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Objective: Shed light on the experiences and determinants of young people's and adolescents' participation in formal participation mechanisms during the SARS-CoV-2 pandemic in Chile. Methods: Cross-sectional, descriptive study with a qualitative approach, within the constructivist research paradigm. Three focus groups were conducted with key informants: young people and adolescents who regularly participate in advisory councils of Chile's Ministry of Health (MINSAL). Content analysis was applied for theoretical and emerging categories in the study. The reports were transcribed and studied with data analysis and hermeneutics. This study was conducted during the COVID-19 pandemic, between the months of March and November 2021. Results: During the pandemic, adolescents' and young people's experiences of health participation were affected; however, formal participation mechanisms such as advisory councils allowed for continuity. In this context and based on their experiences, young people and adolescents highlighted some factors that facilitated or limited their participation at three levels: individual, relational, and structural. They highlighted virtual communication, use of social networks, and digital health as excellent tools for the participation of young people and adolescents during the pandemic in Chile. Conclusion: The pandemic affected the participation mechanisms used by young people and adolescents in Chile; however, among the experiences highlighted by young people, aspects that facilitated participation emerged, such as virtual communication, digital health, and other strategies. At the same time, some gaps in health participation widened during this global health crisis, such as access mainly in rural populations.
Objetivo: Divulgar as experiências e determinantes da participação dos jovens e adolescentes em mecanismos formais de participação durante a pandemia de SARS-CoV-2 no Chile. Métodos: Estudo transversal, descritivo, com abordagem qualitativa, ligado ao paradigma construtivista de pesquisa. Foram realizados 3 grupos focais com informantes-chave: jovens e adolescentes que participam regularmente dos conselhos consultivos do Ministério da Saúde do Chile. Foi aplicada a técnica de análise de conteúdo para as categorias teóricas e emergentes do estudo. Os relatos foram transcritos e estudados com técnicas de análise de dados e hermenêutica. Este estudo foi realizado durante a pandemia de COVID-19, entre os meses de março e novembro de 2021. Resultados: Durante a pandemia, as experiências de participação de adolescentes e jovens na saúde foram afetadas, porém os mecanismos formais de participação, como os conselhos consultivos, permitiram sua continuidade. Nesse contexto, os jovens e adolescentes, em suas experiências, destacaram alguns fatores que facilitaram ou limitaram a participação, conforme três níveis de gestão: individual, relacional e estrutural. A comunicação virtual, o uso das redes sociais e a saúde digital destacaram-se como excelentes ferramentas para a participação de jovens e adolescentes em tempos de pandemia no Chile. Conclusão: A pandemia afetou os mecanismos de participação de jovens e adolescentes no Chile. No entanto, dentro das experiências destacadas pelos jovens, surgiram aspectos como comunicação virtual, saúde digital e outras estratégias que facilitaram a participação. Por outro lado, nessa crise de saúde mundial, aumentaram algumas lacunas na participação em saúde, como o acesso, principalmente em populações rurais.
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RESUMEN Objetivo. Develar las experiencias y determinantes de la participación de adolescentes y jóvenes en mecanismos formales de participación durante la pandemia por SARS-CoV-2 en Chile. Métodos. Estudio transversal, descriptivo de enfoque cualitativo, adscrito al paradigma constructivista de investigación. Se realizaron 3 grupos focales con informantes claves, adolescentes y jóvenes, quienes participan regularmente en consejos consultivos del Ministerio de Salud (MINSAL) en Chile. Se aplicó la técnica de análisis de contenido para categorías teóricas y emergentes del estudio. Los relatos fueron transcritos y estudiados con técnica de análisis de datos y hermenéutica. Este estudio fue realizado durante la pandemia de COVID-19, entre los meses de marzo y noviembre del 2021. Resultados. Durante la pandemia, las experiencias de participación en salud de adolescentes y jóvenes se vieron afectadas; no obstante, los mecanismos de participación formales, como los consejos consultivos, permitieron dar continuidad. En este contexto, adolescentes y jóvenes dentro de sus experiencias destacaron algunos factores que facilitaron o limitaron la participación, de acuerdo con tres niveles de gestión: individual, relacional y estructural, destacándo la comunicación virtual, el uso de redes sociales y la salud digital como excelentes herramientas para la participación de jóvenes y adolescentes en tiempos de pandemia en Chile. Conclusión. La pandemia ha afectado a los mecanismos de participación de adolescentes y jóvenes en Chile. No obstante, dentro de las experiencias destacadas por los jóvenes han surgido aspectos como la comunicación virtual, la salud digital y otras estrategias que han facilitado la participación. Por otro lado, en esta crisis sanitaria mundial se han acrecentado algunas brechas en la participación en salud, como el acceso principalmente en poblaciones rurales.
ABSTRACT Objective. Shed light on the experiences and determinants of young people's and adolescents' participation in formal participation mechanisms during the SARS-CoV-2 pandemic in Chile. Methods. Cross-sectional, descriptive study with a qualitative approach, within the constructivist research paradigm. Three focus groups were conducted with key informants: young people and adolescents who regularly participate in advisory councils of Chile's Ministry of Health (MINSAL). Content analysis was applied for theoretical and emerging categories in the study. The reports were transcribed and studied with data analysis and hermeneutics. This study was conducted during the COVID-19 pandemic, between the months of March and November 2021. Results. During the pandemic, adolescents' and young people's experiences of health participation were affected; however, formal participation mechanisms such as advisory councils allowed for continuity. In this context and based on their experiences, young people and adolescents highlighted some factors that facilitated or limited their participation at three levels: individual, relational, and structural. They highlighted virtual communication, use of social networks, and digital health as excellent tools for the participation of young people and adolescents during the pandemic in Chile. Conclusion. The pandemic affected the participation mechanisms used by young people and adolescents in Chile; however, among the experiences highlighted by young people, aspects that facilitated participation emerged, such as virtual communication, digital health, and other strategies. At the same time, some gaps in health participation widened during this global health crisis, such as access mainly in rural populations.
RESUMO Objetivo. Divulgar as experiências e determinantes da participação dos jovens e adolescentes em mecanismos formais de participação durante a pandemia de SARS-CoV-2 no Chile. Métodos. Estudo transversal, descritivo, com abordagem qualitativa, ligado ao paradigma construtivista de pesquisa. Foram realizados 3 grupos focais com informantes-chave: jovens e adolescentes que participam regularmente dos conselhos consultivos do Ministério da Saúde do Chile. Foi aplicada a técnica de análise de conteúdo para as categorias teóricas e emergentes do estudo. Os relatos foram transcritos e estudados com técnicas de análise de dados e hermenêutica. Este estudo foi realizado durante a pandemia de COVID-19, entre os meses de março e novembro de 2021. Resultados. Durante a pandemia, as experiências de participação de adolescentes e jovens na saúde foram afetadas, porém os mecanismos formais de participação, como os conselhos consultivos, permitiram sua continuidade. Nesse contexto, os jovens e adolescentes, em suas experiências, destacaram alguns fatores que facilitaram ou limitaram a participação, conforme três níveis de gestão: individual, relacional e estrutural. A comunicação virtual, o uso das redes sociais e a saúde digital destacaram-se como excelentes ferramentas para a participação de jovens e adolescentes em tempos de pandemia no Chile. Conclusão. A pandemia afetou os mecanismos de participação de jovens e adolescentes no Chile. No entanto, dentro das experiências destacadas pelos jovens, surgiram aspectos como comunicação virtual, saúde digital e outras estratégias que facilitaram a participação. Por outro lado, nessa crise de saúde mundial, aumentaram algumas lacunas na participação em saúde, como o acesso, principalmente em populações rurais.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Participação Social , COVID-19 , Chile , Estudos Transversais , Grupos Focais , Estratégias de eSaúdeRESUMO
OBJECTIVES: Present the methodology for comprehensive evaluation of the implementation of the Mental Health Global Action Programme (mhGAP) in Chile and describe the program's results. METHODS: Cross-sectional evaluative study based on a survey of key program informants deployed in 29 public health services in the country, as well as individual interviews and focus groups with key actors and experts. The evaluation was focused on the relevance and impact of mhGAP on the provision of mental health services and on the implementation of the program. RESULTS: The participants gave a positive evaluation of the progressive implementation of mhGAP in Chile. In particular: 1) They reported having better tools for detecting, diagnosing, and treating common disorders, and efficient referral strategies; (2) They rated all modules as important, the most relevant being self-harm/suicide (x¯ = 4.77) and mental and behavioral disorders in children and adolescents (x¯ = 4.58); (3) They favorably assessed the National Mental Health Day training courses and the subsequent courses repeated at the local level, indicating that these courses contributed to successful implementation of mhGAP; (4) They agreed on the need to incorporate new actors, strengthen certain aspects, and expand information on the program. CONCLUSIONS: The implementation of mhGAP in Chile is an emblematic example of learning supported by the development of community mental health and family health, among other factors. These accomplishments offer a unique opportunity to continue advancing the implementation of this program in the country and to implement this experience in other contexts in Latin America and the Caribbean.
OBJETIVOS: Apresentar a metodologia de avaliação completa da implementação do Programa de ação mundial para reduzir as lacunas em saúde mental (Mental Health GAP, mhGAP) no Chile e descrever seus resultados. MÉTODOS: Estudo avaliativo transversal baseado em levantamento realizado com profissionais de referência do programa, distribuídos em 29 serviços de saúde da rede pública do país, e entrevistas individuais e grupos focais com as principais partes interessadas e especialistas. O enfoque da avaliação foi a relevância e o impacto do mhGAP na prestação de serviços de saúde mental e a implementação do programa. RESULTADOS: Os participantes do estudo avaliaram positivamente a implementação progressiva do mhGAP no Chile. Em particular, 1) eles afirmaram possuir recursos melhores para detecção, diagnóstico e tratamento de transtornos frequentes e estratégias de encaminhamento eficientes; 2) classificaram todos os módulos como importantes, com destaque a autoagressão/suicídio (x¯ = 4,77) e transtornos mentais e de comportamento em crianças e adolescentes (x¯ = 4,58); 3) avaliaram de forma favorável a realização das Jornadas Nacionais de Saúde Mental e suas iterações em nível local contribuindo ao sucesso da implementação do mhGAP e 4) concordaram com a necessidade de atrair mais interessados, reforçar alguns aspectos e ampliar a divulgação do programa. CONCLUSÕES: A implementação do mhGAP no Chile é um caso emblemático de aprendizado apoiado no avanço da saúde mental comunitária e saúde da família, entre outros fatores. Esta conquista cria uma oportunidade única para continuar a expandir a implementação do programa no país e disseminar esta experiência a outros contextos na América Latina e Caribe.
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RESUMEN Objetivos. Presentar la metodología de evaluación integral de la implementación del Programa de Acción Mundial para Superar las Brechas en Salud Mental (mhGAP) en Chile y exponer sus resultados. Métodos. Estudio evaluativo de corte transversal basado en una encuesta a referentes clave del programa, desplegados en los 29 servicios públicos de salud del país, y entrevistas individuales y grupos focales con actores clave y expertos. El foco de la evaluación estuvo en la relevancia e impacto del mhGAP en la prestación de servicios de salud mental y en la implementación del programa. Resultados. Los participantes evaluaron positivamente la implementación progresiva del mhGAP en Chile, en particular: 1) manifestaron contar con mejores herramientas de detección, diagnóstico y tratamiento de trastornos frecuentes, y estrategias eficientes de derivación; 2) calificaron todos los módulos como importantes; los más relevantes fueron autolesión/suicidio (x¯ = 4,77) y trastornos mentales y conductuales del niño y el adolescente (x¯ = 4,58); 3) evaluaron favorablemente las Jornadas Nacionales y sus réplicas y su contribución al éxito de la implementación del mhGAP; 4) coincidieron en la necesidad de incorporar nuevos actores, fortalecer algunos aspectos y ampliar la información sobre el programa. Conclusiones. La implementación del mhGAP en Chile constituye un caso emblemático de aprendizaje, apoyado por el desarrollo de la salud mental comunitaria y la salud familiar, entre otros factores. Lo logrado abre una oportunidad única para continuar avanzando en la implementación de este programa en el país y transmitir esta experiencia a otros contextos de América Latina y el Caribe.
ABSTRACT Objectives. Present the methodology for comprehensive evaluation of the implementation of the Mental Health Global Action Programme (mhGAP) in Chile and describe the program's results. Methods. Cross-sectional evaluative study based on a survey of key program informants deployed in 29 public health services in the country, as well as individual interviews and focus groups with key actors and experts. The evaluation was focused on the relevance and impact of mhGAP on the provision of mental health services and on the implementation of the program. Results. The participants gave a positive evaluation of the progressive implementation of mhGAP in Chile. In particular: 1) They reported having better tools for detecting, diagnosing, and treating common disorders, and efficient referral strategies; (2) They rated all modules as important, the most relevant being self-harm/suicide (x¯ = 4.77) and mental and behavioral disorders in children and adolescents (x¯ = 4.58); (3) They favorably assessed the National Mental Health Day training courses and the subsequent courses repeated at the local level, indicating that these courses contributed to successful implementation of mhGAP; (4) They agreed on the need to incorporate new actors, strengthen certain aspects, and expand information on the program. Conclusions. The implementation of mhGAP in Chile is an emblematic example of learning supported by the development of community mental health and family health, among other factors. These accomplishments offer a unique opportunity to continue advancing the implementation of this program in the country and to implement this experience in other contexts in Latin America and the Caribbean.
RESUMO Objetivos. Apresentar a metodologia de avaliação completa da implementação do Programa de ação mundial para reduzir as lacunas em saúde mental (Mental Health GAP, mhGAP) no Chile e descrever seus resultados. Métodos. Estudo avaliativo transversal baseado em levantamento realizado com profissionais de referência do programa, distribuídos em 29 serviços de saúde da rede pública do país, e entrevistas individuais e grupos focais com as principais partes interessadas e especialistas. O enfoque da avaliação foi a relevância e o impacto do mhGAP na prestação de serviços de saúde mental e a implementação do programa. Resultados. Os participantes do estudo avaliaram positivamente a implementação progressiva do mhGAP no Chile. Em particular, 1) eles afirmaram possuir recursos melhores para detecção, diagnóstico e tratamento de transtornos frequentes e estratégias de encaminhamento eficientes; 2) classificaram todos os módulos como importantes, com destaque a autoagressão/suicídio (x¯ = 4,77) e transtornos mentais e de comportamento em crianças e adolescentes (x¯ = 4,58); 3) avaliaram de forma favorável a realização das Jornadas Nacionais de Saúde Mental e suas iterações em nível local contribuindo ao sucesso da implementação do mhGAP e 4) concordaram com a necessidade de atrair mais interessados, reforçar alguns aspectos e ampliar a divulgação do programa. Conclusões. A implementação do mhGAP no Chile é um caso emblemático de aprendizado apoiado no avanço da saúde mental comunitária e saúde da família, entre outros fatores. Esta conquista cria uma oportunidade única para continuar a expandir a implementação do programa no país e disseminar esta experiência a outros contextos na América Latina e Caribe.
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Humanos , Capacitação Profissional , Transtornos Mentais/terapia , Serviços de Saúde Mental , Avaliação de Programas e Projetos de Saúde , Chile , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Grupos Focais , Região do Caribe , América LatinaRESUMO
BACKGROUND: Data on disability are regularly collected by different institutions or ministries using specific tools for different purposes, for instance to estimate the prevalence of disability or eligibility of specific populations for social benefits. The interoperability of disability data collected in countries is essential for policy making and to monitor the implementation of the Convention on the Rights of Persons with Disabilities. The first objective of this paper is to map and compare tools that collect data on disability for different purposes, more specifically the Brazilian National Health Survey and the Brazilian Functioning Index to the World Health Organization (WHO) and the World Bank Model Disability Survey (MDS), currently recommended as a standard tool for disability measurement. The second objective is to demonstrate the usefulness and value of the International Classification of Functioning, Disability and Health Linking Rules to map and compare population-based surveys and other content-related tools collecting data on disability, even when these have already been developed based on the International Classification of Functioning, Disability and Health. METHODS: Disability information collected with the three different tools was mapped and compared using the International Classification of Functioning, Disability and Health Linking Rules. RESULTS: Although the disability module in the Brazilian National Health Survey is fundamentally different from the MDS, the mapping disclosed that several modules of the Brazilian National Health Survey already cover many aspects necessary to estimate prevalence and understand disability as currently recommended by the WHO and the World Bank. The Brazilian Functioning Index and the MDS are both based on the International Classification of Functioning, Disability and Health and are very similar in the approach and content of their questions on functioning. Specific information on environmental factors is essential to identify needs and barriers, as well as to devise procedures to reduce injustice and inequalities. This information is still not targeted broadly enough in both the Brazilian National Health Survey and the Brazilian Functioning Index. CONCLUSIONS: Overall, this mapping exercise showed that applying the International Classification of Functioning, Disability and Health linking rules to population-based data coming from different sources provides researchers and stakeholders involved in decision-making with standardized and straightforward information about overlaps and gaps. Implications for Rehabilitation Data on functioning and disability regularly collected with different purposes and by different institutions or ministries within a country can be compared using the International Classification of Functioning, Disability and Health as a reference framework and the International Classification of Functioning, Disability and Health linking rules. The recently published refinements of the International Classification of Functioning, Disability and Health Linking Rules go beyond the sole linking to International Classification of Functioning, Disability and Health categories and provide standardized procedures to document the perspective of linked questions or the categorization of response options. They are therefore useful to compared tools that have been developed based on the International Classification of Functioning, Disability and Health. The current disability module of the Brazilian Health Survey needs a revision to be suitable to collect data on disability that is Convention on the Rights of Persons with Disabilities conform and guarantees interoperability with disability data from other sources in Brazil, especially from disability assessment for social benefits and implementation of policies.
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Atividades Cotidianas , Pessoas com Deficiência , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Brasil , Coleta de Dados , Avaliação da Deficiência , Pessoas com Deficiência/reabilitação , Pessoas com Deficiência/estatística & dados numéricos , Definição da Elegibilidade , Inquéritos Epidemiológicos , Humanos , Prevalência , Inquéritos e QuestionáriosRESUMO
OBJECTIVE:: To describe the adult population perception of cigarette advertising at point of sale, according their tobacco-use status and socio-demographic characteristics such as sex, age, race/color, region, household location and schooling. MATERIALS AND METHODS:: A multivariable analysis was carried out using data from the Global Adult Tobacco Survey in 2008 and the National Health Survey in 2013. RESULTS:: Both surveys showed that among nonsmokers: women, young adults and those who had over 10 years of schooling had more frequently noticed advertising of cigarettes at point of sale. It was also observed that among the population with fewer years of schooling these proportions increased significantly. CONCLUSION:: A measure that completely bans tobacco advertising would be more effective to protect the vulnerable groups from tobacco consumption.
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Publicidade , Comércio , Produtos do Tabaco , Adolescente , Adulto , Brasil , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Abstract: Objective: To describe the adult population perception of cigarette advertising at point of sale, according their tobacco-use status and socio-demographic characteristics such as sex, age, race/color, region, household location and schooling. Materials and methods: A multivariable analysis was carried out using data from the Global Adult Tobacco Survey in 2008 and the National Health Survey in 2013. Results: Both surveys showed that among nonsmokers: women, young adults and those who had over 10 years of schooling had more frequently noticed advertising of cigarettes at point of sale. It was also observed that among the population with fewer years of schooling these proportions increased significantly. Conclusion: A measure that completely bans tobacco advertising would be more effective to protect the vulnerable groups from tobacco consumption.
Resumen: Objetivo: Describir a la población adulta en relación con la percepción de la publicidad de cigarrillos en los puntos de venta, según el estado de consumo de tabaco y características sociodemográficas como sexo, edad, raza/color, región, ubicación del hogar y escolaridad. Material y métodos: Se realizó un análisis multivariado con los datos de la Encuesta Global de Tabaquismo en Adultos de 2008 y la Encuesta Nacional de Salud de 2013. Resultados. Ambas encuestas mostraron que entre los no fumadores: las mujeres, los adultos jóvenes y los que tenían más de 10 años de escolaridad notaron con más frecuencia la publicidad de cigarrillos en puntos de venta. También se observó que estas proporciones aumentaron significativamente entre la población con menos años de escolaridad. Conclusión. Una política que prohíba completamente la publicidad de cigarrillos sería más efectiva para proteger a los grupos vulnerables del consumo de tabaco.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Comércio , Publicidade , Produtos do Tabaco , Brasil , Inquéritos EpidemiológicosRESUMO
From 27 March 2005 onwards, the independent humanitarian medical aid agency Medecins Sans Frontieres, together with the World Health Organization, the Angolan Ministry of Health, and others, responded to the Marburg hemorrhagic fever (MHF) outbreak in Uige, Angola, to contain the epidemic and care for those infected. This response included community epidemiological surveillance, clinical assessment and isolation of patients with MHF, safe burials and disinfection, home-based risk reduction, peripheral health facility support, psychosocial support, and information and education campaigns. Lessons were learned during the implementation of each outbreak control component, and the subsequent modifications of protocols and strategies are discussed. Similar to what was seen in previous filovirus hemorrhagic fever outbreaks, the containment of the MHF epidemic depended on the collaboration of the affected community. Actively involving all stakeholders from the start of the outbreak response is crucial.