Manual de organización y funciones de la Unidad Consolidadora de Compras / Organization and functions manual of the Purchasing Consolidation Unit

El presente documento describe los diferentes elementos que componen el Manual de organización y funciones de la Unidad Consolidadora de Compras, el cual tiene como propósito identificar con claridad su misión, visión, objetivos, funciones, organigrama, así como, las relaciones de trabajo internas y externas

This document describes the different elements that make up the Organization and Functions Manual of the Purchasing Consolidation Unit, which aims to clearly identify its mission, vision, objectives, functions, organizational chart, as well as the internal work relationships and external

El metaverso en el mundo de la salud: el futuro presente. Desafíos y oportunidades / The metaverse in the world of health: The present future. Challenges and opportunities

La Organización Mundial de la Salud define la salud digital como la incorporación de tecnologías de información y comunicación para mejorar la salud. En los últimos años, se vio una fuerte aceleración en la adopción de estas herramientas digitales, lo que impactó de lleno en los modelos asistenciales tradicionales. Actualmente, estamos observando el surgimiento de un gran entorno virtual inmersivo llamado metaverso. Su aparición genera nuevas y desafiantes oportunidades en la salud. En este artículo se exploran algunos conceptos relacionados con este campo, se dan ejemplos concretos de su aplicación en pediatría, se mencionan algunas experiencias en el ámbito hospitalario para finalmente adentrarse en los desafíos y oportunidades que emergen.

The World Health Organization has defined "digital health" as the use of information and communication technologies to improve health. In recent years, there has been a strong acceleration in the adoption of these digital tools, which has had a major impact on traditional healthcare models. We are currently witnessing the emergence of a large immersive virtual environment called the "metaverse." Its emergence creates new and challenging opportunities in health care. This article explores some metaverse-related concepts, provides specific examples of its use in pediatrics, describes experiences in the hospital setting, and finally delves into the resulting challenges and opportunities.

Occurrence of high level methicillin resistance Staphylococcus aureusin patients from health facilities in Akwa Ibom State, Nigeria

Background:Methicillin resistant S. aureus(MRSA) has become a major public health predicament worldwide. This is owing to its involvement in the evolution of MDR strains and difficulty in therapeutic management of infected patients. This study was conducted to investigate the prevalence of methicillin resistance Staphylococcus aureusamong patients in two health facilities in Akwa Ibom State, Nigeria.Materials and Methods:Clinical isolates of patients from University of Uyo Teaching Hospital (UUTH), Uyo and General Hospital, Ikot Abasi (GHIA) were investigated based on the strategic location of the hospitals. The study design was a descriptive cross-sectional study. Three hundred clinical samples were collected from male and female in and out-patients of all ages and processed using standard bacteriological methods. Detection of Staphylococcus aureusand MRSAstrains were done according to standard protocols while antibiotic susceptibility testing of MRSAisolates was conducted using Kirby-Bauer disc diffusion method and interpreted following the CLSI 2021 guidelines. Results:The prevalence of MRSAstrains in this study was 42.9%. Majority of patients with MRSAwere from UUTH (44%) closely followed by patients from GHIA(40%). High antibiotics resistant rates of MRSAwere recorded for ampicillin (96.6%), ciprofloxacin (73.3%), erythromycin (63.3%) and cotrimoxazole (60%). Gentamicin and ceftriaxone sensitivity rates were 53.3% and 63.4%, respectively. Conclusion:Health facilities in the state should institute effective antimicrobial stewardship, intensify surveillance and screening of Staphylococcus aureusfor MRSAstrains to guard against dissemination of multidrug resistant strains in both hospital and community settings because of the clinical implications.

Epidemiological analysis of tongue lesions in a tertiary health facility in Tanzania

Background: The tongue is susceptible to a multitude of conditions that can be of developmental, neoplastic, or inflammatory nature, whose occurrence varies globally by age, sex, and ethnicity. The objective of the present study was to determine the incidence of tongue lesions among cases managed in a tertiary hospital in Tanzania. Methods: This study analyzed histological results of patients with tongue lesions diagnosed between 2016 and 2021. Data on the age and sex of the patients and histological diagnosis were collected. Data analysis was done using Statistical Package for the Social Sciences version 27. Results: A total of 190 samples of tongue lesions were studied and 18 different histological diagnoses were observed. Generally, a majority (84.2%) of the biopsied tongue lesions were malignant. The most common (74.7%) lesions diagnosed were squamous cell carcinoma followed by hemangioma (5.3%). A significant association was noted between the nature of the lesions and the age group and sex of the patients. Conclusion: This analysis depicts that tongue lesions are frequently encountered in patients managed in tertiary health facilities in Tanzania. A majority of these lesions are malignant tumors. The sex and age of the patients are determining factors for the occurrence of tongue lesions

Strengthening healthcare through family medicine training in the Gambia: The journey so far

According to the World Health Organizations (WHO) family medicine forms the bedrock upon for accessible, affordable and equitable healthcare for any country. The need for family doctors is more acute for low income countries like The Gambia. More so that The Gambian health infrastructure is suboptimal and appropriate health personnel is low. This is worsened by brain drain leading to poor health indices. Despite these challenges and more, the department of Family Medicine was accredited for training in the Gambia with improved infrastructure (at the training centre), with 7 residents. Though there are still challenges there are also opportunities and strengths. There is therefore hope that the right personnel will be produced for an improved Gambian health system.

Saúde em Dados / Health in data

O Boletim CEInfo "Saúde em Dados" é uma publicação em formato eletrônico com periodicidade anual e de livre acesso editado pela Coordenação de Epidemiologia e Informação (CEInfo) da Secretaria Municipal da Saúde de São Paulo (SMS-SP). O documento é apresentado em dois formatos: uma versão em PDF para consulta e download e outra em formato aberto com conteúdo das diferentes unidades territoriais/administrativas do Município de São Paulo ­ Coordenadoria Regional de Saúde/Supervisão Técnica de Saúde e Subprefeitura. O "Saúde em Dados" foi criado para promover a disseminação de dados sobre nascimentos, mortes e adoecimento da população paulistana, além da estrutura de estabelecimentos/serviços da rede SUS e sua produção assistencial com o objetivo de contribuir com a organização das ações de saúde no Município. Desde 2021, são apresentados os registros de síndrome gripal (SG), síndrome respiratória aguda grave (SRAG) e óbitos decorrentes da pandemia de Covid-19. Na sua 22ª edição, foram incluídos a proporção de nascidos vivos com anomalias congênitas prioritárias segundo definição do Ministério da Saúde, além de alguns agravos de notificação compulsória: doenças e agravos relacionados ao trabalho (DART), acidentes e violências. Os coeficientes foram calculados com a projeção da população residente em 2022 e padronizados por idade com base na população residente de 2020 do Município de São Paulo. Como destaque e a partir desta edição, são apresentados indicadores de mortalidade segundo sexo biológico para as doenças isquêmicas do coração, doenças cerebrovasculares, diabetes mellitus, câncer de pulmão e câncer colorretal. As informações podem ser utilizadas na produção de análises sobre a situação de saúde e de apoio aos gestores, trabalhadores e demais interessados em discutir as ações e políticas de saúde na cidade de São Paulo. Assim qualquer pessoa pode acessar estes conteúdos e utilizá-los com diferentes finalidades e formatos, sendo necessária apenas a preservação da sua origem e citação da fonte. Espera-se que esta publicação cumpra sua finalidade como mais um instrumento público de divulgação de informações de saúde, de apoio aos gestores e à participação social do SUS na cidade de São Paulo.

Estándares de calidad para evaluar establecimientos de salud que brindan servicios de cuidado integral de salud para adolescentes. Norma técnica de salud / Quality standards to evaluate health facilities that provide comprehensive health care services for adolescents. technical health standard

Los estándares de calidad han sido diseñados para ser evaluados mediante un proceso con las siguientes características: i) Evaluación orientada a resultados centrados en el/la usuario/a (adolescentes); ii) evidencias medibles de los procesos y resultados evaluados; iii) flexibilidad para evaluar diversas evidencias que los equipos de salud presenten para demostrar el cumplimiento; y, iv) seguimiento a usuarios/as trazadores/ras. (Anexo N°5 para adolescentes).

Factors associated with utilisation of post abortion care services among women of reproductive age in Nairobi county Kenya

Background: Complications of abortion are a major contributing factor to maternal mortality, especially in Africa. 31% of maternal deaths in Nairobi are attributed to abortions complications. While Post abortion Care (PAC) is a proven approach in addressing mortality and burden of abortion complications, determinants of use among women who need the service, PAC health seeking behaviours, the health systems capacity to provide PAC and experiences of women and providers on PAC is not well documented. This study sought to address this gap. Objective: To determine factors that influence utilization of PAC services among women of reproductive age in Nairobi County. Design: Cross-sectional survey design which employed a quantitative data collection approach. Setting: Mbagathi hospital and Mama Lucy Kibaki hospital. Subjects and Intervention: Women of reproductive age attending reproductive health services at selected health facilities. The intervention was post abortion care. Results: Single women are 62.5% (OR 0.375) less likely to seek PAC services than married women. Prior knowledge of post abortion care (PAC) services is a statistically significant determinant of seeking of PAC services (P <0.05). Women with prior knowledge about post abortion care (PAC) services are twice likely (O.R 2.318) to seek PAC services. Prior experiences, with Gender of health care provider while seeking PAC services (P-Value 0.044), waiting time (0.008) and service affordability (p<0.05) significantly determines whether one seeks PAC services or not. Conclusion: Utilization of PAC services in Nairobi County is determined by experiences, perceptions, as well as individual level factors such as marital status

Midwives' perceptions of and attitudes towards prevention of mother-to-child-transmission of HIV

Background: Prevention of mother-to-child transmission (PMTCT) of HIV services has become an integral part of antenatal services. Prevention of mother-to-child transmission was introduced in all the regions of Ghana, but mother-to-child transmission (MTCT) continued to increase. Objectives: To explore and describe midwives' perceptions and attitudes towards PMTCT of HIV services. Method: Quantitative research approach and descriptive cross-sectional design were used. The population includes all midwives between the ages of 21 and 60 years who work in antenatal care (ANC) clinics in 11 district hospitals in the Central Region of Ghana where the study was conducted. Forty-eight midwives were interviewed using a census sample process. Data were analysed using the Statistical Package for the Social Sciences version 21. Correlation analysis was performed to find the relationships between the attitudes and the perceptions of the midwives on PMTCT of HIV services. Results: Seventy percent of midwives had positive perceptions of PMTCT of HIV services and 85% had positive attitudes towards the provision of PMTCT of HIV services. Midwives were screening all pregnant women who visited the ANCs and referring those who tested positive to other institutions where they can be monitored. Some of the concerns considered were views on retesting HIV-infected pregnant women throughout their pregnancy. There was a positive correlation between attitudes and perceptions of midwives on PMTCT of HIV services. Conclusion: Midwives had positive perceptions and positive attitudes towards the PMTCT of HIV services that they were providing to antenatal attendees. Also, as the attitudes of the midwives towards PMTCT of HIV services improved, their perceptions of PMTCT services also improved. Contribution: Decentralisation of PMTCT of HIV services to community-based health facilities is appropriate to enable sub-district health facilities to test for HIV and provide counselling services to pregnant women.

Pattern of histologic variants of ameloblastoma in a secondary health care facility in Lagos State: A 5-year retrospective study

Background: Ameloblastoma is a benign epithelial odontogenic neoplasm which is common among the dwellers of sub-Saharan Africa. The various histologic types have been elucidated. Aim: This study aimed to assess the prevalent histologic types of ameloblastoma in a Lagos secondary health care facility. Materials and methods: A five-year retrospective review of histopathologically diagnosed slides was done. Data extracted include the age, gender, location, ethnicity, and histologic variants, which were analysed with SPSS version 26. Percentages, ratio, mean, standard deviation were determined, and p-value ⩽ 0.05 was considered significant. Result: A total of 77 histopathologically diagnosed ameloblastoma slides were included in this study. Males were more affected than females in ratio 1.2:1 with the mean age 33.61±13.3. Ameloblastoma was commonest in the third decade of life and more in the mandible than maxilla. The commonest histologic type was the conventional/follicular type which occurred more in males and this was followed by the unicystic/intraluminal type. Conclusion: The commonest histologic variant was the follicular (conventional) and occurred more in males. This was followed by the intraluminal (unicystic) histologic variant that was commoner in females in this Lagos State secondary health care facility.

Compliance and perception towards COVID-19 preventive protocols among hospital staff in a tertiary health facility, Southwest Nigeria

Background: The COVID-19 outbreak response in Nigeria was challenged by the existing weak health sector and the frontline health workers for COVID-19 pandemic response are exposed to the pathogen. One militating factor undermining the control and prevention of COVID-19 in Nigeria was poor compliance to preventive measures. This study assessed the compliance with COVID-19 prevention protocols among healthcare workers in Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Methods: A cross sectional study and subjects were selected through a multi-stage sampling technique. Data collection was done using interviewer-administered semi-structured questionnaire over a period of five months (JuneOctober, 2021). Data was analyzed using IBM, Statistical Package for Social Sciences (SPSS) version 27.0 and p value was set at <0.05 as the threshold for statistical significance. Results: Majority (60.1%), of the respondents got information on COVID-19 protocols through seminars and workshops. However, more than a quarter (28.8%) of the respondents said the use of available PPE was suboptimal. More than one-third, (35.8%), of respondents believe the protocols are too strict. There is, however, good perception (93.3%), but relatively lower compliance (58.7%) of COVID-19 protocols among the staff. Age, marital status and sex were associated with compliance towards COVID-19 protocols in this study (P<0.05). Identified significant predictors (p<0.05) of compliance include age (AOR=1.944), female sex (AOR=7.829). Conclusion: Most respondents had good knowledge of availability, perception of effectiveness, but relatively lower compliance with the COVID-19 protocols in this facility. The government or hospital authority make sure that necessary steps to further boost compliance are taken

Weight bias and stigma in healthcare professionals: a narrative review with a Singapore lens

Addressing weight stigma is essential to obesity management as it causes inequalities in healthcare and impacts the outcomes of health. This narrative review summarises systematic review findings about the presence of weight bias in healthcare professionals, and interventions to reduce weight bias or stigma in these professionals. Two databases (PubMed and Cumulative Index to Nursing and Allied Health Literature [CINAHL]) were searched. Seven eligible reviews were identified from 872 search results. Four reviews identified the presence of weight bias, and three investigated trials to reduce weight bias or stigma in healthcare professionals. The findings may help further research and the treatment, health and well-being of individuals with overweight or obesity in Singapore. Weight bias was prevalent among qualified and student healthcare professionals globally, and there is a lack of clear guidance for effective interventions to reduce it, particularly in Asia. Future research is essential to identify the issues and inform initiatives to reduce weight bias and stigma among healthcare professionals in Singapore.

The correlates of health facility-related stigma and health-seeking behaviors of people living with HIV

Objective@#This study aims to assess the presence of stigma in health facilities and health-seeking behaviors of persons living with HIV (PLHIV).@*Methods@#This study utilized a cross-sectional design employing self-report questionnaires answered online. A total of 100 PLHIV participants were recruited using the respondent-driven sampling method.@*Results@#Results revealed that most participants are young adult men who have been diagnosed with HIV within the last five years. Overall, participants display moderate health-seeking behavior (M = 2.94, SD = 0.54), and moderate experience of health facility-related stigma (M = 2.21, SD = 0.87). Further, there is a negative correlation between age and health-seeking behavior (r = −0.2796, p = 0.049). The type of facility is significantly correlated with HIV stigma (r = 0.4050, p = 0.036).@*Conclusion@#A sustained linkage to care is essential for a PLHIV to remain engaged on his health and well-being. Necessary strategies should be implemented to improve the health-seeking behaviors of PLHIV. Public Rural Health Units are considered to be the most stigmatizing health facility. The presence of health facility-related stigma requires immediate action of the government to reinvigorate these catchment centers as providers of stigma-free and nondiscriminatory primary health care.

Principles of extramural health care for chronic wounds in China / 中华创伤杂志(英文版)

Development of extramural health care for chronic wounds is still in its infancy in China, and thus it is urgent and vital to establish a correct concept and practicable principles. The authors reviewed recent domestic and international literature and summarized the following treatment procedures and principles for extramural health care of chronic wounds. (1) The patient needs to do self-assessment of the wound by using available simple methods; (2) The patient consults with professional physicians or nurses on wound care to define the severity and etiology of the non-healing wound; (3) Professionals evaluate the existing treatment strategies; (4) Etiological treatments are given by professionals; (5) Patients buy needed dressings via the more convenient ways from pharmacies, e-commerce platform or others; (6) Professionals provide a standardized and reasonable therapeutic plan based on the patient's wound conditions; (7) Both professionals and the patient pay attention to complications to prevent adverse outcomes; (8) Professionals strengthen the public education on wound care and integrated rehabilitation. This review expected to provide new perspectives on the therapeutic strategies for chronic wounds in an extramural setting.

O perfil de queixas técnicas relacionadas a equipos comercializados no Brasil e o impacto na segurança do paciente / The profile of technical complaints related to infusion sets sold in Brazil and the impact on patient safety / El perfil de las quejas técnicas relacionadas con los equipos vendidos en Brasil y el impacto en la seguridad del paciente

Equipos são dispositivos médicos que, ao apresentarem desvios de qualidade, podem ocasionar agravos a elevado número de pessoas. Este estudo objetivou avaliar o perfil das notificações de queixas técnicas realizadas no Sistema Notivisa, desenvolvido pela Agência Nacional de Vigilância Sanitária, para discussão sobre o seu impacto na segurança do paciente. Por meio de metodologia quantitativa foram avaliados equipos comercializados no período de 2016 a 2017, cinco anos após a instituição da certificação metrológica compulsória. As principais queixas técnicas se referiram a problemas na integridade (82,70%): defeito mecânico, vazamentos, problemas no corta-fluxo, oclusão de fluido e descolamento, problemas na embalagem ou rotulagem (8,54%) e presença de corpo estranho e sujidades (7,97%). Tais falhas podem interferir nos procedimentos diagnósticos e/ou de tratamento, como a administração de medicamentos quimioterápicos, de antibióticos e também a realização de transfusões. Assim, a tecnovigilância é fundamental para a segurança sanitária no mercado a partir da identificação dos riscos e da possibilidade de mitigá-los, promovendo a segurança do paciente.

Infusion sets are medical devices that, when presenting quality deviations, can cause harm to a large number of people. This study aimed to evaluate the profile of technical complaint notifications made on the Notivisa System, developed by Anvisa ­ Agência Nacional de Vigilância Sanitária (National Agency for Health Surveillance), so as to discuss its impact on patient safety. By means of quantitative methodology, devices sold from 2016 to 2017 was evaluated, five years after the establishment of compulsory metrological certification. The main technical complaints referred to integrity problems (82.70%): mechanical defect, leaks, flow shutdown issues, fluid obstruction and detachment, packaging or labeling problems (8.54%) and presence of foreign bodies and dirt (7.97%). Such failures can interfere with diagnostic and/or treatment procedures such as the administration of chemotherapy drugs, antibiotics and also the transfusion process. Thus, the technovigilance is essential for health safety in the market, based on the identification of risks and the possibility of mitigating them, thus promoting the patient safety.

Los equipos son aparatos médicos quepueden resultar en daños a un gran número de personas por si acaso presentan desviaciones de calidad. El objetivo de esta investigación ha sido evaluar el perfil de notificacio-nes de quejas técnicasregistradas en el Sistema Notivisa, desarrollado por Anvisa ­ Agência Nacional de Vigilância Sanitária (Agencia Nacional de Vigilancia Sanitaria) con miras a la discusión de su impacto en la seguridad del paciente. Valiéndose de la metodología cuantitativa se evaluaron los equipos comercializadosdesde 2016 hasta 2017, que coincide con los cinco años tras la institución de la certificación metrológica obligatoria. Las principales quejas técnicas (82,70%) se refirieron a problemas de integridad: defecto me-cánico, fugas, problemas en el corta flujo oclusión y despegue de fluidos, dificultades en el embalaje o en la rotulación (8,54%) además de la presencia de cuerpo extraño y suciedades (7,97%). Dichos desperfectospueden obstaculizar los procedimientos de diagnóstico y/o de tratamiento, como la administración de fármacos quimioterapéuticos, antibióticos y también la realización de trasfusiones. De ahí que la tecnovi-gilancia sea fundamental para la vigilancia sanitaria en el mercado a partir de la identificación de riesgos sumada a la posibilidad de paliarlos, fomentando la seguridad del paciente.

Recopilación de experiencias exitosas en relación a la atención integral de salud en adolescentes y jóvenes. Documento técnico / Compilation of successful experiences in relation to comprehensive health care in adolescents and young people. Technical document

La publicación describe experiencias exitosas de salud en adolescentes y jóvenes ejecutadas en los establecimientos de salud y otras instituciones con el objetivo de evidenciar, documentar y dar a conocer las experiencias de trabajo que se vienen realizando en nuestro país y que contribuyen con el bienestar de la población adolescente y joven. En total se presentaron al concurso 54 experiencias, de los cuales, a través del cumplimiento de los requisitos establecidos en la base del concurso, sólo 51 experiencias cumplieron los requisitos solicitados, y a través de una rúbrica se calificó y se obtuvo 8 experiencias exitosas ganadoras: 2 experiencias en trabajo en comunidad, 1 experiencia en Talleres, 2 experiencias en trabajos con familias, 1 experiencia en docencia y 2 experiencias en paquete de atención integral de salud

Contigo MINSA. Boletín informativo 2022. Edición 7 / With you MINSA. Newsletter 2022. Edition 7

Desde el 27 de octubre de este año, fecha en que asumimos la gestión, también aceptamos el reto de darle a nuestro Ministerio de Salud (MINSA), un rostro humano, social e inclusivo que permita brindar un servicio digno y de calidad en cada posta, centro de salud y hospital de todo el país. Este compromiso se evidencia, también, en el avance que hemos logrado en los procesos de cambio de grupo ocupacional y de línea de carrera, nombramiento y homologación de los trabajadores de salud, pues reconocemos que la estabilidad laboral del personal es clave para brindar un mejor servicio a la población. Hemos ratificado el compromiso del sector de seguir fortaleciendo el Esquema Regular de Vacunación y contra la COVID-19, así como apoyar a los pacientes oncológicos, lo cual tenemos que abordar mediante un trabajo multisectorial, con planes multianuales para cumplir con los indicadores que hoy se ven trazados con políticas de Estado. Asimismo, conocedores de la realidad del primer nivel de atención y de los hospitales de referencia y apoyo, dotaremos a los establecimientos de salud, de equipamiento y medicamentos necesarios para cerrar las brechas existentes con énfasis en la salud preventiva y el concepto de médico de familia. Por último, reivindicamos el esfuerzo del personal de salud que estuvo en la primera línea de batalla frente a la COVID-19, reafirmando nuestro compromiso de seguir trabajando por el cumplimiento de sus derechos laborales

Lineamientos técnicos para el funcionamiento y la atención en los hogares de espera materna / Technical guidelines for the operation and care in maternity waiting homes

Los presentes Lineamientos técnicos para el funcionamiento y la atención en los hogares de espera materna (HEM), han sido creados para brindar al personal del Sistema Nacional Integrado de Salud, las disposiciones para la atención a las mujeres en etapas de embarazo, puerperio y persona recién nacida a fin de dar cumplimiento a lo establecido en la Ley Nacer con Cariño para un Parto Respetado y un Cuidado Cariñoso y Sensible para el Recién Nacido, en adelante La Ley. Este documento permitirá generar las condiciones para que toda mujer en etapas de embarazo, puerperio y persona recién nacida, pueda tener una experiencia positiva del parto, por medio de una amplia gama de servicios, entre los cuales se encuentra la sensibilización a partir de la preparación prenatal integral, la provisión a la mujer embarazada y su familia de la información necesaria para la búsqueda de atención oportuna en los establecimientos de salud, así como conocer sus derechos y obligaciones

These Technical Guidelines for the operation and care in Maternity Waiting Homes (HEM) have been created to provide the staff of the National Integrated Health System with provisions for care for women in stages of pregnancy, puerperium and person newborn in order to comply with the provisions of the Born with Affection Law for a Respectful Childbirth and Affectionate and Sensitive Care for the Newborn, hereinafter The Law. This document will generate the conditions so that all women in stages of pregnancy, puerperium and newborn person, can have a positive experience of childbirth, through a wide range of services, among which is awareness-raising based on comprehensive prenatal preparation, provision to pregnant women and their families of the necessary information to seek timely care in health facilities, as well as to know their rights and obligations