ABSTRACT
El quehacer del profesional de la medicina ha evolucionado de tal manera que progresiva-mente se ha ido incorporando a otros campos del conocimiento y a otros desempeños, entre ellos la investigación comunitaria, el desarrollo de programas para la promoción de la salud y prevención de la enfermedad, la administración pública, el desarrollo sostenible y la construcción de políticas públicas. Ese desempeño, sumado a su labor como clínico, se enmarca en la situación actual del país con crisis gubernamental, institucional y social; con descenso ostensible de la calidad de vida, a pesar del aumento en su cantidad (esperanza de vida), y ensanchamiento de la brecha de pobreza y de las iniquidades; con debilitamiento de la familia; con generalización del conflicto arma-do; con persistencia de otras formas de violencia; con dificultades en el acceso a los servicios, y con enfermedades endémicas y emergentes.
The work of the medical professional has evolved in such a way that he/she has been progressively incorporated into other fields of knowledge and other activities, including community research, development of programs for health promotion and disease prevention, public administration, sustainable development and the construction of public policies. This performance, added to his work as a clinician, is framed in the current situation of the country with governmental, institutional and social crisis; with ostensible decrease in the quality of life, despite the increase in its quantity (life expectancy), and widening of the poverty gap and iniquities; with weakening of the family; with generalization of armed conflict; with persistence of other forms of violence; with difficulties in access to services, and with endemic and emerging diseases
Subject(s)
Humans , Schools, Medical , Health Sciences , Public Policy , Students, Medical , Child , Sustainable Development , Health PromotionABSTRACT
INTRODUCTION: A national initiative on reduction of HIV mother-to-child-transmission is being implemented since 2003 in Colombia, including HIV counseled and voluntary testing as part of the routine antenatal care, comprehensive care with ARV treatment to HIV-positive pregnant women and their infected children, caesarian delivery, and replacement of breast milk. OBJECTIVE: To describe the achievements in the implementation of the prevention strategy of mother-to-child HIV transmission, 2003-2005. MATERIALS AND METHODS: The implementation procedures of the Project are described, as well as the coverage percentages achieved, the prevention of vertical transmission and its associated factors, and the six-month prevalence by geographical departments. The probability of transmission adjusted to the ARV treatment offered and the differences by regions are also analyzed. RESULTS: The Project was implemented in 757 municipalities (68%); diagnostic tests were performed to 200,853 pregnant women, 377 of whom were diagnosed as HIV positive (0.19%), with higher prevalences in the Caribbean region, and in the Departments of Quindio and Santander. Complete six-month follow-up after delivery was provided to 285 women and their neonates (12 of whom were HIV-positive). The probability of transmission with the use of ARV schemes during pregnancy (n=170) was 1.78% (IC 95%: 0.37-5.13%). Factors related to probability of transmission were: initial viral load > 10,000/mm3, absence of antenatal care, and late recruitment of pregnant women. No statistical differences were found between the ARV schemes used. In the Caribbean region, antenatal care was lower, and late recruitment of pregnant women was higher. CONCLUSIONS: Reduction of HIV mother-to-child-transmission is an effective preventive intervention, which also strengthens the quality of antenatal care services. Sustainability of this initiative, with nationwide coverage, must be a target for national and regional public health authorities, and for health care providers.