Coordination and regulation in crisis management. Response of the health sector to disasters. The case of the 2017 earthquake in Mexico City

Abstract

The present article analyzes actions carried out by different organizations of the Mexican public health sector to manage the crisis caused by an earthquake in Mexico City. The investigation is focused on the way in which coordination and regulation instruments were used by the health care system in the city affected the legitimacy and ability of the government to cope with the crisis. Our approach assumes that the political and administrative infrastructure has affected decision-making processes in public health care organizations, as well as the types and characteristics of organizations in charge of managing crises. The article uses a case study narrative, and the analysis was mainly based on semi-structured interviews with health sector officials from all organizational levels and in the review of public documents, regulatory instruments such as local and federal laws and internal regulations on the functioning of Mexican health care sector organizations. Different types of coordination and regulation associated with different epistemic communities were observed, as well as the existence of formal protocols and instruments for crises management, which nevertheless operate in fragmented and complex systems.