Conducta suicida en México: análisis comparativo entre población adolescente y adulta.

OBJETIVO: Estimar la prevalencia nacional de conductas suicidas en población adolescente y adulta, por características sociodemográficas, con los datos de la Encuesta Nacional de Salud y Nutrición (Ensanut 2022). Material y métodos. A partir de la Ensanut 2022 se analizan preguntas similares en adolescentes y adultos relacionadas con pensamiento e intento de suicidio alguna vez en la vida y en los últimos 12 meses. RESULTADOS: El 7.6% de la población adolescente y 7.7% de la población adulta pensó alguna vez en suicidarse. La prevalencia de intento de suicidio alguna vez en la vida fue de 6.5% en adolescentes y 3.5% en adultos, y 3.1% en adolescentes y 0.6% en adultos para los últimos 12 meses. Las mujeres reportaron la mayor prevalencia en comparación con los hombres, tanto en pensamiento como en intentos de suicidio. Conclusión. Los hallazgos refuerzan la importancia de establecer la prevención del suicidio en jóvenes como una prioridad en la agenda nacional de salud.

Vigilancia de la salud de los trabajadores expuestos a plaguicidas en el programa de control de vectores en México.

OBJETIVO: Analizar la interpretación e implementación de las políticas para la vigilancia de la salud de los trabajadores del programa para el control de vectores en México. Material y métodos. Se realizó un estudio transversal con métodos mixtos en cuatro estados de México; se incluyen entrevistas semiestructuradas, recolección de datos sobre los plaguicidas aplicados y los resultados del biomonitoreo realizado a los trabajadores y obtenidos de los registros estatales. Resul-tados. En todos los estados participantes se identificó un uso extensivo y variado de plaguicidas altamente peligrosos. Los procesos para monitorear la exposición ocupacional a inhibidores de acetilcolinesterasa son diferentes en cada uno de ellos y en ninguno se calculan los índices biológicos de ex-posición. CONCLUSIONES: El conocimiento sobre las políticas para vigilar la salud de los trabajadores debe fortalecerse y es necesario mejorar el contenido de las políticas vigentes de modo que abarquen los múltiples plaguicidas que aplican los trabajadores, así como sus posibles efectos combinados y a largo plazo.

Violencia en el hogar contra mujeres adultas durante el confinamiento por la pandemia de Covid-19 en México.

OBJECTIVE: To analyze the prevalence of domestic violence in adult women during confinement derived from the Co-vid-19 pandemic and individual, familiar and communitarian associated factors. MATERIALS AND METHODS: A second-ary analysis was carried out the 2020 National Health and Nutrition Survey on Covid-19, with national representation. A logistic regression model adjusted for the variables of interest was performed. RESULTS: The prevalence was 5.8%. The most reported acts were shouting, insults or threats (4.3%). Most of the women who reported some type of violence in the home had already experienced it before the confinement. Low levels of well-being (OR= 1.96, 95%CI: 1.28,2.99), and living in a home where job was lost due to contingency (OR= 1.96, 95%CI: 1.41,2.73) were associated factors. CONCLUSIONS: In care interventions, it is necessary to take into account factors that deepen the vulnerability of women, such as pre-existing violence and loss of employment.

[Child sexual abuse in Mexico: risk behaviors and mental healthindicators in adolescents]. / Abuso sexual infantil en México:conductas de riesgo e indicadoresde salud mental en adolescentes.

OBJECTIVE: To estimate the prevalence of child sexual abuse (CSA) in adolescent population with National Health and Nutrition Survey 2018-19 data. MATERIALS AND METHODS: Questionnaire for adolescents (10 to 19 years old) was analyzed and carry out a stratified analysis and a logistic regression model adjusted for variables of interest. RESULTS: The prevalence of CSA in adolescent population is 2.5% (3.8% for women and 1.2% for men). Among women, CSA was associated with age, marital status, locality type, excessive alcohol consumption, depressive symptomatol-ogy and suicidal thoughts. Among men, CSA was associated with socioeconomical level, depressive symptomatology and suicidal thoughts. CONCLUSIONS: Studies with greater preci-sion and periodicity as well as access to health and justice services are urgent.

OBJETIVO: Determinar la prevalencia de abuso sexual infantil (ASI) por sexo en adolescentes a partir de la Encuesta Nacio-nal de Salud y Nutrición 2018-19 y analizar las asociaciones con características sociodemográficas, conductas de riesgo e indicadores de salud mental. MATERIAL Y MÉTODOS: Se analizó el cuestionario para población adolescente (10-19 años), se estimaron prevalencias de ASI y se realizó un mo-delo de regresión logística ajustado por variables de interés. Resultados. La prevalencia nacional de ASI es de 2.5% (3.8. RESULTADOS: La prevalencia nacional de ASI es de 2.5% (3.8% mujeres y 1.2% hombres). Entre las mujeres se encontró asociación con la edad, el estado conyugal, el tipo de localidad, el consumo excesivo de alcohol, la sintomatología depresiva y los pensamientos suicidas. Entre los hombres, se encontró asociación con el nivel socioeconómico, la sintomatología depresiva y los pensamientos suicidas. CONCLUSIONES: Es urgente realizar estudios con mayor precisión y periodicidad y garantizar el acceso a los servicios de salud y de justicia posevento.

[Disrespect and abuse during childbirth and abortion in Latin America: systematic review and meta-analysisDesrespeito e maus-tratos durante o parto e o aborto na América Latina: revisão sistemática e meta-análise]. / Irrespeto y maltrato durante el parto y el aborto en América Latina: revisión sistemática y metaanálisis.

OBJECTIVE: This review synthesizes the evidence (quantitative, general, and by typological categories) of disrespect and abuse during childbirth and abortion in health facilities in Latin America and the Caribbean. METHODS: Systematic searches identified 18 primary studies. Q and I2 were calculated, meta-analyses and meta-regressions were performed, and subgroups were analyzed using a DerSimonian and Laird random-effects model grouped by inverse variance and the Freeman-Tukey double arcsine transformation. RESULTS: Studies conducted in five Latin American countries were identified. No studies from the Caribbean were found. The aggregate prevalence of disrespect and abuse during childbirth and abortion was 39%. The aggregated prevalence of the phenomenon in childbirth was 43% and 29% during abortion. The high heterogeneity made it impossible to generate aggregate measures according to typological categories. Nevertheless, the frequencies of specific forms of the phenomenon were grouped typologically. CONCLUSIONS: The evidence suggests that disrespect and abuse during childbirth and abortion care are human-rights and public-health problems that are prevalent in some countries of the Region. It is necessary to reach international consensus on the definition and operationalization of this problem and to develop standardized methods for its measurement. Doing so is essential in order to achieve the targets of the 2030 Agenda related to reducing maternal and newborn morbidity and mortality and eliminating all forms of violence and discrimination against women.

OBJETIVO: Esta revisão sintetiza as evidências quantitativas, gerais e desagregadas por categorias tipológicas do desrespeito e maus-tratos na atenção institucional ao parto e ao aborto na América Latina e Caribe. MÉTODOS: Dezoito estudos primários foram identificados por meio de buscas sistemáticas. Foi feito o cálculo de Q e I2 e realizadas meta-análises, metarregressões e análises de subgrupos com um modelo de DerSimonian e Laird de efeitos aleatórios agrupados com variância inversa e transformação de Freeman-Tukey (duplo arco-seno). RESULTADOS: Foram identificados estudos realizados em cinco países da América Latina. Não foi identificado nenhum estudo no Caribe. Observou-se uma prevalência agregada de 39% de desrespeito e maus-tratos durante o parto e o aborto. A medida agregada para este fenômeno durante o parto foi 43% e a medida agregada nos casos de aborto foi 29%. Devido à alta heterogeneidade, não foi possível gerar medidas agregadas segundo categorias tipológicas. No entanto, são descritas as frequências de formas específicas do fenômeno agrupadas tipologicamente. CONCLUSÕES: As evidências indicam que o desrespeito e os maus-tratos na atenção ao parto e ao aborto são uma questão de direitos humanos e de saúde pública prevalente em alguns países da Região. É preciso chegar a um consenso internacional sobre a definição e a operacionalização deste problema e elaborar métodos padronizados para mensurá-lo. Isso é imprescindível para o alcance das metas da Agenda 2030 relativas à redução da morbidade e mortalidade materna e perinatal e à eliminação de todas as formas de violência e discriminação contra a mulher.

[Challenges and inputs of the gender perspective to the study of vector borne diseases]. / Aportes y desafíos del enfoque de género en el estudio de las enfermedades transmitidas por vector.

The analysis of social determinants and gender within the health-disease-care process is an imperative to understand the variables that define the vulnerability of populations, their exposure risks, the determinants of their care, and the organization and participation in prevention and control programs. Ecohealth incorporates the study of the social determinants and gender perspectives because the emergency of dengue, malaria and Chagas disease are bound to unplanned urbanization, deficient sanitary infrastructure, and poor housing conditions. Gender emerges as an explanatory element of the roles played by men and women in the different scenarios (domestic, communitarian and social) that shape exposure risks to vectors and offer a better perspective of success for the prevention, control and care strategies. The objective is to contribute to the understanding on the gender perspective in the analysis of health risks through a conceptual framework.

[Therapeutic adherence to retraining programs for women and men involved in abusive relationships in Mexico]. / Adherencia terapéutica a programas de reeducación para mujeres y hombres en relaciones de pareja violentas.

OBJECTIVE: To analyze the therapeutic adherence among participants in the retraining program operated by the Ministry of Health of Mexico, in eight states in 2010. MATERIALS AND METHODS: This is a cross-sectional and descriptive study that assesses therapeutic adherence in a retraining intervention program for male perpetrators and female victims of intimate partner violence. The intervention was coordinated by a team of previously trained professionals. The selection of participants was made by means of a specific screening test. Overall performance for both groups was analyzed, and based on the attendance they were classified in low adhesion (1-12) medium to high (13 and>). To determine the possibility of adhesion, Student's t tests, a bivariate analysis, and a logistic regression model were performed for each program. RESULTS: 5 539 screenings were applied, of which 88.3% (n = 4 891) were positive. 85% agreed to participate (n = 4 151), but only 75% of potential participants attended at least one session (n = 3 022). 78.5% attended between 1-12 sessions. In the women's program, significant differences in marital status, religion and age groups (p<0.05) were found. In the program for men, significant differences in religion and age groups (p<0.05) were found. CONCLUSIONS: In the Mexican context there are few studies that assess adherence to programs of care and retraining for partner violence. This study is a first approach that opens the possibility to enhance the design and evaluation of such interventions, which are crucial to dismantle violence against women.

[Dietary changes in Mexican women migrating to the U.S]. / Cambios alimenticios en mujeres morelenses migrantes a Estados Unidos.

OBJECTIVE: To describe the dietary changes and processes involved in the incorporation of new foods, in Mexican women with a migratory experience to the U.S. MATERIAL AND METHODS: A qualitative study was conducted, based on grounded theory, of women who had had a migratory experience and were residing in rural zones of the state of Morelos, Mexico. The data were obtained from 47 in-depth interviews carried out from February, 2005 to July, 2006. RESULTS: The women's diet is modified by the migratory experience and the amount of consumption increases during their stay in the U.S. They continue cooking traditional Mexican meals but incorporate foods from their country of destination. These changes are favored by the greater purchasing power, work-related aspects and availability of products and spaces where food is sold. CONCLUSIONS: We need to go deeper into the relationship between food and migration in the context of Mexico - U.S. - Mexico migration and its impact on women's health. We also need to propose public policies geared towards strengthening healthy habits.

Educational intervention for the control of Aedes aegypti with Wolbachia in Yucatan, Mexico.

The implementation of new control strategies for Aedes aegypti (Ae. Aegpyti), a vector of dengue, chikungunya, and Zika viruses, requires communities to adopt specific behaviors to achieve the success of these innovations. AIM: We evaluated the effect of an educational intervention based on the Precede-Proceed Model (PPM) and the Diffusion of Innovations Theory (DIT) for the control and prevention of diseases transmitted by Ae. aegypti through release of male mosquitoes infected with Wolbachia bacteria in a suburban town in Yucatan, Mexico. MATERIAL AND METHODS: From July 2019 to February 2020, a quasi-experimental study was carried out through an educational intervention (pre- and post-measurements) using quantitative-qualitative techniques, in a Yucatan suburban town where male mosquitoes with Wolbachia were released for the suppression of Ae. aegypti populations. Eleven educational workshops were attended by heads of household (n = 19) and schoolchildren (n = 11). Other 136 heads of household not attending the workshops received information individually. RESULTS: The educational intervention had a significant effect on the mean scores of the contributing and behavioral factors for adoption of innovation (p < 0.05) in the pre- and post-intervention measurements. CONCLUSION: Innovative methods for the control and prevention of diseases related to Aedes aegypti can be strengthened through educational interventions supported by sound methodologies. DESCRIPTORS: Community health education, Aedes aegypti, Wolbachia, Mexico.

Concerted Model of Healthcare for Awá Indigenous of Nariño, Colombia.

Indigenous communities in Colombia are facing a critical health situation; alternative health care models based on the vision of the communities themselves are needed. The objective of this research was to create a health care model that decreases health inequities for the Indigenous Awá population of Nariño, Colombia. This study was guided by the paradigm of community-based participatory action research; the process was carried out in 2015 and 2016. The proposed Intercultural Health Care Model is essentially based on health promotion, disease prevention, community empowerment, social participation in health, decentralized health care and coordination between the two medicines (traditional and allopathic). Strategies such as those reported herein, with concerted efforts rather than imposition, maintain human rights and respect for the sovereignty and autonomy of Indigenous people.

Comparison of suicide attempts among nationally representative samples of Mexican adolescents 12 months before and after the outbreak of the Covid-19 pandemic.

BACKGROUND: There is serious concern over the increase in mental health problems during the coronavirus disease 2019 (Covid-19) pandemic. METHODS: Based on data from two Mexican National Health and Nutrition Surveys conducted in 2018-2019 and 2020 (n = 17,925 and 4,913, respectively), we estimated the prevalence of suicide attempts among adolescents 10-19 years old in the previous year. We constructed a multivariate logistic regression model adjusted by sociodemographic characteristics and contextual variables for the Covid-19 pandemic. RESULTS: The prevalence of suicide attempts in the previous year was similar in both surveys. We found that women, youth in urban localities and individuals living in households where a family member had lost her/his job as a result of the Covid-19 contingency were more likely to attempt suicide compared to their counterparts. On the other hand, attending classes online proved to be a protective factor (aOR=0.3, 95% CI=0.1, 0.8, p = 0.022). LIMITATIONS: The principal limitation of our study concerned the restricted size of our sample for the 2020 survey wave. CONCLUSIONS: Population-level policies aimed at providing economic protection and helping youth to return to school would exert a favorable impact on the mental health and suicidal behavior of youths.

Suicidal behaviour in adolescents: Educational interventions in Mexico.

Suicide in adolescents constitutes a public health problem throughout the world. The objective of this study was to identify the prevalence of suicidal behaviour in a public middle school in Mexico and to implement appropriate educational interventions in the school and community contexts. Our work took place from September 2017 to July 2018. We conducted a quasi-experimental, mixed-methodology study with 12-year-old students in first year of middle school (n = 29), using an educational intervention approach within the frame of the Life Skills Education methodology. We included family members and academic staff in the study with the view of sensitising them to suicidal behaviour. At the community level, we worked with the adolescent and adult populations to form 'gatekeepers' (guardians). We administered a questionnaire on psychosocial indicators of depression and suicide risk to 383 students in their first-to-third years of middle school. Other questionnaires were applied, and life skills focus groups (FGs) were organised with the educational intervention participants. The questionnaires addressed suicidal behaviour in adolescents, alcohol consumption, life skills and prosociality. Prevalence of attempted suicide cases came to 14.1% (95 CI% 10.7-17.9), the average age of those who reported having hurt themselves with the purpose of taking their lives was 12.9 years, 75% of those who had attempted suicide were female and 64.8% had consumed alcohol. The educational intervention with students achieved a statistically significant increase in the life skills of participants, specifically as regards self-awareness and overall scores. The family members in the FGs developed greater awareness of suicidal behaviour, and the adolescents engaged at the community level significantly broadened (p < .05) their knowledge of depression. In developing countries such as Mexico, it is essential not only to increase the number of interventions for preventing suicidal behaviour in adolescents, but also to improve instruments for measuring the extent of the problem.

Comparative Analysis of Lifetime Suicide Attempts among Mexican Adolescents, over the Past 12 Years.

OBJECTIVE: To compare the occurrence of suicide attempts across nationally representative samples of the Mexican adolescent population over the past 12 years, and to analyze its association with sociodemographic, lifestyle and mental-health indicators. METHODOLOGY: Data were drawn from the 2006, 2012 and 2018 National Health and Nutrition Surveys (n = 25,056; 21,509; and 17,925 adolescents, respectively). Estimates were based on standardized measurements. RESULTS: The estimated lifetime prevalence rates of suicide attempts were 1.1% in 2006, 2.7% in 2012, and 3.9% in 2018, indicating a 3.4-fold increase. Across the three survey periods, women yielded rates nearly three times higher than men. Lifetime prevalence grew the most among adolescents aged 13-15 years. Compared to the other respondents, the odds of lifetime suicide attempts proved seven times as high for those who had been sexually abused during their childhood, five times as high for those who had been diagnosed with a depressive disorder, three times as high for those who had suffered physical aggression and twice as high for those who had smoked 100+ cigarettes in their lifetimes and those who consumed alcohol. CONCLUSION: The sharp increase in suicide attempts in Mexico calls for an urgent public-health response via universal and targeted interventions supported by national policy and sustained federal funding.

Living Conditions of Adolescents Who Have Attempted Suicide in Mexico.

Suicidal behavior represents a complex public health problem, with a rising number of suicide attempts registered among Mexican adolescents. We undertook a qualitative study in order to understand the living conditions of adolescents who had attempted to take their lives in five Mexican states. We interviewed 37 adolescents who had engaged in suicide attempts in the year prior to our study. To code and analyze the information, we defined the following three categories of living conditions as social determinants of health for adolescents: poverty and vulnerability, education, and health care. To this end, we followed the methodology proposed by Taylor and Bogdan, and used Atlas.ti 7.5.18 software for analyses. Among our findings, we noted that poverty, manifested primarily as material deprivation, rendered the daily lives of our interviewees precarious, compromising even their basic needs. All the young people analyzed had either received medical, psychological, and/or psychiatric care as outpatients or had been hospitalized. School played a positive role in referring adolescents with suicidal behavior to health services; however, it also represented a high-risk environment. Our findings highlight the urgent need to implement a national intersectoral strategy as part of comprehensive public policy aimed at improving the health of adolescents in Mexico.

Promoting fruit, vegetable and simple water consumption among mothers and teachers of preschool children: An Intervention Mapping initiative.

For preschool children, mothers and teachers are the principal models and promoters of fruit, vegetable and simple water consumption at home and school, respectively. However, the daily intake of these food and drink items falls below recommended standards among Mexican adults, posing a high risk of non-communicable diseases such as overweight and obesity across all age groups in the country. The objective of this article is to describe the design, implementation and evaluation of an educational initiative conducted in a Mexican locality with the aim of promoting the consumption of fruits, vegetables (FVs) and simple water (SW) among preschoolers through the influence of their mothers and teachers. We used the Intervention Mapping methodology with qualitative and quantitative components. Mothers attended eight theoretical and practical sessions and two school meetings, while teachers were offered two workshops. Our results revealed positive changes among both groups: participants took greater interest in healthy nutrition, increased their purchase, preparation and intake of FVs and SW and promoted their consumption. This confirms that it is possible to achieve favorable changes in eating habits among those who participate in educational initiatives in Mexico.

Vigilancia de la salud de los trabajadores expuestos a plaguicidas en el programa de control de vectores en México / Pesticide exposed worker´s health surveillance in the vector control program in Mexico

Resumen: Objetivo: Analizar la interpretación e implementación de las políticas para la vigilancia de la salud de los trabajadores del programa para el control de vectores en México. Material y métodos: Se realizó un estudio transversal con métodos mixtos en cuatro estados de México; se incluyen entrevistas semiestructuradas, recolección de datos sobre los plaguicidas aplicados y los resultados del biomonitoreo realizado a los trabajadores y obtenidos de los registros estatales. Resultados: En todos los estados participantes se identificó un uso extensivo y variado de plaguicidas altamente peligrosos. Los procesos para monitorear la exposición ocupacional a inhibidores de acetilcolinesterasa son diferentes en cada uno de ellos y en ninguno se calculan los índices biológicos de exposición. Conclusiones: El conocimiento sobre las políticas para vigilar la salud de los trabajadores debe fortalecerse y es necesario mejorar el contenido de las políticas vigentes de modo que abarquen los múltiples plaguicidas que aplican los trabajadores, así como sus posibles efectos combinados y a largo plazo.

Abstract: Objective: To analyze the interpretation and implementation of the policies for the worker's health surveillance in the vector control program in Mexico. Materials and methods: We conducted a cross-sectional study in four states of Mexico using mixed methods that include semi-structured interviews, data on pesticides applied and the workers' results for plasmatic acetylcholinesterase activity analysis collected from the states' registries. Results: We identified an extended and varied use of highly hazardous pesticides and different processes to monitor occupational exposure to acetylcholinesterase inhibitors in each state. None of the states calculated biological exposure indices. Conclusions: Knowledge of policies for workers' health surveillance needs to be strengthened and there is an urgent need to enhance the content of the existing policies to include the multiple, combined, and long-term occupational exposure of workers in the vector control program in Mexico.

[Adolescent pregnancy in Mexico: a public health issue]. / Embarazo en la adolescencia en una región de México: un problema de Salud Pública.

Adolescent pregnancy is considered a public health issue by the World Health Organization (WHO) because of the biopsychosocial impact that it has on the health of the mother and the child. Complications during pregnancy and childbirth are the leading cause of death for adolescents in most countries. The lack of health guidance and education is a determining factor for the high number of preterm pregnancies. This paper reviews and analyzes this public health issue considering demographic and reproductive aspects, the institutional programs that have been implemented for its prevention, and its characteristics, risk factors, causes and consequences. Furthermore, it presents a description of the dimensions of adolescent pregnancy, in other words, cultural, psychological, social and educational aspects. Regarding education, different interventions focused on increasing knowledge in the prevention of pregnancy at this age and field of application, and that have been applied to adolescents, are reviewed.

El embarazo en la adolescencia se considera un problema de salud pública por la Organización Mundial de la Salud (OMS) debido a las repercusiones biopsicosociales que tiene en la salud de la madre y del hijo(a). Las complicaciones del embarazo y el parto son la principal causa de muerte de las adolescentes en la mayoría de los países. La falta de orientación y educación en salud es un factor determinante en el alto número de embarazos prematuros. En este ensayo se revisa y analiza este problema de salud pública desde los aspectos demográficos y reproductivos, los programas institucionales que se han implementado para su prevención, se enuncian también las características, factores de riesgo, causas y consecuencias; de igual forma se describen las dimensiones del embarazo en la adolescencia: cultural, psicológica, social y educacional, en esta última además se presenta una revisión de distintas intervenciones educativas que se han empleado con adolescentes enfocadas a incrementar conocimientos en la prevención del embarazo a esta edad y sus ámbitos de aplicación.

Barreras para la atención de las conductas suicidas en Ciudad de México: experiencias del personal de salud en el primer nivel de atención / Barriers to Care of Suicidal Behavior in Mexico City: Health Personnel Experiences at the First Level of Care / Barreiras para a atenção das condutas suicidas na Cidade do México: experiências dos profissionais de saúde na atenção básica

Resumen Objetivo: Identificar las barreras que existen para la atención de las conductas suicidas, desde la perspectiva de las/los profesionales de la salud mental del primer nivel de atención de la Ciudad de México. Metodología: Estudio cualitativo exploratorio, basado en 35 entrevistas semiestructuradas, dirigidas a personal de salud de dos unidades de salud mental de referencia nacional. El análisis de la información se hizo mediante el Framework Analysis. Resultados: Las/los participantes consideraron que las conductas suicidas no han sido definidas como una prioridad dentro de los trastornos de salud mental. La ausencia de políticas públicas, la sobrecarga de trabajo, la falta de seguimiento a las/los pacientes, entre otras, fueron identificadas como barreras para una atención adecuada y oportuna. Conclusiones: Los programas de prevención de las conductas suicidas deben tomar en cuenta el contexto socioeconómico de la población y las características de los servicios de salud, así como las necesidades de las personas prestadoras de servicios de salud. Se requiere ampliar el entrenamiento profesional y mejorar el sistema de referencia y contrarreferencia entre los distintos niveles de atención.

Abstract Objective: To identify the existing barriers to the care of suicidal behavior from the perspective of mental health professionals at the first level of care in Mexico City. Methodology: Qualitative exploratory study based on 35 semi-structured interviews conducted on health personnel from two national reference mental health facilities. The data were analyzed with Framework Analysis. Results: The participants considered that suicidal behavior has not been prioritized among mental health disorders. The absence of public policies, work overload, lack of patient follow-up, among others, were identified as barriers to adequate and timely care. Conclusions: Suicidal behavior prevention programs should consider the socioeconomic context of the population, the characteristics of health services, and the needs of health care providers. Professional training should be enhanced, and the referral and counter-referral system across levels of care should be improved.

Resumo Objetivo: Identificar as barreiras existentes para a atenção das condutas suicidas, desde a perspectiva dos profissionais de saúde mental de atenção básica da Cidade do México. Metodologia: Estudo qualitativo exploratório, baseado em 35 entrevistas semiestruturadas, dirigidas a profissionais de saúde de duas unidades de saúde mental de referência nacional. A análise da informação foi feita através do Framework Analysis. Resultados: Os participantes consideraram que as condutas suicidas não têm sido definidas como uma prioridade dentro dos transtornos de saúde mental. A ausência de políticas públicas, a sobrecarga de trabalho, a falta de seguimento aos pacientes, entre outras, foram identificadas como barreiras para uma atenção adequada e oportuna. Conclusões: Os programas de prevenção das condutas suicidas devem considerar o contexto socioeconômico da população e as características dos serviços de saúde, além das necessidades dos profissionais de saúde. É necessário ampliar o treinamento profissional e melhorar o sistema de referência e contrarreferência entre os diferentes níveis de atenção.

Violencia en el hogar contra mujeres adultas durante el confinamiento por la pandemia de Covid-19 en México / Violence at home against adult women during the confinement by the Covid-19 pandemic in Mexico

Resumen: Objetivo: Analizar la prevalencia de violencia en el hogar y factores individuales, familiares y comunitarios asociados en mujeres adultas durante el confinamiento por Covid-19. Material y métodos: Se realizó un análisis secundario de la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19 con representación nacional. Se utilizó un modelo de regresión logística ajustado por variables de interés. Resultados: La prevalencia fue de 5.8%. Los actos más reportados fueron gritos, insultos o amenazas (4.3%). La mayoría de las mujeres que reportaron cualquiera de los tipos de violencia ya la había experimentado antes del confinamiento. Los niveles bajos de bienestar (RM=1.96, IC95%: 1.28,2.99) y vivir en algún hogar donde se perdió un empleo por la contingencia (RM=1.96, IC95%: 1.41,2.73) resultaron asociados. Conclusiones: En las intervenciones de atención es necesario tomar en cuenta factores que profundizan la vulnerabilidad de las mujeres como la violencia preexistente y la pérdida de empleo.

Abstract: Objective: To analyze the prevalence of domestic violence in adult women during confinement derived from the Covid-19 pandemic and individual, familiar and communitarian associated factors. Materials and methods: A secondary analysis was carried out the 2020 National Health and Nutrition Survey on Covid-19, with national representation. A logistic regression model adjusted for the variables of interest was performed. Results: The prevalence was 5.8%. The most reported acts were shouting, insults or threats (4.3%). Most of the women who reported some type of violence in the home had already experienced it before the confinement. Low levels of well-being (OR= 1.96, 95%CI: 1.28,2.99), and living in a home where job was lost due to contingency (OR= 1.96, 95%CI: 1.41,2.73) were associated factors. Conclusions: In care interventions, it is necessary to take into account factors that deepen the vulnerability of women, such as pre-existing violence and loss of employment.