Plan técnico para la ejecución de la "Jornada a nivel nacional de acciones integrales e intersectoriales para lucha contra las Arbovirosis en Centros Escolares y Centros de Votación 2024" / Technical plan for the implementation of the "National day of comprehensive and intersectoral actions to combat Arbovirosis in Schools and Voting Centers 2024

En la situación del dengue en El Salvador, inciden determinantes (ambientales, económicos, políticos y sociales), la constante migración del campo a la ciudad, una creciente urbanización sin planificación ni regulación alguna, pobreza, inequidad en el ingreso y condiciones de exclusión que relegan a la población en esta situación a exponerse permanentemente a condiciones de alto riesgo y vulnerabilidad que favorecen la persistencia de la transmisión de arbovirosis, entre ellos se pueden señalar crecimiento poblacional, construcción de viviendas inadecuadas que generan condiciones críticas de hacinamiento, deficiente abastecimiento de agua que obliga a las personas a almacenarla inadecuadamente, una deficiente recolección de desechos sólidos, todo lo cual genera condiciones adecuadas para la multiplicación del Aedes aegypti y la transmisión de la enfermedad. El Ministerio de Salud, anticipándose al retorno de alumnos a un aproximado de 5,000 centros escolares públicos y privados, además de la prevención en 1,600 centros de votación, se ha programado la ejecución de una jornada a nivel nacional de acciones, la cual tiene por objetivo el control del vector en su fase larvaria y adulta; así como, la realización de acciones gubernamentales de carácter preventivas, en el que se realizarán actividades de promoción de la salud encaminadas a la eliminación de criaderos y otras actividades que sean factibles de desarrollar por la comunidad.

In the situation of dengue in El Salvador, determinants (environmental, economic, political and social), the constant migration from the countryside to the city, a growing urbanization without any planning or regulation, affect poverty, inequity in income and conditions of exclusion that relegate the population in this situation to be permanently exposed to conditions of high risk and vulnerability that favor the persistence of transmission of arbovirosis, These include population growth, construction of inadequate housing that generates critical conditions of overcrowding, poor water supply that forces people to store it improperly, poor solid waste collection, all of which generates adequate conditions for the multiplication of Aedes aegypti and the transmission of the disease. The Ministry of Health, anticipating the return of students to approximately 5,000 public and private schools, in addition to prevention in 1,600 voting centers, has scheduled the execution of a day at the national level of actions, which has as its objective the control of the vector in its larval and adult phase; as well as the carrying out of preventive governmental actions, which will include health promotion activities aimed at the elimination of hatcheries and other activities that are feasible to develop by the community

Multisectoral collaboration at the human-animal-environmental interface

The pathway to strengthen multisectoral collaboration at the human-animal-environmental interface (HAI) aims to improve health security through One Health implementation. It outlines strategic guides and tools developed to support Member States through different steps of the HAI pathway.

Отчет о результатах консультаций с государствами-членами, организациями-партнерами и негосударственными структурами по созданию Платформы обеспечения доступа к новым лекарственным средствам: январь – февраль 2023 г.: резюме

Европейская программа работы ВОЗ на 2020–2025 гг. «Совместные действия для улучшения здоровья жителей Европы» (ЕПР) выдвигает на передний план важность обеспечения социально справедливого и устойчивого доступа к качественным лекарственным средствам для достижения всеобщего охвата услугами здравоохранения и Целей в области устойчивого развития (ЦУР). Вопросы доступа к лекарственным средствам и изделиям медицинского назначения неизбежно возникают на стыке постановки трех задач ЦУР, а именно: ЦУР 3 – содействовать повышению уровня здоровья и благополучия; ЦУР 9 – развивать промышленность и инфраструктуру и поощрять инновации; и ЦУР 17 – активизировать партнерства ради достижения поставленных Целей.

Barreiras e facilitadores da implementação do Programa Saúde na Escola (PSE) no município de Francisco Morato / Barriers and facilitators of the implementation of the School Health Program (PSE) in the municipality of Francisco Morato

Introdução: O Programa de Saúde na Escola (PSE), é uma política interministerial da Saúde e da Educação, instituída pelo Decreto Presidencial nº 6.286, do ano de 2007, com o objetivo de promoção de saúde e cultura da paz e prevenção de doenças de crianças, adolescentes e jovens em idade escolar. O programa passou por várias modificações incrementais ao longo dos anos. O município de Francisco Morato aderiu ao programa no ano de 2018. A literatura de políticas públicas evidencia a existência de variáveis que interferem na implementação de políticas, promovendo "gaps" entre a sua formulação e a sua real execução. No caso brasileiro, políticas formuladas no âmbito federal e implementadas no nível municipal, como é o caso do PSE, podem gerar desafios adicionais em decorrência de seu arranjo federativo. Objetivo: Investigar e elucidar as principais barreiras e os facilitadores da implementação do PSE no município de Francisco Morato, compreender como o programa é implementado no município e identificar como é realizada a articulação intersetorial entre as áreas da saúde e a educação para a implementação do programa. Metodologia: Trata-se de uma pesquisa exploratória de natureza qualitativa, com referencial teórico pautado em análise de conteúdo delineado (Bardin, 1977), revisão bibliográfica (Salvador, 1971) e posteriores entrevistas semiestruturadas com gestores e trabalhadores da linha de frente no PSE de Francisco Morato. Resultados: As entrevistas evidenciaram seis barreiras: comunicação; autonomia; planejamento do PSE e suas ações; disparidades entre os profissionais da saúde e da educação; disparidades entre as escolas estaduais e municipais e infraestrutura. Três foram os facilitadores encontrados: comunicação intersetorial municipal; autonomia; e território. Conclusão: Após análise dos resultados foi possível concluir que a articulação intersetorial entre o setor saúde e a educação, bem como a comunicação entre o nível municipal e estadual constituem desafios importantes na implementação do programa. A forma com que o programa é implementado gera desigualdade na atuação entre escolas municipais e estaduais, bem como enfraquece a sua potencialidade de ação no território onde é desenvolvida.

Práticas adotadas pelas equipes de saúde bucal na estratégia saúde da família: uma revisão da literatura / Practices adopted by oral health teams in the family health strategy: a literature review / Prácticas adoptadas por los equipos de salud bucal en la estrategia de salud de la familia: una revisión de la literatura

A inserção da Odontologia no Sistema Único de Saúde, como estratégia de transformação da prática, introduziu novas formas de organização na busca pela melhoria das condições de saúde bucal da população. O objetivo do trabalho foi identificar práticas adotadas pela Equipe de Saúde Bucal na prevenção e promoção da saúde bucal das co- munidades assistidas pela Estratégia Saúde da Família. Trata-se de uma revisão de litera- tura, com uma busca sistematizada nas bases de dados Biblioteca Virtual em Saúde e Scielo, utilizando os descritores: programa saúde da família, estratégia saúde da família, saúde bucal e odontologia. Os critérios de inclusão foram: estudos qualitativos, surveys e mistos, que abordem práticas adotadas pela Equipe de Saúde Bucal da Estratégia Saúde da Família, na prevenção e promoção da saúde bucal. A busca resultou em 435 estudos, após remoção das duplicatas, leitura de títulos, resumos e verificação dos critérios de inclusão foram incluídos 18 artigos. As práticas identificadas foram: educação em saúde, visita domiciliar, humanização do cuidado, educação permanente em saúde e intersetori- alidade. Os resultados mostraram que as práticas de prevenção e promoção de saúde ado- tadas pela Equipe de Saúde Bucal da Estratégia Saúde da Família foram viáveis, uma vez que emergiram de estratégias difundidas pelas políticas públicas, evidenciando a indisso- ciabilidade entre saúde bucal e saúde geral dos usuários e comunidades, contribuindo no processo de consolidação do Sistema Único de Saúde.

The inclusion of Dentistry in the Unified Health System, as a practice transformation strategy, introduced new forms of organization in the quest to improve the oral health conditions of the population. The objective of this work was to identify prac- tices adopted by the Oral Health Team in the prevention and promotion of oral health in communities assisted by the Family Health Strategy. This is a literature review, with a systematic search, in the Virtual Health Library and Scielo databases, using the descrip- tors: family health program, family health strategy, oral health and dentistry. The inclu- sion criteria were: qualitative studies, surveys and mixed, which address practices adop- ted by the Oral Health Team of the Family Health Strategy, in the prevention and promo- tion of oral health. The search resulted in 435 studies, after removing duplicates, reading titles, abstracts and checking the inclusion criteria, 18 articles were included. The identi- fied practices were: health education, home visits, humanization of care, permanent health education and intersectoriality. The results showed that the prevention and health promo- tion practices adopted by the Oral Health Team of the Family Health Strategy were viable, since they emerged from strategies disseminated by public policies, evidencing the inse- parability between oral health and the general health of users and communities , contri- buting to the consolidation process of the Unified Health System.

La inclusión de la Odontología en el Sistema Único de Salud, como estra- tegia de transformación de la práctica, introdujo nuevas formas de organización en la búsqueda de mejorar las condiciones de salud bucal de la población. El objetivo de este trabajo fue identificar las prácticas adoptadas por el Equipo de Salud Bucal en la preven- ción y promoción de la salud bucal en las comunidades asistidas por la Estrategia Salud de la Familia. Se trata de una revisión bibliográfica, con búsqueda sistemática, en la Bi- blioteca Virtual en Salud y en las bases de datos Scielo, utilizando los descriptores: pro- grama de salud familiar, estrategia de salud familiar, salud bucal y odontología. Los cri- terios de inclusión fueron: estudios cualitativos, encuestas y mixtos, que aborden las prác- ticas adoptadas por el Equipo de Salud Bucal de la Estrategia Salud de la Familia, en la prevención y promoción de la salud bucal. La búsqueda resultó en 435 estudios, luego de eliminar duplicados, leer títulos, resúmenes y verificar los criterios de inclusión, se inclu- yeron 18 artículos. Las prácticas identificadas fueron: educación en salud, visitas domi- ciliarias, humanización del cuidado, educación permanente en salud e intersectorialidad. Los resultados mostraron que las prácticas de prevención y promoción de la salud adop- tadas por el Equipo de Salud Bucal de la Estrategia Salud de la Familia fueron viables, ya que surgieron de estrategias difundidas por las políticas públicas, evidenciando la in- separabilidad entre la salud bucal y la salud general de los usuarios y comunidades, con- tribuyendo al proceso de consolidación del Sistema Único de Salud.

Collectively achieving primary health care and educational goals through school-based platforms: financing solutions for intersectoral collaboration.

Despite abundant evidence demonstrating that improvements to health and education are positively correlated, and the importance of school-based platforms to achieve shared impacts, collaboration between ministries of health and education remains limited across low- and middle-income countries. Enhancing this collaboration is essential to realize mutually beneficial results, especially following the COVID-19 pandemic, which severely impacted health and education outcomes globally and highlighted the importance of resilient, domestically funded systems for delivering key social services including primary health care and education. We argue that the lack of an effective joint financing mechanism has hindered adoption of collaborative multisectoral approaches such as the WHO/UNESCO's Health Promoting Schools (HPS) model. HPS is well-positioned to organize, finance, and deliver primary health care and education services through a school-based platform and strategy. Case studies from several low- and middle-income countries highlight the need to expand limited inter-ministerial collaborations to achieve cross-sectoral benefits and ensure sustainability of HPS beyond the lifecycle of external partners' support. It is important to identify ways to widen the resource envelope for sector-specific activities and create efficiencies through mutually beneficial outcomes. This paper offers two pragmatic solutions: an inter-ministerial joint financing mechanism that starts with alignment of budgets but matures into a formal system for pooling funds, or a fixed-term co-financing mechanism that uses donor contributions to catalyze inter-ministerial collaborations. Achieving sustainability in these initiatives would require engaging the ministries of health, education, and finance; developing a common administrative, financial, and monitoring mechanism; and securing long-term commitment from all concerned stakeholders.

[Readiness for intersectoral cooperation to preserve health of megalopolis population].

INTRODUCTION: For a better understanding of issues related to health-preserving activities for the benefit of city population, theoretical knowledge about the attitude and readiness of all interested parties for intersectoral cooperation is needed. The purpose of the study is to analyze readiness of the participants of health-preserving activities for intersectoral cooperation in Moscow. MATERIAL AND METHODS: In 2023, a one-time, one-time study of intersectoral responsibility, commitment and awareness, as well as satisfaction with individual health care (original test cards) was conducted among different participants in the health care of the population of the city of Moscow (n = 1007). From among them, participants were identified -workers of «medical¼ infrastructure facilities of urban space, participants-workers of other facilities (sports, culture, industry, waste disposal, transport, food, trade, education and others) and the population as a participant in intersectoral health saving. RESULTS: The research based on the original integrated assessment methodology shows insufficient readiness for intersectoral cooperation to implement health-saving activities for the benefit of Moscow population. Immature intersectoral responsibility, literacy, motivation for teamwork noted among the participants of the unified health-preserving city space determines the lack of internal conviction that it is necessary to deal with both own health, and health of other members of the urban community. CONCLUSION: The data obtained can form basis for new methodological approaches to prioritize control measures to improve intersectoral cooperation between the participants of health-preserving activities in the metropolis.

Prefeitura de São Paulo promove Avança Saúde - Homem | Minuto Saúde

O Minuto Saúde chegou com os principais acontecimentos desta semana na Secretaria Municipal da Saúde (SMS). ✔ Prefeitura de São Paulo promove Avança Saúde - Homem. ✔ Saúde da capital realiza dia D de combate à dengue. ✔ Ações de PrEP na Rua em vários pontos da capital. ✔ Vacinação do fim de semana.

O Minuto Saúde chegou com os principais acontecimentos desta semana na Secretaria Municipal da Saúde (SMS). ✔ Rede municipal promove ações no Dia Mundial da Gentileza. ✔ Saúde da capital realiza live no Dia Mundial do Diabetes. ✔ Agenda do projeto PrEP na Rua. ✔ Zona norte recebe o Centro de Testagem e Aconselhamento, o CTA da Cidade.

O Minuto Saúde chegou com os principais acontecimentos desta semana na Secretaria Municipal da Saúde (SMS). ✔ Rede municipal promove ações no Dia Mundial da Gentileza. ✔ Saúde da capital realiza live no Dia Mundial do Diabetes. ✔ Agenda do projeto PrEP na Rua. ✔ Zona norte recebe o Centro de Testagem e Aconselhamento, o CTA da Cidade.

Jogos abertos dos idosos e mais | Minuto Saúde

O Minuto Saúde chegou com os principais acontecimentos desta semana na rede municipal! ✅ Capital registra 1 mil novas pessoas cadastradas para uso de profilaxia pré-exposição (PrEPs) nas ações extramuros neste ano. ✅ Centro de Testagem e Aconselhamento, o CTA da Cidade, estará no Jardim Helena na zona leste até sábado (11). ✅ Jogos Abertos dos Idosos realizados pelos equipamentos de saúde da região de São Mateus contam com cerca de 600 participantes.

Segunda edição da Virada Odontológica e mais | Minuto Saúde

O Minuto Saúde chegou com os principais acontecimentos desta semana na rede municipal! ✅ Saúde realiza busca ativa de crianças para vacinação contra poliomielite. ✅Prefeitura promove ações de saúde bucal com Virada Odontológica. ✅ Capacitação de médicos e enfermeiros para identificar a doença falciforme. ✅Rede municipal tem aumento de 85% em atendimentos de Práticas Integrativas e Complementares em Saúde (Pics).

Confira as principais notícias desta semana na rede municipal | Minuto Saúde

O Minuto Saúde chegou com os principais acontecimentos desta semana na rede municipal! ✅ Dia Nacional da Vacinação. ✅ Live sobre a campanha Outubro Rosa. ✅ Capital promove ações de vacinação contra raiva em cães e gatos, na segunda quinzena de outubro. ✅ Agenda do Centro de Testagem e Aconselhamento, o CTA da Cidade.

The development of an integrated neighborhood approach for health promotion and prevention: a qualitative exploration of stakeholders' views.

BACKGROUND: Although the promise of integrated neighborhood approaches, including the essential roles of communities and collaboration between the medical and social domains, has been widely acknowledged, the realization of such approaches in practice often remains difficult. To gain insight into the development of integrated neighborhood approaches, this case study describes the experiences of stakeholders involved in such an approach for health promotion and prevention in Rotterdam. METHODS: Interviews with 18 stakeholders (including health and social care professionals, health insurance employees, and policymakers) were conducted, and stakeholders' statements were analyzed thematically. RESULTS: The results reveal a lack of alignment among the professional, organizational, and system levels. Elements needed for collaboration between health and social care professionals are not supported at the organizational and system levels. The lack of integration at the policy and organizational levels encourages competition and self-interest instead of stimulating collaboration. CONCLUSIONS: Intersectoral collaboration and coordination must take place not only between professionals, but also at the organizational and policy levels. As long as integration at the organizational and system levels is lacking, professionals' ability to collaborate and provide coordinated support to neighborhood residents will be compromised.

Lineamientos técnicos para la supervisión de enfermería / Technical guidelines for nursing supervision

La supervisión de los servicios de enfermería es fundamental para constatar que se proporcione el cuidado con eficiencia, eficacia, calidad, calidez y equidad a la persona familia y comunidad, con conocimientos técnico científicos y tecnológicos, en las Redes Integrales e Integradas de Salud (RIIS) del Ministerio de Salud. En ese sentido los(as) profesionales de enfermería, aportan decididamente a la organización de la prestación de servicios de salud, ajustando su accionar al enfoque integral; por ello es importante fortalecer la función de supervisión en los diferentes niveles de atención para incidir positivamente, con procesos y procedimientos técnico-administrativos que faciliten la mejora continua de la calidad del cuidado de enfermería, que forma parte de un equipo multidisciplinario dentro de la organización

Supervision of nursing services is essential to ensure that care is provided efficiently, effectively, quality, warmth and equity to the family and community, with scientific and technological know-how, Integrated Health Networks (RIIS) of the Ministry of Health. In this sense, the nursing professionals(s) contribute decisively to the organization of the provision of health services, adjusting their actions to the comprehensive approach; therefore it is important to strengthen the supervisory function at the different levels of care in order to have a positive impact, with processes and administrative procedures that facilitate the continuous improvement of the quality of nursing care, part of a multidisciplinary team within the organization

Collaboration for success: the Global Initiative for Childhood Cancer in Latin America / Colaborar para tener éxito: la Iniciativa Mundial contra el Cáncer Infantil en América Latina / Colaboração para o sucesso: a Iniciativa Global para o Câncer Infantil na América Latina

[ABSTRACT]. The Global Initiative for Childhood Cancer (GICC) aims to increase the cure rate for children with cancer globally by improving healthcare access and quality. The Pan American Health Organization (PAHO), St. Jude Children’s Research Hospital (St. Jude), and collaborators have joined efforts to improve outcomes of children with cancer in Latin America and the Caribbean (LAC) using the CureAll framework. In this article, we describe the process of developing regional resources aimed at accelerating the GICC implementation in LAC. In March 2021, PAHO formed regional working groups to develop core projects aligned with CureAll pillars and enablers. Seven working groups emerged from regional dialogues: early detection, nursing, psychosocial, nutrition, supportive care, treatment abandonment, and palliative care. PAHO arranged regular online meetings under the mentorship and support of St. Jude regional/transversal programs and international mentors. Between April and December 2021, 202 multidisciplinary experts attended 43 online meetings to promote the dialogue between stakeholders to improve childhood cancer outcomes. Fourteen technical outputs were produced: four regional snapshots, four technical documents, two virtual courses, one set of epidemiological country profiles, one educational content series for parents/caregivers, and two communication campaigns. The ongoing dialogue and commitment of PAHO, St. Jude, LAC working committees, and international collaborators are essential foundations to successfully accelerate GICC implementation. This is achievable through the development of materials of regional and global relevance. Further research and evaluation are needed to deter- mine the impact of these strategies and resources on childhood cancer outcomes in LAC and other regions.

[RESUMEN]. La Iniciativa Mundial contra el Cáncer Infantil tiene como objetivo aumentar a nivel mundial la tasa de curación del cáncer infantil mediante la mejora del acceso a la atención de salud y de su calidad. La Organización Panamericana de la Salud (OPS), el St. Jude Children’s Research Hospital y los colaboradores han aunado esfuerzos para mejorar los resultados en la población infantil con cáncer en América Latina y el Caribe valiéndose del marco CureAll. En este artículo describimos el proceso de elaboración de recursos regionales destinados a acelerar la aplicación de la Iniciativa Mundial en América Latina y el Caribe. En marzo del 2021, la OPS formó grupos de trabajo regionales para elaborar proyectos básicos que estuvieran en consonancia con los pilares y los elementos facilitadores del CureAll. De los diálogos regionales surgieron siete grupos de trabajo: detección temprana, enfermería, aspectos psicosociales, nutrición, tratamientos de apoyo, abandono del tratamiento y cuidados paliativos. La OPS organizó con regularidad reuniones virtuales en las que se contó con la tutoría y el apoyo de programas regionales o transversales del St. Jude Children’s Research Hospital y de mentores internacionales. Entre abril y diciembre del 2021 hubo 43 reuniones virtuales a las que asistieron 202 expertos multidisciplinarios, con el objetivo de promover el diálogo entre las partes interesadas para mejorar los resultados en materia de cáncer infantil. Se elaboraron catorce productos técnicos: cuatro panoramas regionales, cuatro documentos técnicos, dos cursos virtuales, un conjunto de perfiles epidemiológicos de países, una serie con contenidos educativos para padres y cuidadores y dos campañas de comunicación. El diálogo y el compromiso constantes de la OPS, el St. Jude Children’s Research Hospital, los comités de trabajo de América Latina y el Caribe y los colaboradores internacionales son las bases fundamentales para conseguir que se acelere la aplicación de la Iniciativa Mundial. Esto se puede lograr mediante la elaboración de materiales que resulten pertinentes a nivel regional y mundial. Son necesarias más investigaciones y evaluaciones para determinar el impacto que tienen estas estrategias y recursos en los resultados que se obtienen en el cáncer infantil en América Latina y el Caribe y en otras subregiones.

[RESUMO]. A Iniciativa Global para o Câncer Infantil tem como objetivo aumentar a taxa de cura de crianças com câncer no mundo todo, melhorando o acesso a cuidados e a qualidade da assistência médica. A Organização Pan-Americana da Saúde (OPAS), o St. Jude Children's Research Hospital (St. Jude) e colaboradores uniram esforços para melhorar o desfecho de crianças com câncer na América Latina e no Caribe (ALC) no âmbito do marco CureAll. Neste artigo, descrevemos o processo de desenvolvimento de recursos regionais com o objetivo de acelerar a implementação da Iniciativa na ALC. Em março de 2021, a OPAS formou grupos de trabalho regionais para desenvolver projetos centrais alinha- dos com os pilares e facilitadores do CureAll. A partir das reuniões de diálogo regionais, foram criados sete grupos de trabalho: detecção precoce, enfermagem, atenção psicossocial, nutrição, cuidados de suporte, abandono do tratamento e cuidados paliativos. A OPAS organizou reuniões virtuais regulares sob a orientação e o apoio dos programas regionais e transversais do St. Jude e de mentores internacionais. Entre abril e dezembro de 2021, 202 especialistas multidisciplinares participaram de 43 reuniões virtuais para promover o diálogo entre as partes interessadas a fim de melhorar os desfechos do câncer infantil. Foram produzidos 14 materiais técnicos: quatro panoramas regionais, quatro documentos técnicos, dois cursos virtuais, um conjunto de perfis epidemiológicos nacionais, uma série de conteúdo educacional para pais e cuidadores e duas campanhas de comunicação. O diálogo e o compromisso contínuos da OPAS, do St. Jude, dos comitês de trabalho da ALC e dos colabora- dores internacionais são bases essenciais para acelerar com sucesso a implementação da Iniciativa Global para o Câncer Infantil. Isso é possível por meio do desenvolvimento de materiais de relevância regional e mundial. São necessárias mais pesquisas e avaliações para determinar o impacto dessas estratégias e recursos nos resultados do câncer infantil na ALC e em outras regiões.

Adoption of community-based strategies for sustainable vector control and prevention.

Community engagement strategies provide tools for sustainable vector-borne disease control. A previous cluster randomized control trial engaged nine intervention communities in seven participatory activities to promote management of the domestic and peri-domestic environment to reduce risk factors for vector-borne Chagas disease. This study aims to assess the adoption of this innovative community-based strategy, which included chickens' management, indoor cleaning practices, and domestic rodent infestation control, using concepts from the Diffusion of Innovations Theory. We used questionnaires and semi-structured interviews to understand perceptions of knowledge gained, intervention adoption level, innovation attributes, and limiting or facilitating factors for adoption. The analysis process focused on five innovation attributes proposed by the Diffusion of Innovations Theory: relative advantage, compatibility, complexity, trialability, and observability. Rodent management was highly adopted by participants, as it had a relative advantage regarding the use of poison and was compatible with local practices. The higher complexity was reduced by offering several types of trapping systems and having practical workshops allowed trialability. Observability was limited because the traps were indoors, but information and traps were shared with neighbors. Chicken management was not as widely adopted due to the higher complexity of the method, and lower compatibility with local practices. Using the concepts proposed by the Diffusion of Innovations Theory helped us to identify the enablers and constraints in the implementation of the Chagas vector control strategy. Based on this experience, community engagement and intersectoral collaboration improve the acceptance and adoption of novel and integrated strategies to improve the prevention and control of neglected diseases.

Relaciones institucionales en la implementación de estrategias de promoción, protección y apoyo de la lactancia materna: una revisión integrativa / Institutional relationships in the implementation of breastfeeding promotion, protection and support strategies: an integrative review

Fundamentos: la importancia que tiene la lactancia materna en la salud y calidad de vida de los individuos hace necesario que las políticas establecidas para su promoción sean operadas mediante la participación y articulación de instituciones y a través de redes interinstitucionales. Métodos: para la compilación de la información se hizo una revisión integrativa de literatura, cuyo propósito fue ampliar la comprensión de un tema a partir de la recopilación, sistematización y análisis de producciones científicas. Resultados: se seleccionaron 14 artículos publicados entre 2013 y 2020 y, en su mayoría, escritos en inglés, provenientes de países como Estados Unidos, Alemania, Reino Unido y Samoa. Los temas más recurrentes fueron el análisis de políticas públicas, la coordinación de programas y la percepción del funcionamiento de las estrategias de promoción, protección y apoyo a la lactancia materna. En conclusión: las relaciones intra e interinstitucionales son claves a la hora de implementar políticas de promoción de la lactancia materna. Sin embargo, para su puesta en marcha, se requiere financiación y articulación en los niveles operativos de sistemas de salud. En definitiva, las labores de articulación, seguimiento y evaluación requieren relaciones fortalecidas que fomenten, protejan, promuevan y apoyen la práctica de la lactancia materna. (AU)

Background: the importance of breastfeeding in the health and quality of life of individuals makes it necessary for the policies established for its promotion to be implemented through the participation and coordination of institutions and through inter-institutional networks. Methods: for the compilation of the information, an integrative literature review was carried out, the purpose of which was to broaden the understanding of a topic through the collection, systematization and analysis of scientific productions. Results: 14 articles published between 2013 and 2020 and mostly written in English were selected from countries such as the United States, Germany, United Kingdom and Samoa. The most recurrent themes were the analysis of public policies, program coordination and perceptions of the functioning of breastfeeding promotion, protection and support strategies. Conclusions: Intra- and inter-institutional relationships are key to the implementation of breastfeeding promotion policies. However, their implementation requires funding and coordination at the operational levels of health systems. In short the articulation, monitoring and evaluation require strengthened relationships that encourage, protect, promote and support the practice of breastfeeding. (AU)

Public health advocacy strategies to influence policy agendas: lessons from a narrative review of success in trade policy.

BACKGROUND: Despite accumulating evidence of the implications of trade policy for public health, trade and health sectors continue to operate largely in silos. Numerous barriers to advancing health have been identified, including the dominance of a neoliberal paradigm, powerful private sector interests, and constraints associated with policymaking processes. Scholars and policy actors have recommended improved governance practices for trade policy, including: greater transparency and accountability; intersectoral collaboration; the use of health impact assessments; South-South networking; and mechanisms for civil society participation. These policy prescriptions have been generated from specific cases, such as the World Trade Organization's Doha Declaration on TRIPS and Public Health or specific instances of trade-related policymaking at the national level. There has not yet been a comprehensive analysis of what enables the elevation of health goals on trade policy agendas. This narrative review seeks to address this gap by collating and analysing known studies across different levels of policymaking and different health issues. RESULTS: Sixty-five studies met the inclusion criteria and were included in the review. Health issues that received attention on trade policy agendas included: access to medicines, food nutrition and food security, tobacco control, non-communicable diseases, access to knowledge, and asbestos harm. This has occurred in instances of domestic and regional policymaking, and in bilateral, regional and global trade negotiations, as well as in trade disputes and challenges. We identified four enabling conditions for elevation of health in trade-related policymaking: favourable media attention; leadership by trade and health ministers; public support; and political party support. We identified six strategies successfully used by advocates to influence these conditions: using and translating multiple forms of evidence, acting in coalitions, strategic framing, leveraging exogenous factors, legal strategy, and shifting forums. CONCLUSION: The analysis demonstrates that while technical evidence is important, political strategy is necessary for elevating health on trade agendas. The analysis provides lessons that can be explored in the wider commercial determinants of health where economic and health interests often collide.