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1.

Familia, amigos y otras fuentes de información asociadas al inicio de las relaciones sexuales en adolescentes de El Salvador./ [Family, friends, and other sources of information associated with the initiation of sexual relations by adolescents in El Salvador].

Ruiz-Canela, Miguel; López-Del Burgo, Cristina; Carlos, Silvia; Calatrava, María; Osorio, Alfonso; Irala, Jokin de
| Idioma(s): Español
OBJECTIVE: The objective of this study is to verify the influence of messages Salvadorian youth receive about sexuality, affection, and leisure from family, friends, and the media on the initiation of sexual activity. METHODS: Cross-sectional study based on a representative sample of 2 615 students (from 13 to 19 years of age) in El Salvador. A random systematic sampling was used to select 30 schools. Sociodemographic aspects, lifestyles, and sources of information on sexuality and love used by the young people were collected. RESULTS: The average age of the young people studied was 15 (SD = 1.8). In all, 638 (24.4%) of the young people stated that they had had sexual relations. The following factors are associated with a greater probability of having had sexual relations: a perception that siblings (OR = 1.8, CI 95%: 1.2-2.7) or friends (OR = 1.7, CI 95%: 1.3-2.2) encourage them to have sex. Protective factors were found to be the supervision of parents (OR = 0.5, CI 95%: 0.4-0.7); messages received from friends that encourage abstinence (OR = 0.7, CI 95%: 0.6-1.0) or from siblings (OR = 0.7, CI 95%: 0.5-0.8); and favorable messages related to marriage received from parents (OR = 0.4, CI 95%: 0.3-0.6). CONCLUSIONS: Messages from family and friends are factors that seem to influence the initiation of sexual activity by young people. Sexual health promotion programs in El Salvador should take these factors into account.
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2.

Familia, amigos y otras fuentes de información asociadas al inicio de las relaciones sexuales en adolescentes de El Salvador/ Family, friends, and other sources of information associated with the initiation of sexual relations by adolescents in El Salvador

Ruiz-Canela, Miguel; López-del Burgo, Cristina; Carlos, Silvia; Calatrava, María; Osorio, Alfonso; Irala, Jokin de
| Idioma(s): Español
OBJETIVO: El objetivo de este estudio es comprobar cómo influyen en el inicio de la actividad sexual de los jóvenes salvadoreños los mensajes que reciben sobre cuestiones de sexualidad, afectividad y ocio a través de la familia, los amigos y los medios de comunicación. MÉTODOS: Estudio transversal a partir de una muestra representativa de 2 615 estudiantes (de 13 a 19 años) de El Salvador. Se utilizó un muestreo sistemático aleatorio para seleccionar 30 colegios. Se recogieron aspectos sociodemográficos, estilos de vida y fuentes de información sobre sexualidad y amor utilizadas por los jóvenes. RESULTADOS: La edad media de los jóvenes fue de 15 años (DE = 1,8). En total 638 (24,4 por ciento) jóvenes afirmaron haber tenido relaciones sexuales. Los siguientes factores se asociaron con una mayor probabilidad de haber tenido relaciones sexuales: percibir que los hermanos (OR = 1,8, IC 95 por ciento: 1,2-2,7) o los amigos (OR = 1,7, IC 95 por ciento: 1,3-2,2) apoyan que se tengan relaciones sexuales. Como factores protectores se encontraron la supervisión de los padres (OR = 0,5, IC 95 por ciento: 0,4-0,7); recibir mensajes que apoyan la abstinencia por parte de amigos (OR = 0,7, IC 95 por ciento: 0,6-1,0) o hermanos (OR = 0,7, IC 95 por ciento: 0,5-0,8) y recibir mensajes favorables al matrimonio por parte de los padres (OR = 0,4, IC 95 por ciento: 0,3-0,6). CONCLUSIONES: Los mensajes de la familia y amigos son factores que parecen influir en el inicio de las relaciones sexuales de los jóvenes. Los programas de promoción de la salud sexual en El Salvador deberían tener en cuenta estos factores. OBJECTIVE: The objective of this study is to verify the influence of messages Salvadorian youth receive about sexuality, affection, and leisure from family, friends, and the media on the initiation of sexual activity. METHODS: Cross-sectional study based on a representative sample of 2 615 students (from 13 to 19 years of age) in El Salvador. A random systematic sampling was used to select 30 schools. Sociodemographic aspects, lifestyles, and sources of information on sexuality and love used by the young people were collected. RESULTS: The average age of the young people studied was 15 (SD = 1.8). In all, 638 (24.4 percent) of the young people stated that they had had sexual relations. The following factors are associated with a greater probability of having had sexual relations: a perception that siblings (OR = 1.8, CI 95 percent: 1.2-2.7) or friends (OR = 1.7, CI 95 percent: 1.3-2.2) encourage them to have sex. Protective factors were found to be the supervision of parents (OR = 0.5, CI 95 percent: 0.4-0.7); messages received from friends that encourage abstinence (OR = 0.7, CI 95 percent: 0.6-1.0) or from siblings (OR = 0.7, CI 95 percent: 0.5-0.8); and favorable messages related to marriage received from parents (OR = 0.4, CI 95 percent: 0.3-0.6). CONCLUSIONS: Messages from family and friends are factors that seem to influence the initiation of sexual activity by young people. Sexual health promotion programs in El Salvador should take these factors into account.
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3.

Mean age of first sex: do they know what we mean?

de Irala, Jokin; Osorio, Alfonso; Carlos, Silvia; Ruiz-Canela, Miguel; López-del Burgo, Cristina
| Idioma(s): Inglés
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4.

Sistema de salud de El Salvador./ [The health system of El Salvador].

Acosta, Mónica; Sáenz, María del Rocío; Gutiérrez, Blanca; Bermúdez, Juan Luis
| Idioma(s): Español
This paper describes the health conditions in El Salvador and the main característics of the Salvadoran health system, including its structure and coverage, its financial sources, the physical, material and human resources available, the stewardship functions developed by the Ministry of Public Health, and the participation of health care users in the evaluation of the system. It also discusses the most recent policy innovations including the approval of the Law for the Creation of the National Health System, which intends to expand coverage, reduce health inequalities and improve the coordination of public health institutions.
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5.

Understanding use of health services in conditional cash transfer programs: insights from qualitative research in Latin America and Turkey.

Adato, Michelle; Roopnaraine, Terry; Becker, Elisabeth
| Idioma(s): Inglés
Conditional cash transfer programs provide cash grants to poor households conditional on their participation in primary health care services. While significant impacts have been demonstrated quantitatively, little attention is paid to why CCTs have these observed impacts, and as importantly- why impacts are not greater than they are. This article draws on qualitative research from four countries over a ten year period (1999-2009) to provide insights into why expected health and nutrition impacts do and do not occur. In Nicaragua, El Salvador, and Turkey, ethnographic methods were used, involving between 87 and 120 households per country, and in Mexico, focus groups were conducted with 230 people. Key informant interviews were conducted with health care providers in all countries. While CCTs operate primarily on the assumption that a cash incentive will produce behaviour change, we found multiple sociocultural and structural influences on health care decisions that compete with cash. These include beliefs around traditional and modern biomedical practices, sociocultural norms, gender relations, and the quotidian experience of poverty in many dimensions. We conclude that impacts can be increased through a better understanding of multiple contextual influences on health care decisions, and greater attention to the health education components and complementary interventions.
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6.

Sistema de salud de El Salvador/ The health system of El Salvador

Acosta, Mónica; Sáenz, María del Rocío; Gutiérrez, Blanca; Bermúdez, Juan Luis
| Idioma(s): Español
En este artículo se describen las condiciones de salud de la población salvadoreña y, con mayor detalle, el sistema de salud de El Salvador, incluyendo su estructura y cobertura, sus fuentes de financiamiento, los recursos físicos, materiales y humanos con los que cuenta, las actividades de rectoría que desarrolla el Ministerio de Salud Pública y Asistencia Social, y la participación de los usuarios de los servicios de salud en la evaluación del sistema. Asimismo se discuten las más recientes innovaciones implantadas por el sistema salvadoreño de salud, dentro de las que destacan la aprobación de la Ley de Creación del Sistema Nacional de Salud que busca ampliar la cobertura, disminuir las desigualdades y mejorar la coordinación de las instituciones públicas de salud. This paper describes the health conditions in El Salvador and the main característics of the Salvadoran health system, including its structure and coverage, its financial sources, the physical, material and human resources available, the stewardship functions developed by the Ministry of Public Health, and the participation of health care users in the evaluation of the system. It also discusses the most recent policy innovations including the approval of the Law for the Creation of the National Health System, which intends to expand coverage, reduce health inequalities and improve the coordination of public health institutions.
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7.

Resources and obstacles to developing and implementing a structural intervention to prevent HIV in San Salvador, El Salvador.

Dickson-Gomez, Julia; Corbett, A Michelle; Bodnar, Gloria; Rodriguez, Karla; Guevara, Carmen E
| Idioma(s): Inglés
HIV prevention researchers have increasingly advocated structural interventions that address factors in the social, political and economic context to reduce disparities of HIV/AIDS among disadvantaged populations. This paper draws on data collected in three different types of low-income communities (n=6) in the San Salvador metropolitan area in El Salvador. Nine focus group discussions were conducted between January 2006 and July 2007, 6 with community leaders, and 3 with crack cocaine users, as well as in-depth interviews with 20 crack users and crack dealers. We explore opportunities and barriers to the implementation of a community-level, structural intervention. We first analyze the different forms of leadership, and other community resources including existing HIV prevention activities that could potentially be used to address the related problems of crack use and HIV in the communities, and the structural factors that may act as barriers to capitalizing on communities' strengths in interventions. Each of the communities studied demonstrated different resources that stem from each community's unique history and geographic location. HIV testing and prevention resources varied widely among the communities, with resources concentrated in one Older Central community despite a strong need in all communities. In many communities, fear of gang violence and non-responsiveness by government agencies to communities' needs have discouraged community organizing. In the discussion, we offer concrete suggestions for developing and implementing structural interventions to reduce HIV risks that use communities' different but complementary resources.
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9.

Reconsidering childhood undernutrition: can birth spacing make a difference? An analysis of the 2002-2003 El Salvador National Family Health Survey.

Gribble, James N; Murray, Nancy J; Menotti, Elaine P
| Idioma(s): Inglés
It is well understood that undernutrition underpins much of child morbidity and mortality in less developed countries, but the causes of undernutrition are complex and interrelated, requiring a multipronged approach for intervention. This paper uses a subsample of 3853 children under age 5 from the most recent family health survey in El Salvador to examine the relationship between birth spacing and childhood undernutrition (stunting and underweight). While recent research and guidance suggest that birth spacing of three to five years contributes to lower levels of infant and childhood mortality, little attention has been given to the possibility that short birth intervals have longer-term effects on childhood nutrition status. The analysis controls for clustering effects arising from siblings being included in the subsample, as well as variables that are associated with household resources, household structure, reproductive history and outcomes, and household social environment. The results of the multiple regression analyses find that in comparison to intervals of 36-59 months, birth intervals of less than 24 months and intervals of 24-35 months significantly increase the odds of stunting (<24 months Odds Ratio (OR) = 1.52; 95% confidence interval (CI): 1.21-1.92; 25-36 months OR = 1.30; 95% CI: 1.05-1.64). Other factors related to stunting and underweight include standard of living index quintile, child's age, mother's education, low birthweight, use of prenatal care, and region of the country where the child lives. Policy and program implications include more effective use of health services and outreach programs to counsel mothers on family planning, breastfeeding, and well child care.
Resultados  1-10 de 1.298