Doctors have played an important role in the development of health institutions in Latin America. However, they are not the only profession that has had a voice in these matters. There are also other factors influencing the development of ministries of health. This issue has gone unnoticed in the literature. This article suggests that it is possible to identify two distinct trends in the creation of health ministries in Latin America. The first, of an early nature, was seen principally in Central America and the Caribbean in countries dependent on or under the influence of the United States which, from the 1880s, promoted health Pan-Americanism. The second trend, which became apparent from 1924, was characterised by the emergence of ministries in a context of institutional breakdown and the appearance of new actors (military or populist leaders). This second trend was first seen in Chile in 1924. This article analyses the creation of the Ministerio de Higiene, Asistencia y Previsión Social (Ministry of Hygiene, Assistance and Social Security) in Chile in 1924 and its subsequent development through to 1931. The analysis looks at the health measures adopted, the context in which this occurred and the debates triggered by the ministry’s process of institutional development, based on parliamentary discussions, presidential speeches, official statistics, legislation, documents prepared by key actors and the press of the time.

中文翻译：

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崩溃与改革：1892-1931 年智利创建卫生和社会福利部之路

医生在拉丁美洲卫生机构的发展中发挥了重要作用。然而，他们并不是唯一在这些问题上有发言权的职业。还有其他因素影响卫生部的发展。这个问题在文献中没有被注意到。本文表明，可以确定拉丁美洲设立卫生部的两种截然不同的趋势。第一种是早期的，主要发生在中美洲和加勒比地区依赖美国或受美国影响的国家，从 1880 年代开始，美国提倡健康泛美主义。第二种趋势从 1924 年开始变得明显，其特点是在机构崩溃的背景下出现了各部委以及新的行动者（军事或民粹主义领导人）的出现。第二种趋势于 1924 年在智利首次出现。本文分析了 1924 年智利卫生、援助和社会保障部 (Ministryio de Higiene, Asistencia y Previsión Social) 的创建及其随后到 1931 年的发展。根据议会讨论、总统讲话、官方统计数据、立法、关键行为者准备的文件和当时的新闻，审视所采取的卫生措施、发生这种情况的背景以及该部的机构发展进程引发的辩论。