Historia clínica electrónica: miradas críticas de médicos del área metropolitana de Buenos Aires, Argentina / Electronic medical records: critical views of doctors in the metropolitan region of Buenos Aires, Argentina / Registro médico eletrônico: pontos de vista críticos dos médicos da área metropolitana de Buenos Aires, Argentina

Resumen Los procesos de digitalización del siglo XX extendieron el uso de Tecnologías de Información y Comunicación al campo de la salud. El artículo aborda la Historia Clínica Electrónica a partir de las críticas y debilidades señaladas por especialistas en Clínica Médica, Medicina General y/o de Familia del Área Metropolitana de Buenos Aires, Argentina. El diseño metodológico cualitativo incluyó 43 entrevistas realizadas entre junio de 2019 y marzo de 2020. El andamiaje teórico interpretativo articula tres campos: Comunicación y Salud; Biomedicina, Biopolítica y Tecnologías de Información y Comunicación; Subjetividad, Derechos y Género. Los principales resultados conciernen a cambios en las relaciones médico-paciente, registro y uso de datos, implicancias sobre los derechos y las subjetividades, potencialidades y problemáticas de la informatización en salud en un contexto de precaria infraestructura, desafíos en la regulación y desigualdades estructurales.(AU)

Abstract Digitalization has extended the use of information and communications technologies in the field of health. This article addresses electronic medical records drawing on the criticisms and weaknesses highlighted by clinical specialists, general practitioners, and family doctors working in the metropolitan region of Buenos Aires, Argentina. The qualitative research design included 43 interviews conducted between June 2019 and March 2020. We developed an interpretive framework structured around three categories: communications and health; biomedicine, biopolitics and information and communication technologies; subjectivity, rights and gender. The main results refer to: changes in doctor-patient relations; data recording and usage; implications for rights and subjectivities; potential and challenges of health informatization in a context of precarious infrastructure; and regulatory challenges and structural inequalities.(AU)

Resumo Os processos de digitalização do século XX estenderam o uso das Tecnologias da Informação e Comunicação ao campo da saúde. O artigo aborda o Registro Médico Eletrônico a partir das críticas e fragilidades apontadas por especialistas em Clínica Médica, Medicina Geral e / ou Família da Área Metropolitana de Buenos Aires, Argentina. O desenho metodológico qualitativo incluiu 43 entrevistas realizadas entre junho de 2019 e março de 2020. O referencial teórico interpretativo articula três campos: Comunicação e Saúde; Biomedicina, Biopolítica e Tecnologias de Informação e Comunicação; Subjetividade, Direitos e Gênero. Os principais resultados referem-se a mudanças nas relações médico-paciente, registro e uso de dados, implicações em direitos e subjetividades, potencialidades e problemas de informatização em saúde em um contexto de infraestrutura precária, desafios na regulação e desigualdades estruturais.(AU)

[Contraception and abortion in Argentina: perspective of obstetricians and gynaecologists]. / Anticoncepción y aborto en Argentina: perspectivas de obstetras y ginecólogos.

OBJECTIVE: To explore the role of obstetricians and gynaecologists in reproductive public health policies in Argentina. MATERIAL AND METHODS: Combination of quantitative methods (survey, n=467) and qualitative methods (semistructured interview, n=35; focus groups, n=6). RESULTS: The great majority of respondents believe that abortion and contraception are serious public health issues. Seven out of 10 considered the implementation of family planning services and post-abortion contraceptive counseling to be priorities. One-half favored promoting social debate on abortion. The great majority thought that de-criminalization of abortion would help to diminish maternal mortality and that abortion should not be penalized when the womans life or health is at risk, or in cases of rape or fetal malformations. CONCLUSIONS: Abortion and contraception are important issues for physicians. Advocacy efforts within this community need to focus on an integral vision of health, emphasizing their social responsibility.

El aborto en las trayectorias de mujeres y varones de la ciudad de Buenos Aires / O aborto nas trajetórias de mulheres e homens da cidade de Buenos Aires / Abortion and women and men trajectories in Buenos Aires

Sobre la base de entrevistas a treinta mujeres y treinta varones, residentes en el área metropolitana de Buenos Aires, acerca de sus experiencias de aborto, se reconstruyen trayectorias en las que el aborto constituye un hito. Se concluye que la ilegalidad no influye en la decisión de interrumpir un embarazo, sino en las condiciones diferenciales de su práctica clandestina; que las huellas del aborto marcan diferencialmente a las mujeres, en cuyo cuerpo es practicado, que a los varones, participantes secundarios del proceso, aunque las huellas sean perdurables tanto en mujeres como en varones. Asimismo, se muestra que en las mujeres pobres, al primer embarazo sigue un nacimiento y luego un aborto; que en las clases medias, al primer embarazo sigue el aborto y luego los hijos; y que la eventualidad de interrumpir el embarazo no se plantea sólo en situaciones excepcionales sino que forma parte del proceso desencadenado por la sospecha de un embarazo.

Tendo como base entrevistas feitas com 30 mulheres e 30 homens, residentes na área metropolitana de Buenos Aires, a respeito de suas experiências de aborto, reconstroem-se trajetórias nas quais o aborto constitui um marco. Conclui-se que a ilegalidade não influi na decisão de interromper uma gravidez, mas sim nas condições diferenciais de sua prática clandestina; que os traços do aborto marcam de forma diferente mais as mulheres, em cujo corpo é praticado, do que os homens, participantes secundários do processo, embora as marcas sejam perduráveis tanto em mulheres como em homens. Do mesmo modo, mostra-se que, nas mulheres pobres, à primeira gravidez segue-se um nascimento e depois um aborto; que nas classes médias, à primeira gravidez segue-se o aborto e depois os filhos; e que a eventualidade de interromper a gravidez não se dá só em situações excepcionais, mas sim que faz parte do processo desencadeado pela suspeita de uma gravidez.

This article presents results of the Argentine chapter of the HEXCA research project, on Heterosexualities, Contraception and Abortion in four South American cities. In-depth interviews were conducted with 30 women and 30 men residing in the Buenos Aires metropolitan area, about their experiences of abortion as a landmark in their personal trajectories. Findings show that illegality does not determine the decision to interrupt a pregnancy, but the differential conditions of its clandestine practice; abortion leaves a mark both on women and on men. For low-income women, the first pregnancy results in childbirth, then followed by an abortion; while for middle-class women the first pregnancy results in an abortion, then followed by children. The interruption of a pregnancy is not a response to exceptional situations, but an ordinary part of the process initiated by the suspicion of a pregnancy.

Opiniones y representaciones sociales de varones sobre aborto en Buenos Aires, Argentina / Opiniões e representações sociais de homens sobre aborto em Buenos Aires, Argentina / Men's opinions and social representations about abortion in Buenos Aires, Argentina

Este artículo está basado en una investigación cualitativa cuyo objetivo fue explorar las opiniones de varones de 25 a 39 años de estratos socioeconómicos medios y populares, residentes en el Área Metropolitana de la Ciudad de Buenos Aires, Argentina (n: 30) acerca de la despenalización del aborto y sus representaciones sociales sobre el mismo. Los hallazgos han corroborado resultados previos y han aportado nuevos conocimientos. Se confirmó la ambivalencia de los discursos sobre el aborto, ya que primaron una opinión favorable a su despenalización, y una representación social fundada en un eje moral opuesto al aborto. De los resultados se desprende la necesidad de investigar los puntos de vista de los varones sobre los derechos de mujeres y varones, y de profundizar los sondeos de opinión a través de estudios cualitativos en los que se indaguen sus representaciones sociales en el campo de los derechos sexuales y reproductivos.

Este artigo está baseado em uma investigação qualitativa cujo objetivo foi explorar as opiniões de homens de 25 a 39 anos, de estratos socioeconômicos médios e populares, residentes na Área Metropolitana da Cidade de Buenos Aires, Argentina (n: 30), a respeito da despenalização do aborto e suas representações sociais sobre o mesmo. Os achados corroboraram resultados prévios e contribuíram com novos conhecimentos. Confirmou-se a ambivalência dos discursos sobre o aborto, já que primaram uma opinião favorável à sua despenalização e uma representação social fundada em um eixo moral oposto ao aborto. Dos resultados deduz-se a necessidade de investigar os pontos de vista dos homens sobre os direitos de mulheres e homens, e de aprofundar as sondagens de opinião através de estudos qualitativos nos quais se indague sobre suas representações sociais no campo dos direitos sexuais e reprodutivos.

This article is based on a qualitative study of men's opinions and social representations about abortion, consisting of thirty interviews with men 25 to 39 years old in the city of Buenos Aires, Argentina. The main findings support previous results and provide new knowledge on the subject. They corroborate the ambivalence of discourses on abortion: an opinion in favor of de-criminalizing abortion prevailed, together with a social representation based on the moral opposition to it. In conclusion, there is a need for further studies of men's opinions about women's and men's rights, as well qualitative studies about social representations to complement public opinion surveys in the field of sexual and reproductive rights.

A strategic assessment of the reproductive health and responsible parenthood programme of Buenos Aires, Argentina.

Since 1991, Argentina has had provincial reproductive health laws, a far-reaching national programme and strong public consensus in support of reproductive health policies. Nevertheless, the challenges of strengthening public services, increasing the number of programme sites and resisting conservative attacks remain. This article describes an assessment of the reproductive health programme of the city of Buenos Aires, passed in 2000, whose objectives are to prevent unwanted pregnancies and sexually transmitted diseases/HIV and to train health personnel. The programme operates in every public hospital and primary health care centre in the city. The assessment was conducted jointly by the Ombudsperson's Office of Buenos Aires and the Centre for the Study of State and Society (CEDES). Hormonal contraceptives, IUDs and male condoms were mostly available, but emergency contraception, female condoms and other barrier methods were not Some health professionals and service users were knowledgeable about the new laws and the reproductive rights recognised under the law. Over 90% were satisfied with quality of care in service delivery but many professionals described excessive workloads, deficient infrastructure, and shortages of supplies and staff. Wanting help to obtain a tubal ligation was the most frequent reason for the claims lodged with the Ombudsperson's Office, followed by HIV, quality of care, and abortion. Information and training for both health care providers and women's and human rights NGOs was carried out.

Abortion in a restrictive legal context: the views of obstetrician-gynaecologists in Buenos Aires, Argentina.

In Argentina, unsafe abortions are the primary cause of maternal mortality, accounting for 32% of maternal deaths. During reform of the National Constitution in 1994, the women's movement effectively resisted the reactionary government/church position on abortion. Health professionals, including obstetrician-gynaecologists, played conflicting roles in this debate. This article presents results from a study carried out in 1998-1999 of the views of 467 obstetrician-gynaecologists from public hospitals in Buenos Aires and its Metropolitan Area, focus group discussions with 60 of them, and interviews with heads of department from 36 of the hospitals. The great majority believed abortion was a serious public health issue; that physicians should provide abortions which are not illegal; that abortion should not be penalized to save the woman's life, or in cases of rape or fetal malformations; and that women having illegal abortions and abortion providers should not be imprisoned. Some 40% thought abortion should not be penalized if it is a woman's autonomous decision. Those who were better disposed towards the de-penalization of abortion cited a combination of public health reasons and the need for social equity. The women's health and rights movement should do advocacy work with this professional community on women's needs and rights, given the prominent role they play in reproductive health care provision and in the public sphere.

Anticoncepción y aborto en Argentina: perspectivas de obstetras y ginecólogos / Contraception and abortion in Argentina: perspective of obstetricians and gynaecologists

OBJETIVO: Reflexionar sobre el rol de los tocoginecólogos/as en torno a las políticas públicas en salud reproductiva en Argentina. MATERIAL Y MÉTODOS: Combinación de métodos cuantitativos (encuesta, n=467) y cualitativos (entrevista semiestructurada, n=35; grupos focales, n=6). RESULTADOS: Para los profesionales, el aborto y la anticoncepción son problemas muy relevantes. Siete de 10 otorgaron máxima prioridad a implementar servicios de planificación familiar y consejería anticonceptiva pos-aborto. Uno de 2 propuso promover el debate social sobre aborto. La gran mayoría acordó que despenalizar el aborto contribuiría a disminuir la mortalidad materna y que la ley no debería penalizarlo ante riesgo de vida o salud, violación o incesto y malformación incompatible con la vida extrauterina. CONCLUSIONES: Las cuestiones más críticas del campo de la salud reproductiva forman parte de la agenda de los médicos. Las acciones de abogacía deben profundizar una visión integral de la salud y destacar la responsabilidad social de estos actores.

OBJECTIVE: To explore the role of obstetricians and gynaecologists in reproductive public health policies in Argentina. MATERIAL AND METHODS: Combination of quantitative methods (survey, n=467) and qualitative methods (semistructured interview, n=35; focus groups, n=6). RESULTS: The great majority of respondents believe that abortion and contraception are serious public health issues. Seven out of 10 considered the implementation of family planning services and post-abortion contraceptive counseling to be priorities. One-half favored promoting social debate on abortion. The great majority thought that de-criminalization of abortion would help to diminish maternal mortality and that abortion should not be penalized when the woman’s life or health is at risk, or in cases of rape or fetal malformations. CONCLUSIONS: Abortion and contraception are important issues for physicians. Advocacy efforts within this community need to focus on an integral vision of health, emphasizing their social responsibility.

Índice de estigma en personas que viven con VIH: Argentina, informe ejecutivo 2011

Ante la demanda de la comunidad de personas que viven con VIH exigiendo una transformación social a nivel grlobal, ONUSIDA y sus asociados internacionales ICW Global, IPPF, GNP+ proponen investigar este fenómeno del estigma y la discriminación con información basada en la evidencia para determinar sus causas y percepciones y desarrollar más y mejores intervenciones estructurales basadas en los derechos para reducir la estigmatización y la discriminación. En nuestro país se invita a la Red de Personas Viviendo con VIH/Sida de Mar del Plata y a la Fundación Huesped, para que, potenciando sus capacidades y saberes, tomen a su cargo esta tarea.

Comunicación y salud en la Argentina / Communication and health in Argentina

Contenido: Desafíos de salud publica en la Argentina. La salud en los medios. Comunicación médica institucional. Campañas e intervenciones. Política de salud y comunicación.

Los médicos frente a la anticoncepción y el aborto: ¿una transición ideológica? / Doctors against contraception and abortion: An ideological transition?

En la Argentina, la problemática de la salud reproductiva y de los derechos sexuales y reproductivos atraviesa una transición consistente en el pasaje desde una monolítica situación de restricciones y silencios a otra con mayor visibilidad pública y paulatinos cambios institucionales y programáticos. El análisis de las opiniones de los profesionales directamente involucrados en la prestación de servicios de salud reproductiva de los hospitales públicos resulta altamente relevante en este contexto y es, además, una pieza clave para los cambios normativos y programáticos necesarios. Este libro presenta los resultados de un estudio que generó el primer cuadro de situación acerca de las opiniones sobre la salud reproductiva de los profesionales más directamente vinculados a la atención médica de las mujeres de los sectores urbanos de menores recursos económicos: los tocoginecólogos que se desempeñan en la red asistencial pública de la ciudad de Buenos Aires y de seis partidos del Gran Buenos Aires. El conocimiento producido permitirá contribuir al mejoramiento de la calidad de la atención en salud reproductiva y a la promoción del ejercicio efectivo de los derechos sexuales y reproductivos de la población, y en particular, de las mujeres.