RESUMO
RESUMEN Introducción: En el siglo XX, el Síndrome de Inmunodeficiencia Adquirida, detectado en los Estados Unidos de Norteamérica en el año 1981, alcanzó de inmediato carácter epidémico explosivo en las principales urbes del país y se extendió a otras partes del mundo, como un grave problema de la salud mundial. El objetivo del presente trabajo es evaluar el nivel de información sobre VIH/sida, que tienen los estudiantes del cuarto año de la carrera de Medicina de la Universidad de Gambia. Métodos: Se realizó un estudio observacional-descriptivo de corte transversal, durante el año 2020, a partir de la colaboración entre profesionales de la salud de la Universidad de Gambia y cubanos del mismo sector que prestan sus servicios en esa nación. El universo y muestra los conformaron los 44 estudiantes del año mencionado. Resultados: Los encuestados poseen una información inadecuada acerca del tema; con mayor dificultad los estudiantes del sexo masculino; un alto por ciento reconoce la vía sexual como la principal en la transmisión del VIH/sida y el uso regular y adecuado del preservativo como medio de protección contra el virus; pero no dominan las condiciones de sexo seguro. El servicio de consejería es la principal orientación ante una relación sexual dudosa; en tanto que, el medio primordial de adquisición de los conocimientos fue la escuela. Discusión: Se constató la correspondencia de los resultados actuales con los de investigaciones de diferentes partes del mundo, en las cuales destaca el factor de la masculinidad y lo cultural como determinantes en el conocimiento y percepción del riesgo en los individuos. Se reconoce además el papel del personal de salud para la prevención y educación de la población.
ABSTRACT Introduction: In the 20th century, the Acquired Immune Deficiency Syndrome, detected in the United States of America in 1981, immediately acquired an explosive epidemic in the main cities of the country and spread to other parts of the world, as a serious problem of the world health. The objective of this work is to evaluate the level of information on HIV / AIDS that students in their fourth year of Medicine at the University of Gambia have. Methods: An observational-descriptive cross-sectional study was carried out during 2020, based on the collaboration between health professionals from the University of Gambia and Cubans from the same sector who provide their services in that nation. The universe and sample were made up of the 44 students of the mentioned year. Results: Respondents have inadequate information on the subject; with greater difficulty male students; a high percent recognize the sexual route as the main one in the transmission of HIV / AIDS and the regular and adequate use of condoms as a means of protection against the virus; but the conditions of safe sex do not dominate. The counseling service is the main orientation before a questionable sexual relationship; whereas, the primary means of acquiring knowledge was school. Discussion: The correspondence of the current results with those of research from different parts of the world was verified, in which the masculinity and cultural factors stand out as determinants in the knowledge and perception of risk in individuals. The role of health personnel for prevention and education of the population is also recognized.
RESUMO
Recently, increasing attention has been given to behavioural and relational aspects of the people who both define and shape health systems, placing them at the core. A growing refrain includes the assertion that important decisions determining health system performance, including agenda setting, policy formulation and policy implementation, are made by people. Within this actor-oriented approach, good leadership has been identified as a key contributing factor in health systems strengthening. However, leadership remains ill-defined and under-researched, especially in resource-limited settings, and understanding the links between leadership and health outcomes remains a challenge. We explore the concept and practice of healthcare leadership at sub-national level in a low-income country setting, using a people-centric research methodology. In June and July 2013, 15 in-depth interviews were conducted with key informants in formal healthcare leadership roles across urban, peri-urban and rural settings of The Gambia, West Africa. Participants included the entire spectrum of Regional Health Team (RHT) Directors and Chief Executive Officers of all government hospitals, as well as one clinical officer-in-charge in a secondary-level major health centre. We found reference to several important aspects of, and approaches to, leadership, including (i) setting a clear vision; (ii) engendering shared leadership; and (iii) paying attention to human relations in management. Participants described attending to constituencies in government, international development agencies and civil society, as well as to the populations they serve. By illuminating the multi-polar networks within which these leaders are embedded, and through which they operate, we provide insight into the complex 'organizational ecology' of the Gambian health system. There is a need to further research and develop healthcare leadership across all levels, within various political, socio-economic and cultural contexts, in order to better work with a range of health actors and to engage them in identifying and acting upon opportunities for health systems strengthening.