and being the first point of contact in the healthcare system. This implies that an ANP will have competencies to participate in the elaboration of public policy as well as on teams dedicated to care for individuals, families, groups, and communities in disease prevention, health promotion, treatment, recuperation, and palliative care (7, 9, 10). Consequently, working on the implementation of the EPA can possibly lead to transformation of healthcare systems in the clinical area, improvement in the access to primary healthcare, and in the design and development of investigation projects whose results can be applied in practice; in short, it would affect the quality and effectiveness of healthcare at different levels and allow the urgent and much needed evolution of healthcare systems (11). With this perspective, the fundamental question is whether sufficient political interest exist for the development of APN's roles, the definition of APN's limits, the adaption of the existing structure, the establishment of guidelines for educational programs, and the application of expert knowledge, among other aspects, in benefit of health coverage, healthcare quality, and the establishment of a sustainable healthcare system.
Antecedentes: La economía colombiana, se ha caracterizado por una amplia apertura y libre mercado, tanto que hoy tiene tratados comerciales con los bloques más importantes del mundo. Esta característica exige tener unas condiciones de alta competitividad y diversificación, por lo que los Gobiernos nacional y regional intentan impulsar algunos sectores que tradicionalmente han sido inexplotados como el turismo y específicamente el Turismo de Salud, con el fin de convertirlo en un sector de clase mundial, que coadyuve a generar fuentes de riqueza, empleo y diversificación de la economía. El Turismo Médico es un sector que cada día toma mayor fuerza y credibilidad y en algunos países como Singapur, Malasia o Costa Rica constituyen un aporte importante al PIB. Objetivo: Describir la cadena de valor de sector Turismo de Salud, del Área de Cúcuta, determinar sus ventajas y desventajas y proponer estrategias que permitan su desarrollo como alternativa económica para la zona de frontera. Método: Documental y cuantitativo, enfocado en los actores del subsector, con especial énfasis en las Instituciones Prestadoras de Salud, y teniendo como teorías fundamentales, la Cadena de Valor y el Diamante de Porter. Resultados: La región cuenta con la infraestructura, una posición geoestratégica y las condiciones sociales y económicas necesarias, para lograr el surgimiento del subsector,aunque para lograrlo se requiere, principalmente, que las instituciones de salud logren acreditaciones internacionales, sus trabajadores tengan un buen nivel de bilingüismo y se desarrolle una adecuada estrategia de mercadeo y de articulación entre actores del sistema. Conclusiones: Existen las condiciones necesarias para que el turismo de salud se convierta en una alternativa económica viable, siendo necesario diseñar políticas y estrategias dirigidas a la articulación de los actores, el mejoramiento de la infraestructura, la capacitación del recurso humano y la certificación de calidad de las instituciones prestadoras de salud.Palabras Clave: Alternativa económica, Cadena de Valor, Norte de Santander, Turismo de Salud. Abstract Background: The Colombian economy has been characterized by a wide open free market, including current agreements with major trade blocs in the world. This feature requires high competitiveness and diversification conditions, thus national and regional governments must try to promote some sectors that have traditionally been unexploited such as Health Tourism, in order to make it become a world-class industry that contributes to generate economic wealth, employment and diversification of the economy. Health tourism is a growing industry in countries such as Singapore, Malaysia, and Costa Rica, making an important contribution to the GPD. Objective: To establish the chain value in Health Tourism in the Cúcuta area, determining its advantages and disadvantages and proposing strategies for its development as an economic alternative to the border area. Method: Documental and quantitative, focused on Health Provider Institutions, with chain value and porter diamond as fundamental theories. Results: The results indicate that the region has the necessary infrastructure, a geostrategic position and the social and economic conditions that favor the emergence of the sector. It is necessary for the health institutions to obtain international accreditation, bilingual skills of the employees, and an adequate marketing strategy and articulation between the actors of the system. Conclusions: There are conditions for development of health tourism as a viable economic alternative. Design of policies, infrastructure improvement, human resource training, and quality certification of health institutions are necessary.Keywords: Economic alternative, Chain Value, Norte de Santander, Health tourism. Resumo Antecedentes: A economia colombiana tem sido caracterizada por um mercado livre aberto, tendo hoje acordos comerciais com grandes blocos do mundo. Esta característica exige ter uma alta competitividade e diversificação, de modo que os governos nacionais e regionais tentam empurrar alguns setores que tradicionalmente tem sido inexplorado, como o turismo e mais especificamente o Turismo de Saúde, a fim de torná-lo uma indústria de classe mundial, que contribua para a geração de riqueza, emprego e diversificação da economia. O Turismo Médico é um setor que cada dia toma maior força e credibilidade e em alguns países como Singapura, Malásia ou Costa Rica constitui um aporte importante ao PIB. Objetivo: Descrever a cadeia de valor do setor Turismo de Saúde da área de Cucuta, determinar suas vantagens e desvantagens e propor estratégias que permitam seu desenvolvimento como alternativa económica para a área de fronteira. Método: Documental e quantitativo, enfocado nos atores do subsetor, com particular ênfase nas Instituições Emprestadoras de Saúde, e tendo como teorias fundamentais: a Cadeia de Valor e o Diamante de Porter. Resultados: A região conta com a infraestrutura, uma posição geoestratégica vantajosa e as condições sociais e económicas necessárias para alcançar o surgimento do subsetor, embora para atingi-lo se requer, principalmente, que as instituições de saúde consigam a acreditação internacional, os seus trabalhadores tenham um bom nível de bilinguismo e se desenvolva uma adequada estratégia de marketing e de articulação entre atores do sistema. Conclusões: Existem as condições necessárias para que o turismo de saúde se torne uma alternativa econômica viável, sendo necessário elaborar políticas e estratégias dirigidas à articulação dos atores, melhoramento da infraestrutura, formação de recurso humano e certificação de estratégias de qualidade nas instituições de saúde.Palavras-chave: Alternativa económica, Cadeia de Valor, Norte de Santander, Turismo de Saúde.
Hace algunas semanas, al analizar la compleja situación de los gigantes hipotecarios Fannie Mae y Fredie Mac (ver LETRAS INTERNACIONALES N° 33) concluimos que parecía poco probable la nacionalización de las mismas, salvo que la situación se agravara mas allá de lo previsible en ese momento y obligara al Departamento del Tesoro de los Estados Unidos a una solución drástica, en la búsqueda de contener la constante caída del valor de las mismas, lo cual finalmente termino ocurriendo, obligando a evitar que el desplome de ambas compañías arrastraran de forma más profunda a la ya golpeada economía de los Estados Unidos. También señalábamos que si ese fuera el caso, "el problema será más sistémico aun y los costos totales difíciles de absorber por un gobierno cada vez más endeudado y con menor margen de maniobra" Y, es que el riesgo sistémico se acentúo esta semana, cuando el cuarto banco de inversiones de los Estados Unidos, Lehman Brothers, realizó varios anuncios, casi de forma simultánea, que hicieron renacer los temores, finalmente confirmados, que desde el comienzo de la crisis, se cernían sobre la salud financiera de este banco pionero que acababa de cumplir sus primeros 158 años. Las noticias se sucedieron de forma continua, y en este caso lamentablemente, se han tratado todas de malas noticias. En primer lugar, se produce el anuncio de que la firma de inversiones Ospraie Management, del cual Lehman tiene un 20 % de participación desde el año 2005, anuncio severas pérdidas como resultado de la especulación que el mismo había realizado en los mercados de commodities, los cuales vienen en caída libre desde mediados de julio pasado. Como consecuencias de dichas pérdidas que alcanzaron casi un 40% en este año (de los cuales un 27 % se dio solamente en el mes de agosto), la firma debió cerrar uno de sus más conocidos hedge funds. En segundo lugar, y de forma casi simultánea, el Banco de Desarrollo de Corea del Sur (KDB), anuncio que daba por finalizada las negociaciones que venía llevando adelante con Lehman Brothers acerca de una posible capitalización de la firma. Recordemos que esta forma de capitalización a través de bancos y fondos de inversión del extranjero, es la fórmula que los grandes bancos norteamericanos vienen aplicando como paliativo a las grandes pérdidas registradas en los Estados Unidos. A modo de ejemplo, Citibank ha recibido USD 7.500 millones del fondo de inversiones de Abu Dhabi, USD 6.900 millones de la Government of Singapore Investment Corp y USD 5.600 millones de la Kuwait Investment Authority. Y, es que en este caso, los coreanos del KDB, decidieron, de forma que ahora sabemos correcta, que la posible capitalización de Lehman no sería suficiente para frenar el drenaje y que finalmente sus millones terminarían en un saco roto. En tercer lugar, el banco anuncio perdidas por 3.900 millones de dólares en el pasado trimestre debido principalmente a sus resultados en el mercado hipotecario subprime, lo cual ha servido de anuncio final al mercado de que la viabilidad de la firma de manera independiente era muy poco probable, presentándose el lunes pasado al amparo de la ley de bancarrota. Pero, y la FED y el Departamento del Tesoro porque no acudieron a su rescate como hicieron en marzo pasado con Bear Stearns? De momento se señala que las comparaciones con Bear Stearns no son correctas en un ciento por ciento, ya que en el caso de Lehman el mercado estuvo consciente de la situación del mismo por mucho tiempo y ha tenido tiempo para prepararse. Por otro lado, Lehman se vio beneficiada de una consecuencia de la caída de Bear Stearns, y fue la extensión de la FED en el rol de prestamista de última instancia a todos los operadores financieros, lo cual le permite acceder a liquidez cuando Wall Street u otros bancos no se la dan. Y es esta alternativa la que Lehman utilizo de forma constante en los últimos meses, pero, como su modelo de negocios estaba en serios problemas, se tornaba necesario algo más que la liquidez puntual, sino la transformación del mismo en un negocio viable y rentable. La fuerza de los hechos llevo a una caída sin precedentes de este gigante financiero, que ahora será desmembrado en partes y vendido en sus unidades aun rentables a distintos bancos e inversores del planeta, pero el daño y los temores se instalaron fuertemente en el mercado, sobre todo con la noticia simultanea de la compra de Merril Lynch por el Bank of America. Por la salud del resto del mercado y en definitiva de todos, esperemos que estas sean las últimas noticias de este tipo que tengamos en los próximos meses, pero, aun es temprano para poder afirmarlo, ya que el riesgo se ha vuelto sistémico y, casi nadie está a salvo. Coordinador Académico Adjunto. Licenciatura en Estudios Internacionales. FACS-ORT.
Advanced Practice Nursing (APN) emerged as a response to the need for professionals capable of giving care to patients, thereby improving the quality of healthcare; the results obtained by implementing APNs in healthcare teams confirm that APNs can be implemented in the healthcare of patients of all ages and with varied health situations (1). Levels of development in APN are very diverse in distinct countries, in the legal aspect as well as in the roles that a nurse with this level of training can fulfill. The International Council of Nurses (ICN) counts around seventy countries as being preoccupied with introducing clear function for APNs (20); nonetheless, literature describes the main progress in this sense occurring in Canada, Australia, Ireland, Finland, the United Kingdom, and the United States, although in the last ten years significant advances have been identifies in Belgium, Germany, Switzerland, Thailand, Singapore, Korea, and Africa (3, 4). In Latin-American, progress in this initiative is embryonic: the role that a APN can fulfill has not been sufficiently disseminated and the implementation of this strategy has been limited by healthcare policies in many countries or by the opposition to APNs by professionals in other areas who are reacting to misinformation or to fear of usurpation of certain functions by APNs. However, in primary care, APNs have been incorporated into healthcare teams, and research shows positive results for the expansion of coverage and reduction of healthcare costs, in both rural areas and urban centers (1, 5). Thanks to these advances, in 2000 the ICN supported the creation of the International Nurse Practitioner/Advanced Practice Nursing Network (INP/APNN) with the objective of favoring dialogue, advancing the installation of APNs in the countries, facilitating the interchange of knowledge, determining the limits in the expansion of the role of nurses, and defining the guidelines for the formation of human resources at this level. Likewise, the World Health Organization and the Pan-American Health Organization (PAHO) have worked with universities and nursing associations in Latin America and the Caribbean to, through context analyses, propose implementation of APNs (5). During August 2018, the 10th Conference of the International Nursing Council convened in Rotterdam with the goal of exploring the role of APNs in the transformation of healthcare (6). With the participation of more than fifty countries, the council established a global panorama of the situation and of the challenges nursing faces as an active participant and agent for achieving universal health coverage. An important conclusion drawn from the event is the recognition given by all participating countries to APNs for allowing significant advancement of strategies for primary healthcare and the achievement of goals related with universal health coverage and sustainable development: the guarantee of a healthy life and the promotion of wellness for everyone at every age (4, 5). These propositions imply a process and the need for countries to work towards the expansion of nursing roles, which requires the promotion of a collective project that unites different sectors involved in the formation of human talent, on one hand, that the offering of health services on the other. Likewise, administrators of education and health policy along with associations involved in the nursing discipline need to contribute to the analyses of strategies for implementing a sustainable and efficient health system that allows universal access to health (1, 4, 7). In this context, APNs are understood to have undergone master or doctorate level training that develops scientific knowledge, clinical expertise, leadership, political formation, communicational capacity, and education for the patient, family, and community groups. Therefore, the professional is enabled to take ethical decisions, work autonomously, interact in intra- and interdisciplinary groups, and understand that ANP's work will be determined by the unique environment, healthcare structure, and legislation of different countries. In accord with Morán-Peña (8), the International Nursing Council states that APNs are characterized by an autonomous practice that allows the implementation of tools like: valuation, diagnostic reasoning, decision making for the handling of cases, plan development, implementation and evaluation of programs as part of consultation services, and being the first point of contact in the healthcare system. This implies that an ANP will have competencies to participate in the elaboration of public policy as well as on teams dedicated to care for individuals, families, groups, and communities in disease prevention, health promotion, treatment, recuperation, and palliative care (7, 9, 10). Consequently, working on the implementation of the EPA can possibly lead to transformation of healthcare systems in the clinical area, improvement in the access to primary healthcare, and in the design and development of investigation projects whose results can be applied in practice; in short, it would affect the quality and effectiveness of healthcare at different levels and allow the urgent and much needed evolution of healthcare systems (11). With this perspective, the fundamental question is whether sufficient political interest exist for the development of APN's roles, the definition of APN's limits, the adaption of the existing structure, the establishment of guidelines for educational programs, and the application of expert knowledge, among other aspects, in benefit of health coverage, healthcare quality, and the establishment of a sustainable healthcare system.
Las necesidades crecientes de recursos y de gestión del sector público sobrepasan la capacidad del Estado para solucionar el déficit histórico de infraestructura en Colombia. Esto, ha conducido al sector público a suscribir acuerdos contractuales con el sector privado conocidos como Asociaciones Público Privadas, APP. En este tipo de asociaciones es común que se presenten múltiples obstáculos y problemas tales como: sobrecostos, mayores tiempos de ejecución, dificultades de financiación, diferencias políticas, restricciones legales y conflictos sociales, entre otros, los cuales se conocen en la literatura como Factores Negativos y Factores de Riesgo. Sin embargo, también se encuentran Factores Positivos y Factores Críticos de Éxito tales como: capacidades de estructuración, de construcción y mantenimiento, disponibilidad de financiación, apropiada asignación de riesgos y una rigurosa factibilidad técnica. El estudio de los anteriores factores ha sido un área de investigación creciente en los países desarrollados, debido al interés de los sectores público, privado y de la academia, de explorar mejores formas de financiar e implementar acuerdos de APP. Sin embargo, existe poca evidencia de estudios en países en vía de desarrollo y, a la fecha, no se evidencia investigaciones de este tipo en Colombia. Por lo anterior, esta investigación tiene como propósito establecer qué Factores Positivos y qué Factores Negativos determinan la creación de APP en Colombia, qué Factores Críticos de Éxito y qué Factores de Riesgo determinan la ejecución de APP en Colombia. Para efectos de esta investigación, estos factores se denominarán "Factores Determinantes", esto es, los factores que determinan el éxito en la creación y ejecución de APP en Colombia, para lo cual, se sigue la terminología utilizada por Hammami, Ruhashyankiko y Yehoue (2006) y por Li (2003). Se realizó una investigación cualitativa de tipo descriptivo con enfoque histórico hermenéutico, que inicia con una revisión extensiva de la literatura en APP. Luego, se aplicó el método de entrevista estructurada y el instrumento de Li (2003) a expertos en APP en Colombia con alta responsabilidad gerencial y/o directiva, cuyo propósito fue indagar sus percepciones acerca de los Factores Determinantes de las APP en infraestructura en Colombia. Los resultados obtenidos fueron analizados e interpretados por medio de las técnicas de Índice de Significancia, Análisis de Contenido, ANOVA y Tukey, para luego compararlos y contrastarlos con los resultados obtenidos en otros estudios en países desarrollados como Estados Unidos, Reino Unido, China, Singapur, entre otros. De las conclusiones se destaca que: el apoyo social de las comunidades, la no afectación al medio ambiente, el acceso a mercados financieros, la disponibilidad de fuentes de financiación, un marco legal y regulatorio estable, un contrato bien definido, un eficaz diseño de proyecto, una adecuada gestión de riesgos y el compromiso del sector público, son los Factores Determinantes más significativos para el éxito de las APP en infraestructura en Colombia. Se espera que los resultados de esta investigación puedan contribuir a futuros estudios en APP en Colombia ; Abstract: The growing needs for resources and management of the public sector exceed the capacity of the State to solve the historical infrastructure deficit in Colombia. This has led the public sector to enter into contractual agreements with the private sector known as Public-Private Partnerships, PPP. In this type of associations, it is common that there are multiple obstacles and problems such as cost overruns, longer execution times, financing difficulties, political differences, legal restrictions and social conflicts, among others, which in the literature known as Negative Factors and Risk Factors. However, there are also Positive Factors and Critical Success Factors such as structuring, construction and maintenance capabilities, availability of financing, appropriate risk allocation and a rigorous technical feasibility. The study of the above factors has been a growing area of research in developed countries, due to the interest of the public, private and academic sectors to explore better ways to finance and implement PPP agreements. However, there is little evidence of this type of studies in developing countries and, to date there is no evidence of this type of research in Colombia. Therefore, this research has the purpose of establishing what Positive and Negative Factors determining the creation of APP in Colombia, what Critical Success Factors and Risk Factors determining the execution of PPP in Colombia. For the purposes of this research, these factors will be called "Determining Factors", that is, the factors that determine the success in the creation and execution of PPPs in Colombia, for which, the terminology used by Hammami, Ruhashyankiko and Yehoue (2006) and Li (2003). Qualitative descriptive research with historical hermeneutic approach was carried out, starting with an extensive literature review in APP. Then, the structured interview method and the Li instrument (2003) to experts in PPP in Colombia are applied with high managerial and / or managerial responsibility, whose purpose is to investigate their perceptions about the Determining Factors of PPPs in infrastructure in Colombia. Through the techniques of Significance Index, the results obtained were analyzed and interpreted, Content Analysis, ANOVA and Tukey, to then compare and contrast them with the results obtained in other studies in developed countries such as United States, United Kingdom, China, Singapore, and others. The conclusions highlight that: the social support of the communities, the non-impact on the environment, access to financial markets, the availability of funding sources, a stable legal and regulatory framework, a well-defined contract, an effective design of project, adequate risk management and public sector commitment, are the most significant determining factors for the success of PPPs in infrastructure in Colombia. It´s expected that the results of this research might contribute to future studies in PPP in Colombia ; Doctorado
Introducción: Colombia se presenta como uno de los países con mayor potencial para exportar servicios en los próximos años, en cuanto a turismo de salud se refiere. La imagen de sus médicos en diferentes especialidades ha venido aumentando, gracias a su preparación, calidad y relativo bajo costo con respecto a los países de la región. Santander, concretamente con las zonas francas en salud, ha venido alcanzando reconocimiento a nivel latinoamericano. El potencial que tiene este turismo se argumenta en los logros del sector salud y los efectos en cuanto al turismo internacional y en el desarrollo socio-económico de algunas regiones. Objetivo: Identificar las estrategias exitosas, fortalezas y debilidades del turismo médico en el ámbito nacional e internacional que permitan recomendar acciones estratégicas para generar ventajas competitivas al sector de salud en Santander y lo lleven al liderazgo. Metodología: Revisión de tema, con búsqueda sistemática de información bibliográfica, se utilizaron los descriptores DeCS: "Comercialización de Servicios de Salud", "Turismo Médico", "Economía de la Salud", "Servicios de Salud", "Comercio", "Economía Hospitalaria", en las bases de datos Scielo, Google Scholar, PubMed, además de realizar entrevistas con expertos de las entidades. Resultados: Se encontró que Colombia cuenta con una buena posición a nivel mundial y latinoamericano en términos de turismo en salud destacándose por la oferta de servicios en cardiología, cirugía estética y ortopedia; España cuenta con uno de los mejores sistemas de salud y tiene el séptimo puesto en la comercialización de servicios hospitalarios; India, Israel y Singapur lideran los temas de investigación e innovación posicionándolos también como potencias en el turismo médico. Conclusiones: Comparando a Bucaramanga y Área Metropolitana con otras ciudades y países, aún se requiere mayor reconocimiento como región y aunque se cuenta con entidades certificadas internacionalmente, es necesario trabajar en equipo con otras entidades prestadoras, el gobierno, agremiaciones y formar recursos humanos para atender el mercado internacional. [Vargas-Mantilla MM. Revisión de estrategias de turismo de salud e identificación de aportes para Santander, Colombia. MedUNAB 2017-2018; 20((3): 349-361] ; Introduction: Colombia is one of the countries with the greatest potential to export services in the next years, in terms of health tourism. The image of its doctors in different specialties has been increasing, thanks to their preparation, quality and relative low cost with respect to the countries of the region. Santander, specifically with the free trade zones in health, has been achieving recognition in Latin America. The potential of this tourism is argued in the achievements of the health area and the effects in terms of international tourism and the socio-economic development of some regions. Objective: To identify the successful strategies, strengths and weaknesses of medical tourism in the national and international scope that allow recommending strategic actions to create competitive advantages to the health sector in Santander and guide it to leadership. Methodology: A topic review with a systematic search of bibliographic information, in which DeCS descriptors were used such as Marketing of Health Services, medical tourism, Health economics, Health services, trading and Hospital economy in the databases Scielo, Google Scholar and Pubmed; in addition, interviews were conducted with experts from the entities. Results: It was found that Colombia has a good position in the world and Latin America in terms of health tourism, standing out for the offer of services in cardiology, aesthetic surgery and orthopedics; Spain has one of the best health systems and has the seventh position in the marketing of hospital services. India, Israel and Singapore lead the research and innovation issues, positioning them also as powers in medical tourism. Conclusions: Comparing Bucaramanga and Metropolitan Area with other cities and countries, it needs even more recognition as a region and although there are internationally certified entities, it is necessary to work as a team with other health providers, the government, associations and train staff to serve the international market. [Vargas-Mantilla MM. Review of Health Tourism Strategies and Identification of Contributions to Santander, Colombia. MedUNAB 2017-2018; 20(3): 349-361] ; Introdução:AColômbia é um dos países com maior potencial para exportar serviços nos próximos anos, em termos de turismo de saúde. A imagem de seus médicos em diferentes especialidades tem aumentado, graças à sua preparação, qualidade e baixo custo relativo em relação aos países da região. O estado de Santander, especificamente com as zonas francas em saúde, vem conquistando reconhecimento na América Latina. O potencial deste turismo é reconhecido nas conquistas do setor de saúde e os efeitos são discutidos em turismo internacional e desenvolvimento socioeconômico de algumas regiões. Objetivo:Identificar as estratégias, pontos fortes e fracos de sucesso do turismo médico no âmbito nacional e internacional que permitem recomendar ações estratégicas para gerar vantagens competitivas para o setordesaúdeemSantanderelevá-loàliderança. Metodologia:Revisão do tema, com busca sistemática de informações bibliográficas, foram utilizados os descritores DeCS: "Marketing de Serviços de Saúde", "Turismo Médico", "Economia da Saúde", "Serviços de Saúde", "Comércio", " Economia hospitalar ", nos bancos de dados Scielo, Google Scholar,PubMed,alémderealizarentrevistascom especialistasdasentidades.Resultados:AColômbia encontrou uma boa posição no mundo e na América Latina em termos de turismo em saúde, destacando-se pela oferta de serviços em cardiologia, cirurgia estética e ortopedia; AEspanha tem um dos melhores sistemas de saúde e tem o sétimo lugar na comercialização de serviços hospitalares; Índia, Israel e Cingapura lideram as questões de pesquisa e inovação,posicionando-astambémcomofortalezasno turismo médico. Conclusões: Comparando Bucaramanga e a Área Metropolitana com outras cidades e países, ainda é necessário mais reconhecimento como região e, embora existamentidadescertificadasinternacionalmente,é necessário trabalhar em equipe com outras entidades de crédito,ogoverno,associaçõesecapacitarrecursos humanos para participar mercado internacional. [Vargas-Mantilla MM. Revisão das estratégias de turismo de saúde e identificação de contribuições para Santander, Colômbia. MedUNAB2017-2018; 20(3): 349-361]
ResumenLas ontologías de ciudad y territorio, la experiencia que de ellos tenemos y las técnicas que usamos para gobernarlos, la propia concepción de las formaciones socioespaciales que habitamos, son históricamente específicas, dependen de una genealogía de prácticas, saberes, discursos, regulaciones y representaciones articulados de forma compleja pero legible en el tiempo. Para inaugurar esta sección de historias urbanas hemos decidido dar un paso atrás, ampliar nuestro horizonte de reflexión e intentar aproximarnos a las lógicas y patrones por las que espacio y tiempo se entrelazan a través de un diálogo transdisciplinar. Para ello hemos invitado a dos autores de referencia en el campo de la geografía histórica y la historia espacial, Derek Gregory y Stuart Elden, miembros del Consejo Asesor Internacional de Urban, a entablar una conversación en torno a los espacios de la historia.Stuart Elden comenzó su carrera docente en la Universidad de Warwick y ha disfrutado de puestos como visitante en las universidades de Virginia, California, New York, Singapur, Washington o Londres, entre otras. En la actualidad es profesor en la Universidad de Durham. Fue uno de los editores fundadores de la revista Foucault Studies y en la actualidad es editor de Environment & Planning D: Society & Space. Ha publicado varios libros y numerosos artículos dedicados al análisis de la dimensión espacial en la obra de pensadores clave del siglo XX y a rastrear las intersecciones entre espacio y poder y la historia de nuestra concepción moderna del territorio. Su último libro como autor, Terror and Territory, ha ganado el Globe Book Award for Public Understanding of Geography y el Julian Minghi Outstanding Research Award del Political Geography Speciality Group, ambos de la Association of American Geographers.Derek Gregory desempeñó diversos puestos docentes en la Universidad de Camdridge, ha sido profesor visitante en numerosos centros y organismos de todo el mundo y editor en diversas revistas de reconocido prestigio. En la actualidad es profesor en la University of British Columbia, donde ha recibido varios premios y la condición de Distinguished University Scholar. Además ha sido premiado por la Alexander von Humboldt Stiftung, ha recibido la Founder's Medal de la Royal Geographical Society, es miembro de la British Academy y la Royal Society of Canada y doctor honoris causa por las universidades de Roskilde y Heidelberg. Ha dedicado buena parte de su amplia trayectoria a recorrer y estudiar diversas geografías históricas y a reflexionar sobre las intersecciones posibles entre la geografía y la teoría social contemporánea; obras como Geographical Imaginations o The Colonial Present —con nueve ediciones publicadas– son ampliamente reconocidas como textos clave en la teoría geográfica del siglo XX. Ha sido además Managing Editor de la última edición de The Dictionary of Human Geography.Con ellos hemos debatido sobre el lugar de la historia en la teoría socioespacial y en su propio trabajo, sobre los viejos y nuevos modos de pensar la intersección entre historia y territorio, espacio y tiempo, sobre las implicaciones de la geografía y la historia para pensar la política contemporánea y los retos al pensamiento crítico y la labor académica en la actual encrucijada de ataque neoliberal a la universidad pública y al Estado de Bienestar.Palabras clave: Teoría socio-espacial, historia espacial, geografía histórica, filosofía de la historia, Michel Foucault, compromiso social en la academia.AbstractThe ontologies of the city and territory, our experience of them and the techniques we use to govern them, the very concept of the socio-spatial formations that we inhabit, are all historically specific: they depend on a genealogy of practices, knowledges, discourses, regulations, performances and representations articulated in a way that is complex yet nevertheless legible over time. We have decided to open the Urban Histories section by stepping back, broadening the horizon of our analysis and looking at the logic and the patterns that intertwine space and time though cross-disciplinary dialogue. For this purpose, we have invited two key authors in the field of historical geography and spatial history, Derek Gregory and Stuart Elden, members of Urban's International Advisory Board, to join a conversation about the spaces of History.Stuart Elden started his career as a lecturer at the University of Warwick and has held visiting posts at the Universities of Virginia, California, New York, Singapore, Washington and London, amongst others. He is currently Professor at Durham University. He was a founding editor of Foucault Studies and is currently the editor of Environment & Planning D: Society & Space. He has published several books and numerous articles that analyse the spatial dimension in the work of key twentieth century thinkers and trace the intersections between space, power, and the history of our modern conception of territory. His last authored book, Terror and Territory, won the Globe Book Award for Public Understanding of Geography and the Political Geography Speciality Group Julian Minghi Outstanding Research Award, both from the Association of American Geographers.Derek Gregory began his career as a lecturer at the University of Cambridge, has been Visiting Professor at a string of universities around the world and editor in a number of internationally renowned journals. He is currently Professor at the University of British Columbia, where he has received several awards and Distinguished University Scholar status. His work has also been awarded by the Alexander von Humboldt Stiftung, he is a Fellow of the British Academy and the Royal Society of Canada, and has received the Founder's Medal of the Royal Geographical Society and honorary doctorates from the Universities of Roskilde and Heidelberg. A considerable part of his long career is devoted to the inspection and analysis of a wide range of historical geographies and reflection on possible interfaces between geography and contemporary social theory. Works such as Geographical Imaginations or The Colonial Present —now in its 9th printing— are widely acknowledged as key contributions to twentieth-century geographical theory. Gregory has also been Managing Editor of the 5th edition of The Dictionary of Human Geography.Our discussion with them covers the place of history in socio-spatial theory and in their own work, old and new ways of thinking about the intersection between history and territory, space and time, the implications of geography and history for thinking about contemporary politics, and the challenges now faced by critical thought and academic work in the current neo-liberal attack on public universities and the welfare state.Keywords: Socio-spatial Theory, Spatial History, Historical Geography, Philosophy of History, Michel Foucault, Social Commitment at the University.
I believe sometimes it is useful to begin by stating the obvious: Unlike in the case of the international financial system which has belatedly engaged in an exercise to develop a global architecture of rules, a structure of global governance already exists for international trade. The WTO is regarded as a fairly muscular repository of the rules and regulations governing international trade. While the WTO has played a useful and deterrent role through the TPR mechanism in tracking protectionist trends during the crisis, the more effective deterrence has been through the corpus of binding commitments that members have entered into in successive Rounds of negotiations.2. Any discussion regarding the further development of the WTO system has to begin with a shared understanding of the reasons for its present stasis. In my view. the underlying issue is the remarkable changes that have taken place in global competitiveness as a result of which a number of developing countries have begun to enjoy rapid growth while the traditional leaders in developed countries are experiencing sluggishness. The present crisis has only served to highlight this dichotomy. Major economies like the U.S. are going through a protectionist phase, with the latest manifestation being the Border Security Bill approved last month which strangely, seeks to transfer, at least partly, the cost of restricting illegal immigration from across the border to skilled professionals through imposition of higher visa charges. On the other hand, the emerging economies are preoccupied with restructuring their economies to maintain their high growth trajectories. As a result, in Asia at least, domestic consumption is emerging as a key driver of growth. Regional integration has received greater impetus and autonomous liberalization has become a prerequisite to linking with international supply chains. Intra-Asian trade for instance, has become the most dynamic factor in increasing global trade.3. The short point is that the traditional leaders of the multilateral process are preoccupied with economic recovery, while the emerging economies are preoccupied with adjusting to rapid growth. We are therefore witnessing a leadership vacuum in the MTS. I would not like to speculate on how and when this problem will be fixed. But it certainly will be fixed as all stakeholders in the MTS recognize the implications of a WTO weakened by failure of the Doha Round.4. Given this situation, one cannot expect easy consensus on initiatives for further development of the MTS. It also has to be recognized that the WTO of today is a significantly different entity than it was a decade ago and a top down work plan, which is perceived to have been drawn up in some backrooms, will not sell with the membership. Such a work plan can only emerge through an inclusive and consensual exercise over a period. In my view, such an exercise needs to be taken up in 2 phases:5. In the short term, concurrent with the Doha Round negotiations, it is possible to obtain consensus on a number of initiatives to strengthen the deliberative processes in the WTO and enhance the usefulness of the WTO for all stakeholders, public and private. These initiatives can be taken without a fresh Ministerial mandate. Such initiatives could include:Changes in Committee procedures to make the deliberations more effective and relevant to current market situations;A facilitative mechanism to resolve low threshold disputes.A bolder programme on RTA's with the ultimate objective of devising principles for best practices;An integrated data base for NTM's with access to all stakeholders; At the same time, an informal process needs to be launched to explore ideas for a post- Doha work programme.6. As far as the medium term is concerned, the launch of a new work programme has to be linked to the conclusion of the Doha Round. For the reasons I have mentioned, it is essential that such a work programme evolves in a fully transparent and inclusive manner and reflects a balance of interests of all members. It is too early in the day to discuss what such a balanced programme should look like, but nevertheless, some considerations would be valid in drawing up such a programme. Some issues like further liberalization in the market access areas of Agriculture, NAMA and Services would continue to be the major anchor of future negotiations, along with work on the unfinished business in agricultural subsidies. However, in order to reflect the significant changes that have taken place in the global economy as well as the global trading system, the work programme would need to focus on some key issues:Firstly, the major impediments to market access are no longer tariffs but non tariff barriers. The work programme would therefore need to focus on regulatory issues which impinge on market access as distinct from tariff liberalization. This would include a more intensive horizontal engagement on improving the TBT-SPS disciplines to address the issue of Standards in particular and NTB's in general. Similarly, a comprehensive work programme on RTA's with the objective of mainstreaming them into the WTO disciplines, is essential.Thirdly, the remarkable growth being witnessed in several parts of the developing world is being accompanied by a spurt in innovation in these countries. The $2,500 car, the $25 mobile phone, the $10 water purifier, the low cost mobile X-Ray machine are only some examples of this. Much more is to come. These innovations have the potential for revolutionizing global manufacturing. The global IPR disciplines must facilitate, not hinder the process. The new work programme should reflect this new reality.Fourthly, the issue of equity in the global trading system has to be addressed. This would involve dealing with asymmetries in value creation across the world. Trade can only contribute to poverty reduction if it helps in spreading value creation all along the value chain. Africa cannot indefinitely remain only the commodities supplier to the world. Value creation in poor countries has to be a central preoccupation of the new engagement. 7. There would be demands for inclusion of other issues which may not command multilateral consensus but are important for some members. These would include the remaining Singapore issues as well as other issues such as an expanded agreement on global electronic commerce. On these issues, the onus is on the proponents to build consensus by demonstrating that the outcomes will be beneficial for the global trading system.8. The experience with the UR plurilaterals provides a good basis for designing the format for negotiations on those issues which require the participation of a subset of members. In my view, variable geometry means both, variable in terms of participation and/ or variable in terms of the nature of commitments.9. As far as climate change issues are concerned, it is important not to allow the tail to wag the dog. If political differences impede an international agreement in the Climate Change negotiations, they will do the same if the WTO takes up work on the issue. Once there is multilateral consensus in the Climate Change negotiations, the modifications in the WTO rules should involve a fairly straightforward negotiation. My impression is that our experience with the MEAs in force today has been pretty good and there has been little, if any, dispute on their trade implications.
Desde la década de 1980, la migración laboral ha venido feminizándose cada vez en mayor medida en el este y sudeste asiáticos. Para principios del siglo XXI, se estimaba que había más de dos millones de mujeres trabajando en la región, lo que constituye un tercio de la población migrante. Casi todas las mujeres migrantes se desempeñan en labores reproductivas, como el trabajo doméstico y los servicios sexuales, en hogares de particulares y sectores comerciales informales. No obstante la gran necesidad de proteger su bienestar y sus derechos humanos, los gobiernos de los países de destino ven a los migrantes simplemente como una fuerza laboral que se requiere para cubrir la escasez de mano de obra local, e ignora las medidas de protección y las políticas en función del género. Por su parte, bajo la presión para incrementar los ingresos de divisas extranjeras, los países que constituyen la fuente de esta fuerza laboral alientan a sus mujeres a migrar y a remitir sus ganancias, pero ante la competencia mundial, los gobiernos de estos países han mostrado poco interés en el bienestar de las mujeres migrantes. En el contexto de los antecedentes poco alentadores en materia de derechos humanos de los países del este y sudeste asiáticos, los actores no estatales han adquirido una importancia creciente en la defensa de los derechos de los migrantes, lo que han logrado a través de redes locales y transnacionales. Las raíces de la migración–feminizada y que por lo tanto tiene en cuenta consideraciones de género–en el este y sudeste asiáticos se encuentran en el rápido pero desigual desarrollo económico de la región, caracterizado por la desigualdad y el conflicto que producen las diferencias de género, clase social y nacionalidad. La transferencia de mujeres extranjeras de la región desde economías de bajos ingresos (Filipinas, Tailandia, Indonesia y Viet Nam, entre otros) hacia países de altos ingresos (Singapur, Malasia, la Región Administrativa Especial de Hong Kong, Taiwán Provincia de China, la República de Corea y Japón) intensifica la actual desigualdad de género, injusticia económica y discriminación étnica. Sin embargo, la migración internacional es un proceso contradictorio que, si bien brinda a las mujeres migrantes oportunidades para la movilidad social, también las somete a abusos y explotación. La mayoría de las mujeres migrantes son trabajadoras independientes empleadas por contrato que buscan trabajo en el exterior a fin de aumentar los ingresos familiares y sus ahorros personales. El empoderamiento resulta de su resistencia diaria a las estructuras de poder existentes, así como de la oportunidad de acumular recursos personales y colectivos. El análisis de las políticas de inmigración de Asia y de los patrones de migración de las mujeres revela que existen seis categorías de mujeres migrantes con sus respectivas características: • trabajadoras domésticas • animadoras (trabajadoras sexuales) • trabajadoras no autorizadas • esposas inmigrantes • trabajadoras capacitadas • trabajadoras que comparten un patrimonio étnico con la población que las recibe (como los brasileños de origen japonés en el Japón y los chinos de ascendencia coreana en la República de Corea). Estas seis categorías de mujeres migrantes se diferencian entre sí en razón de las condiciones de traslado al otro país, de empleo y de protección legal, por lo que difieren en cuanto a las formas en que enfrentan las prácticas desiguales y discriminatorias que encuentran en sus lugares de destino. En consecuencia, los ciudadanos conscientes y las organizaciones no gubernamentales recurren a diferentes acciones civiles y contramedidas para mejorar los derechos de las mujeres migrantes. Los gobiernos de los estados importadores de mano de obra del este y sudeste asiáticos tienen niveles distintos de tolerancia política frente a las actividades de la sociedad civil, por lo que existen diferencias importantes en cuanto a las capacidades y los recursos con que cuentan sus sociedades civiles para la acción colectiva. La bibliografía sobre este tema identifica tres niveles de efectividad de las acciones civiles y de la resistencia de la mujer en Asia. El primer nivel agrupa a Singapur y Malasia, donde la aplicación de estrictas políticas de inmigración, rígidos sistemas de contratación laboral y bajos grados de tolerancia del activismo cívico por parte del Estado limitan seriamente las acciones a favor de las trabajadoras migrantes. El segundo nivel reúne al Japón y la República de Corea, donde los estrictos controles fronterizos y las grandes cantidades de trabajadores, combinados con un relativamente alto grado de tolerancia de la acción colectiva, permiten a muchos grupos y organizaciones desafiar la autoridad del Estado y brindar asistencia legal y cultural a los trabajadores migrantes. En el tercer nivel se encuentra la Región Administrativa Especial de Hong Kong, donde, a pesar de una estricta política de inmigración y un rígido sistema de contratación laboral, el legado colonial británico permite a los trabajadores migrantes defender abiertamente sus derechos económicos y emprender acciones colectivas. La frecuencia de las manifestaciones de trabajadoras migrantes, en particular de las trabajadoras domésticas filipinas en Hong Kong, destaca la importancia de establecer redes transnacionales que permitan estrechar los vínculos entre los trabajadores migrantes en los países fuentes de la mano de obra y las naciones receptoras. La creciente presencia de un movimiento transnacional de protección en toda la región de Asia facilita los esfuerzos de las organizaciones civiles por mejorar los derechos y el bienestar de las trabajadoras migrantes. En conclusión, la feminización de la migración ha incrementado la desigualdad y la injusticia basadas en el género, la clase social y la nacionalidad en Asia. Pero al mismo tiempo, ha abierto nuevas oportunidades para que las mujeres migrantes puedan aumentar los ingresos familiares y la creciente sociedad civil de Asia pueda desafiar las políticas y prácticas opresivas que afectan a las trabajadoras migrantes. A pesar de que persisten muchos obstáculos legales e institucionales a la justicia social en los países que importan mano de obra, las acciones civiles de ciudadanos y trabajadores migrantes constituyen un paso importante hacia el reconocimiento de los derechos de las trabajadoras migrantes. ; Since the 1980s, labour migration has been increasingly feminized in East and Southeast (hereafter E/SE) Asia. By the beginning of the twenty-first century, more than two million women were estimated to be working in the region, accounting for one third of its migrant population. Most female migrants are in reproductive occupations such as domestic work and sex services, in private households and informal commercial sectors. Despite the great need to protect their welfare and human rights, governments of their destination countries view migrants as merely a workforce to meet labour shortages, and ignore protective measures and gender-sensitive policies. Under pressure to increase foreign revenues, labour-source countries encourage their women to migrate and remit their earnings from abroad, but in the face of global competition, governments of source countries have shown little interest in their migrant women's welfare. In the context of the E/SE Asian countries' bleak records of human rights practices, non-state actors have assumed increasing importance in advocating migrants' rights, which they have done through local and transnational networks. Feminized, and therefore gendered, migration in E/SE Asia has its roots in the region's rapid but uneven economic development, which is characterized by the inequality and conflict that differences of gender, class and nationality produce. The transfer of foreign women within the region from the low-income economies (the Philippines, Indonesia, Viet Nam, Pakistan, Bangladesh among others) to the high-income ones (Singapore, Malaysia, Hong Kong Special Administrative Region (SAR), Taiwan Province of China, the Republic of Korea and Japan) intensifies existing gender inequality, economic injustice and ethnic discrimination. International migration is, however, a contradictory process that, while providing migrant women with opportunities for social mobility, also subjects them to abuses and exploitation. The majority of Asia's migrant women are independent contract workers seeking employment abroad in order to augment family incomes and personal savings. Empowerment results from their everyday resistance to existing power structures, and from the opportunity to accumulate individual and collective resources. An analysis of Asia's immigration policies and women's migration patterns reveals six widely recognized and designated categories and characteristics of the women involved: • domestic workers • entertainers (sex workers)• unauthorized workers • immigrant wives • skilled workers • workers who share an ethnic heritage with that of the host population (such as Japanese-Brazilians in Japan and Korean-Chinese in the Republic of Korea). These six categories of migrant women differ from one another in the conditions of their border crossing, employment and legal protection, and they therefore differ in the ways in which they resist the unequal and discriminatory practices they encounter at their destinations. Consequently, concerned citizens and non-governmental organizations choose different civil actions and counteractive measures to enhance migrant women's rights. The governments of labour-importing states in E/SE Asia vary in their political tolerance of civil-society activities. There are thus significant differences in the capacities and resources that their civil societies have for collective action. The existing literature indicates three levels of effectiveness of civil actions and women's resistance in Asia. The first is found in Singapore and Malaysia, where strict immigration policies, rigid labour contract systems and low degrees of state tolerance for civil activism severely curtail pro-migrant actions. The second level characterizes Japan and the Republic of Korea, where tight border controls and large numbers of undocumented workers, combined with relatively high degrees of tolerance for collective action, allow many groups and organizations to challenge state authority and provide legal and cultural assistance to migrants. The third level is manifest in Hong Kong SAR, where despite a strict immigration policy and rigid labour contract system, the British colonial legacy permits migrants to openly pursue economic rights and collective action. The frequency of demonstrations by migrants, especially Filipino domestic workers in Hong Kong SAR, highlights the importance of transnational networking that links migrants in sending and receiving countries. The growing presence of a transnational advocacy movement throughout Asia facilitates the efforts of civil organizations to enhance migrants' rights and welfare. In conclusion, feminized migration has increased inequality and injustice based on gender, class and nationality in Asia. It has also, however, opened up opportunities for migrant women to increase family incomes and for Asia's growing civil society to challenge oppressive policies and practices affecting migrants. Although many legal and institutional barriers to social justice remain in labour-importing countries, civil actions by citizens and migrants comprise significant steps toward the realization of migrant workers' rights. ; Depuis les années 80, les travailleurs migrants en Asie de l'est et du sud-est sont de plus en plus des femmes. Au début du XXIème siècle, on estimait que plus de deux millions de femmes, soit un tiers de la population migrante, travaillaient dans la région. La plupart des immigrées ont des emplois liés à l'économie de reproduction: elles sont employées de maison ou engagées dans l'industrie du sexe, travaillent dans des ménages privés ou le secteur commercial informel. Bien que leur bien-être et leurs droits aient un grand besoin d'être protégés, les gouvernements des pays d'accueil ne voient dans les immigrées qu'une force de travail capable de remédier à la pénurie de main-d'oeuvre et ne se soucient guère de prendre des mesures de protection ou d'appliquer des politiques nuancées selon le sexe. Pressés d'accroître leurs recettes en devises, les pays d'émigration encouragent leurs ressortissantes à émigrer et à rapatrier leurs gains de l'étranger et, face à la concurrence mondiale, leurs gouvernements s'intéressent peu au bien-être de celles qui ont émigré. Vu les pratiques des pays de l'Asie de l'est et du sud-est en matière de droits de l'homme et leur triste bilan dans ce domaine, des acteurs non étatiques ont pris de plus en plus de place dans la défense des droits des migrants, qu'ils assument par le biais de réseaux locaux et transnationaux. La féminisation des migrations en Asie de l'est et du sud-est, avec toutes les spécificités que cela suppose, vient du développement économique rapide mais inégal de la région, qui se caractérise par des disparités et des différences entre sexes, entre classes et entre nationalités qui engendrent des conflits. Les femmes se déplacent à l'intérieur de la région, quittant les pays à faible revenu (Philippines, Thaïlande, Indonésie et Viet Nam notamment) pour les pays à revenu élevé (Singapour, Malaisie, Région administrative spéciale (RAS) de Hong Kong, Province chinoise de Taiwan, République de Corée et Japon) et ce déplacement accentue les inégalités entre les sexes, l'injustice économique et la discrimination ethnique déjà existantes. Les migrations internationales sont cependant des phénomènes contradictoires qui, tout en offrant aux migrantes des chances de mobilité sociale, les exposent en même temps à des abus et à l'exploitation. La majorité des migrantes d'Asie sont des travailleuses contractuelles indépendantes qui cherchent un emploi à l'étranger pour grossir les revenus de leur famille et leur épargne personnelle. Elles acquièrent leur autonomie en résistant jour après jour aux structures de pouvoir en place, et en accumulant tout ce qu'elles peuvent gagner à titre individuel et collectif. Une analyse des politiques migratoires d'Asie et des caractéristiques des migrations féminines fait apparaître six catégories largement reconnues, qui définissent les femmes par des caractéristiques données: • employées de maison • entraîneuses (travailleuses du sexe) • travailleuses clandestines • épouses d'immigrés • travailleuses qualifiées • travailleuses qui ont un patrimoine ethnique commun avec la population du pays d'accueil (tels que les Nippo-Brésiliennes au Japon et les Sino-Coréennes en République de Corée). Ces six catégories de femmes immigrées se distinguent les unes des autres par les conditions dans lesquelles elles ont franchi la frontière, leur emploi et la protection que leur offre la loi et donc aussi par leur mode de résistance aux pratiques inégalitaires et discriminatoires auxquelles elles sont confrontées dans le pays d'accueil. Les modes d'action et de lutte que choisissent les citoyens concernés et les organisations non gouvernementales pour faire valoir les droits des migrantes varient en conséquence. Les gouvernements des Etats de l'Asie de l'est et du sudest qui importent de la main-d'oeuvre tolèrent à des degrés divers les activités de la société civile, de sorte que les capacités et moyens d'action collective dont celle-ci dispose varient sensiblement selon les pays. Il ressort de la littérature existante que l'on peut distinguer trois niveaux d'efficacité parmi les actions tentées par la société civile et la résistance des femmes en Asie. C'est à Singapour et en Malaisie qu'elles sont les moins efficaces: de strictes politiques d'immigration, des systèmes rigides d'attribution de contrats de travail et un Etat peu tolérant envers le militantisme civil réduisent sévèrement les actions de défense des droits des migrantes. Le second niveau correspond au Japon et à la République de Corée, où de sévères contrôles aux frontières et une multitude de travailleuses sans papiers, mais aussi une tolérance assez grande à l'égard de l'action collective, permettent à de nombreux groupes et organisations de contester l'autorité de l'Etat et d'apporter une assistance juridique et culturelle aux migrantes. Le troisième niveau est atteint dans la RAS de Hong Kong où, malgré une politique d'immigration stricte et un système rigide d'attribution des contrats de travail, l'héritage colonial britannique permet aux migrantes de faire valoir ouvertement leurs droits économiques et de mener une action collective. La fréquence des manifestations d'immigrées, en particulier d'employées de maison philippines dans la RAS de Hong Kong, montre l'importance des réseaux transnationaux qui relient les migrantes des pays d'origine et des pays d'accueil. La présence de plus en plus forte d'un mouvement de défense transnational dans toute l'Asie rend plus facile la tâche des organisations civiles qui s'emploient à défendre les droits et le bien-être des migrantes. En conclusion, la féminisation des migrations a aggravé les inégalités et l'injustice fondées sur le sexe, la clase et la nationalité en Asie. Elle a cependant donné aux femmes migrantes la possibilité de grossir les revenus familiaux et a permis à une société civile en expansion en Asie de contester les politiques et pratiques qui ont pour effet d'opprimer les migrants. Bien qu'il reste de nombreux obstacles juridiques et institutionnels à la justice sociale dans les pays importateurs de main-d'oeuvre, certaines des actions menées par les nationaux et les migrants marquent un progrès sensible vers la réalisation des droits des travailleurs migrants.
