Projeto de apoio e monitoramento de um serviço de referência às unidades de saúde da Atenção Básica na descentralização do atendimento da tuberculose / Project of support and monitoring of a reference service to health care units Primary Care in the decentralization of tuberculosis care

Relatar a experiência do Centro de Referência Estadual para TB do Hospital Sanatório Partenon no desenvolvimento de intervenções de apoio às equipes de saúde da AB que iniciaram suas ações de controle da TB a partir de capacitação teórico-prática para descentralização do atendimento desse agravo. (AU)

Strengthening government management capacity to scale up HIV prevention programs through the use of Technical Support Units: lessons from Karnataka state, India.

Scaling up HIV prevention programming among key populations (female sex workers and men who have sex with men) has been a central strategy of the Government of India. However, state governments have lacked the technical and managerial capacity to oversee and scale up interventions or to absorb donor-funded programs. In response, the national government contracted Technical Support Units (TSUs), teams with expertise from the private and nongovernmental sectors, to collaborate with and assist state governments. In 2008, a TSU was established in Karnataka, one of 6 Indian states with the highest HIV prevalence in the country and where monitoring showed that its prevention programs were reaching only 5% of key populations. The TSU provided support to the state in 5 key areas: assisting in strategic planning, rolling out a comprehensive monitoring and evaluation system, providing supportive supervision to intervention units, facilitating training, and assisting with information, education, and communication activities. This collaborative management model helped to increase capacity of the state, enabling it to take over funding and oversight of HIV prevention programs previously funded through donors. With the combined efforts of the TSU and the state government, the number of intervention units statewide increased from 40 to 126 between 2009 and 2013. Monthly contacts with female sex workers increased from 5% in 2008 to 88% in 2012, and with men who have sex with men, from 36% in 2009 to 81% in 2012. There were also increases in the proportion of both populations who visited HIV testing and counseling centers (from 3% to 47% among female sex workers and from 6% to 33% among men who have sex with men) and sexually transmitted infection clinics (from 4% to 75% among female sex workers and from 7% to 67% among men who have sex with men). Changes in sexual behaviors among key populations were also documented. For example, between 2008 and 2010, the proportion of surveyed female sex workers in 9 districts reporting that they used a condom at last intercourse rose from 60% to 68%; in 6 districts, the proportion of surveyed men who have sex with men reporting that they used a condom at last anal sex increased from 89% to 97%. The Karnataka experience suggests that TSUs can help governments enhance managerial and technical resources and leverage funds more effectively. With careful management of the working and reporting relationships between the TSU and the state government, this additional capacity can pave the way for the government to improve and scale up programs and to absorb previously donor-funded programs.

Defining and assessing evidence for the effectiveness of technical assistance in furthering global health.

In an era when health resources are increasingly constrained, international organisations are transitioning from directly managing health services to providing technical assistance (TA) to in-country owners of public health programmes. We define TA as: 'A dynamic, capacity-building process for designing or improving the quality, effectiveness, and efficiency of specific programmes, research, services, products, or systems'. TA can build sustainable capacities, strengthen health systems and support country ownership. However, our assessment of published evaluations found limited evidence for its effectiveness. We summarise socio-behavioural theories relevant to TA, review published evaluations and describe skills required for TA providers. We explore challenges to providing TA including cost effectiveness, knowledge management and sustaining TA systems. Lastly, we outline recommendations for structuring global TA systems. Considering its important role in global health, more rigorous evaluations of TA efforts should be given high priority.

Instituto Mesoamericano de Salud Pública: órgano de apoyo técnico y fortalecimiento del Sistema Mesoamericano de Salud Pública / Mesoamerican Public Health Institute: Technical support and capacity strengthening arm of the Mesoamerican Public Health System

OBJETIVO: El Instituto Mesoamericano de Salud Pública (IMSP) se constituyó en 2009 como órgano técnico del Sistema Mesoamericano de Salud Pública (SMSP) y la Red Virtual de Instituciones Académicas. En la primera fase se identificaron las necesidades de fortalecimiento de sistemas de salud y se evaluaron los primeros resultados de capacitación. MATERIAL Y MÉTODOS: Se realizó un análisis de contenido de los Planes Maestros del SMSP para cada prioridad y se encuestó a los integrantes del Grupo de Trabajo en Malaria y Dengue. RESULTADOS: Se identificaron los temas de capacitación requeridos por áreas de prioridad del SMSP y las necesidades de gestión de conocimiento para control y eliminación de la malaria y dengue. Se elaboró un mapeo de competencias a desarrollar con el personal estratégico, táctico y operativo. El IMSP capacitó a 91 funcionarios de ocho países en su primer año. Estas actividades se desarrollaron de julio 2009 a junio 2010, en consulta a directivos de servicios de salud de países integrantes del Sistema Mesoamericano de Salud Pública, Colombia y México. CONCLUSIONES: El IMSP está respondiendo a las necesidades de salud pública en la región mesoamericana.

OBJECTIVE: The Mesoamerican Public Health Institute (IMSP) was constituted in 2009 as the technical organ of the Mesoamerican Public Health System (SMSP) and the Virtual Network of Academic Institutions. Health system capacity strengthening needs and preliminary training results were assessed in the first phase. MATERIAL AND METHODS: The SMSP Master Plans were content-analyzed for each priority and members of the Malaria and Dengue Working Group were surveyed. RESULTS: The training needs required for each SMSP priority area were identified and knowledge management needs for malaria and dengue analyzed. Competencies were mapped across strategic, tactical and operative personnel that will be requiring them. IMSP trained in its first year 91 persons in eight countries. CONCLUSIONS: IMSP is responding to the Mesoamerican region's public health needs.

Evaluación de Programas de Recursos Humanos. Organización Panamericana de la salud: Instrumento N° 4 / Evaluation of Human Resources Programs. Pan American Health Organization: Instrument No. 4

En octubre de 2007, en la 27ª. Conferencia Panamericana Sanitaria, la Argentina suscribió (Res. Nro. CSP27/10) las 20 "Metas regionales en materia de Recursos Humanos para la Salud 20072015", organizadas en torno a los cinco grandes desafíos mencionados en la Agenda de Salud para las Américas y en el Llamando a la Acción de Toronto. La contribución de OPS/OMS en sus programas de trabajo bienal, en las líneas prioritarias establecidas, fue dirigida a apoyar la formación de recursos humanos en gestión, Economía y salud, brindar cooperación técnica para la mejora de la gestión, producción y acceso al conocimiento en salud, apoyar la consolidación de la ética en investigación, brindar Cooperación técnica en provisión de cursos virtuales y presenciales para líderes en RRHH y salud internacional, apoyar al fortalecimiento de estadísticas vitales y de salud, al desarrollo del sistema de Información Virtual en el Ministerio de Salud de la Nación y a la implementación del observatorio de recursos humanos de salud.