[Proposal for territorial analysis to face the SARS-CoV-2 pandemic based on the Profile of pneumonia and Influenza in Ecuador 2016-2018]. / Propuesta de análisis territorial para enfrentar la pandemia por SARS-CoV-2 basado en el perfil de neumonía e influenza en Ecuador 2016-2018.

OBJECTIVE: The present study seeks to analyse sociodemographic determinants related to severe acute respiratory infections (SARI) and calculate the priorization index in the cantons of Ecuador to identify areas probably most vulnerable to COVID-19 transmission. DESIGN: This descriptive ecological observational study. SETTING: 224 cantons (geographical area) of Ecuador with secondary data sources of hospital information. PARTICIPANTS: The unit of measurement was 224 cantons of Ecuador, in which analysed morbidity and lethality rates for SARI using hospital release data (2016-2018). MAIN MEASUREMENTS: Eight sociodemographic indicators were structuralized, and correlation tests applied for a multiple regression model. The priorization index was created with criteria of efficiency, efficacy, effect size (IRR) and equity. Using the sum of the index for each indicator, the priorization score was calculated and localized in a territorial map. RESULTS: Morbidity associated factors where: school attendance years, urbanization and population density; for mortality resulted: school attendance and ethnics (indigenous) IRR: 1.09 (IC95%:1.06-1.15) and IRR: 1.024 (IC95%:102-1.03) respectively. With lethality where related cantons, with population older than 60 years, IRR: 1.049 (IC95%: 1.03-1.07); 87 cantons had high priority mostly localized in the mountain region and the Morona Santiago Province. CONCLUSIONS: Morbidity and mortality of SARI in Ecuador are associated to social and demographic factors. Priorization exercises considering these factors permit the identification of vulnerable territories facing respiratory disease propagation. The social determinants characteristic for each territory should be added to known individual factors to analyse the risk and vulnerability for COVID in the population.

Guía técnica para la atención del parto culturalmente adecuado / Technical guide for culturally appropriate delivery care

La presente guía plantea la necesidad de introducir un enfoque humanitario, intercultural y de derechos en salud materna y neonatal de un modo más claro y decidido, a fin de que la atención en salud contemple normas y procedimientos de acuerdo a las necesidades culturales de la población, que sean aplicados por el personal de salud de los niveles I y II de atención de todas las instituciones que integran el Sistema Nacional de Salud, y que permitan satisfacer a un mayor número de usuarias/os, particularmente de zonas rurales, campesinas, indígenas y afroecuatorianas donde las barreras de acceso elevan los índices de morbilidad y mortalidad materno infantil. (AU)