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1.

La demanda de cigarrillos y el aumento de impuestos en El Salvador/ Demand for cigarettes and tax increases in El Salvador

Ramos-Carbajales, Alejandro; González-Rozada, Martín; Vallarino, Hugo
| Idioma(s): Español
Objetivo. Analizar las elasticidades de corto plazo y de largo plazo de la demanda de cigarrillos en El Salvador como instrumento para apoyar recomendaciones sobre aumentos de impuestos para reducir la prevalencia y el consumo vía aumento de precios. Métodos. Se analizó la demanda de cigarrillos en El Salvador mediante un modelo econométrico de series de tiempo con una base de datos proveniente de la Dirección General de Impuestos Internos (DGII) y la Dirección General de Estadística y Censos (DIGESTYC) de El Salvador. El período de análisis fue trimestral: 2000Q1-2012T4. Se realizaron las pruebas habituales para evitar que la estimación econométrica fuera espuria. Se halló que las variables ventas en volumen, los precios reales de venta y el ingreso real per cápita estaban cointegradas de primer orden; este resultado permite utilizar un modelo de corrección de error con estimaciones de las elasticidades en el corto plazo y en el largo plazo. Resultados. Se halló que solo las elasticidades de largo plazo son estadísticamente significativas al 5% de probabilidad. Los resultados señalan una elasticidad precio de largo plazo (cinco trimestres) de -0,9287 e ingreso de 0,9978. Conclusiones. El nivel del valor absoluto de la elasticidad precio es algo elevada, aunque está dentro de los niveles estimados en otros estudios en los países de menores ingresos per cápita. Un aumento del impuesto de un monto base de USD (dólares estadounidenses) 1,04 por cajetilla de 20 cigarrillos a USD 1,66 en un período de tres años reduciría la demanda entre 20% y 31% y aumentaría los ingresos fiscales entre 9% y 22%. Objective. Analyze short- and long-term elasticities of demand for cigarettes in El Salvador as a tool for supporting recommendations on tax increases to reduce prevalence and consumption through price increases. Methods. Demand for cigarettes in El Salvador was analyzed through an econometric time-series model using a database from El Salvador’s General Directorate of Internal Taxes (DGII) and the General Directorate of Statistics and Census (DIGESTYC). The analysis period was quarterly: 2000Q1-2012Q4. The usual tests were done to prevent a spurious econometric estimation. It was found that the variables volume sales, actual sale prices, and actual per capita income exhibited first-order cointegration; this result makes it possible to use an error correction model with short- and long-term elasticity estimates. Results. Only long-term elasticities were found to be statistically significant to 5%. Results show long-term price elasticity (5 quarters) of –0.9287 and income price elasticity of 0.9978. Conclusions. Absolute price elasticity is somewhat high, although it is within the levels estimated in other studies in low per-capita income countries. A tax increase from a base amount of US$1.04 per pack of 20 cigarettes to US$1.66 within three years would reduce demand by 20% to 31% and would increase tax revenues by 9% to 22%.
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2.

Factors affecting attendance to cervical cancer screening among women in the Paracentral Region of El Salvador: a nested study within the CAPE HPV screening program.

Alfaro, Karla M; Gage, Julia C; Rosenbaum, Alan J; Ditzian, Lauren R; Maza, Mauricio; Scarinci, Isabel C; Miranda, Esmeralda; Villalta, Sofia; Felix, Juan C; Castle, Philip E; Cremer, Miriam L
| Idioma(s): Inglés
BACKGROUND: Cervical cancer is the third most commonly occurring cancer among women and the fourth leading cause of cancer-related deaths in women worldwide, with more than 85 % of these cases occurring in developing countries. These global disparities reflect the differences in cervical cancer screening rates between high-income and medium- and low-income countries. At 19 %, El Salvador has the lowest reported screening coverage of all Latin American countries. The purpose of this study is to identify factors affecting public sector HPV DNA-based cervical cancer screening participation in El Salvador. METHODS: This study was nested within a public sector screening program where health promoters used door-to-door outreach to recruit women aged 30-49 years to attend educational sessions about HPV screening. A subgroup of these participants was chosen randomly and questioned about demographic factors, healthcare utilization, previous cervical cancer screening, and HPV knowledge. Women then scheduled screening appointments at their public health clinics. Screening participants were adherent if they attended their scheduled appointment or rescheduled and were screened within 6 months. The association between non-adherence and demographic variables, medical history, history of cancer, sexual history, birth control methods, and screening barriers was assessed using Chi-square tests of significance and logistic regression. RESULTS: All women (n = 409) enrolled in the study scheduled HPV screening appointments, and 88 % attended. Non-adherence was associated with a higher number of lifetime partners and being under-screened-defined as not having participated in cervical cancer screening within the previous 3 years (p = 0.03 and p = 0.04, respectively); 22.8 % of participants in this study were under-screened. CONCLUSIONS: Adherence to cervical cancer screening after educational sessions was higher than expected, in part due to interactions with the community-based health promoters as well as the educational session itself. More effective recruitment methods targeted toward under-screened women are required.
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3.

Empowerment for the Right to Health: The Use of the "Most Significant Change" Methodology in Monitoring.

Polet, Fanny; Malaise, Geraldine; Mahieu, Anuschka; Utrera, Eulalia; Montes, Jovita; Tablang, Rosalinda; Aytin, Andrew; Kambale, Erick; Luzala, Sylvie; Al-Ghoul, Daoud; Darkhawaja, Ranin Ahed; Rodriguez, Roxana Maria; Posada, Margarita; De Ceukelaire, Wim; De Vos, Pol
| Idioma(s): Inglés
Quantitative evaluations might be insufficient for measuring the impact of interventions promoting the right to health, particularly in their ability to contribute to a greater understanding of processes at the individual, community, and larger population level through which certain results are obtained. This paper discusses the application of a qualitative approach, the "most significant change" (MSC) methodology, in the Philippines, Palestine, the Democratic Republic of the Congo, and El Salvador between 2010 and 2013 by Third World Health Aid and its partner organizations. MSC is based on storytelling through which the central question--what changes occurred?--is developed in terms of, "who did what, when, why, and why was it important?" The approach focuses on personal stories that reflect on experiences of change for individuals over time. MSC implementation over several years allowed the organizations to observe significant change, as well as evolving types of change. Participants shifted their stories from "how the programs helped them" and "what they could do to help others benefit from the programs" to "what they could do to help their organizations." The MSC technique is useful as a complement to quantitative methods, as it is a slow, participatory, and intensive endeavor that builds capacity while being applied. This makes MSC a useful monitoring tool for programs with participatory and empowering objectives.
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4.

Characterizing the low wage immigrant workforce: a comparative analysis of the health disparities among selected occupations in Somerville, Massachusetts.

Panikkar, Bindu; Woodin, Mark A; Brugge, Doug; Hyatt, Raymond; Gute, David M
| Idioma(s): Inglés
BACKGROUND: This study estimates job-related risks among common low wage occupations (cleaning, construction, food service, cashier/baggers, and factory workers) held by predominantly Haitian, El Salvadorian, and Brazilian immigrants living or working in Somerville, Massachusetts. METHODS: A community-based cross-sectional survey on immigrant occupational health was conducted between 2006 and 2009 and logistic regression was used to assess the job-related risks among the most common low wage occupations. RESULTS: Construction workers reported significantly higher health risks, and lower access to occupational health services than the other occupations. Compared to cashier/baggers, the reference population in this study, cleaners reported significantly lower access to health and safety and work training and no knowledge of workers' compensation. Factory workers reported significantly lower work training compared to cashier/baggers. Food service workers reported the least access to doctors compared to the other occupations. CONCLUSION: We found significant variability in risks among different low wage immigrant occupations. The type of occupation independently contributed to varying levels of risks among these jobs. We believe our findings to be conservative and recommend additional inquiry aimed at assuring the representativeness of our findings.
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5.

Occupational health and safety experiences among self-identified immigrant workers living or working in Somerville, MA by ethnicity, years in the US, and English proficiency.

Panikkar, Bindu; Woodin, Mark A; Brugge, Doug; Desmarais, Anne Marie; Hyatt, Raymond; Goldman, Rose; Pirie, Alex; Goldstein-Gelb, Marcy; Galvão, Heloisa; Chianelli, Monica; Vasquez, Ismael; McWhinney, Melissa; Dalembert, Franklin; Gute, David M
| Idioma(s): Inglés
In this community based research initiative, we employed a survey instrument predominately developed and administered by Teen Educators to assess occupational health risks for Haitian, Salvadoran, and Brazilian immigrants (n = 405) in Somerville, MA, USA. We demonstrate that a combined analysis of ethnicity, years in the US, and English proficiency better characterized the occupational experience of immigrant workers than considering these variables individually. While years in the US (negatively) and English proficiency (positively) explained the occurrence of health risks, the country of origin identified the most vulnerable populations in the community. Brazilians, Salvadorans, and other Hispanic, all of whom who have been in the US varying length of time, with varying proficiency in English language had twice the odds of reporting injuries due to work compared to other immigrants. Although this observation was not significant it indicates that years in the US and English proficiency alone do not predict health risks among this population. We recommend the initiation of larger studies employing c community based participatory research methods to confirm these differences and to further explore work and health issues of immigrant populations. This study is one of the small number of research efforts to utilize a contemporaneous assessment of occupational health problems in three distinct immigrant populations at the community level within a specific Environmental Justice context and social milieu.
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6.

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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7.

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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8.

Resultados de la primera medición de las metas regionales de recursos humanos para la salud en El Salvador. Informe técnico/ Results of the first measurement of the regional goals of human resources for health in El Salvador. Technical report

Organización Panamericana de la Salud
;
| Idioma(s): Español
En El Salvador, el Gobierno impulsa una Reforma del Sector Salud, estableciendo en su Plan 2009- 2014 "diseñar y construir un Sistema Nacional Integrado de Salud basado en la Estrategia de Atención Primaria en Salud Integral (APSI)", lo cual implica la reorganización de la red pública de servicios de salud para mejorar la capacidad resolutiva. En su documento de política "Construyendo la esperanza: Estrategias y recomendaciones en salud 2009 -2014", el Ministerio de Salud, define con claridad las bases conceptuales y propuestas de intervención para superar la deficitaria situación de salud, cuyo resultado esperado será un sistema que conciba la salud como un derecho humano fundamental, que busca permanentemente la equidad en salud y la solidaridad social, reorientando los servicios de salud hacia la promoción y la prevención, basado en un abordaje intersectorial de la salud con enfoque de determinantes sociales de la salud. En este contexto, el MSPAS ha decidido impulsar el desarrollo de la Red Pública Integral e integrada de Servicios de Salud (RIISS) basado en APS1 iniciando con el primer nivel de atención en 74 municipios prioritarios del país y con una planificación progresiva hasta completar en el 2014 con los 262 municipios. En este Proceso de Reforma, el MSPAS, ha definido al Recurso Humano como la piedra angular del mismo, tal como está contemplado en las estrategias 11,18, 19 y 20 del documento "Construyendo la Esperanza" en donde se prioriza la necesidad de contar con una Política de Desarrollo de los Recursos Humanos en Salud y un plan de implementación que reoriente el desarrollo de éstos para alinearlo a la propuesta de reforma, bajo la rectoría del Ministerio a través de la Dirección de Desarrollo de Recursos Humanos. El tema de RRHH ha sido abordado por los diferentes países de la Región de las Américas, y es así como en abril 2005, acuerdan resaltar el papel de los y las trabajadoras de la salud en la construcción de la equidad y el logro de los objetivos del milenio, iniciando así, la Década del Recurso Humano en Salud, estableciendo en Toronto, 5 desafíos, con sus respectivas metas, como producto de la consulta regional sobre las prioridades de los países. El Salvador, ha ratificado su adhesión a este compromiso internacional que refuerza y orienta las acciones que en materia de desarrollo de RHUS se requieren para el país. Con la intención de establecer una Línea base de medición de metas para el desarrollo de los RHUS, que permita identificar los aspectos críticos del tema que deberán incluirse en la Política Nacional, así como contar con un referente que permita el monitoreo de los avances que se vayan alcanzando en esta materia clave para la reforma, el MSPAS, con una amplia participación interinstitucional e intersectorial, realiza el Taller de Medición de Metas Regionales de RHUS para la década 2007 ­ 2015 los días 25 al 27 de Octubre del 2010. El presente documento contiene el resultado de dicha medición (AU)
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10.

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.
Resultados  1-10 de 194