RESUMEN
Objetivo: Analizar el proceso de implementación de una iniciativa de calidad de atención en el postaborto en tres hospitales de Santiago de Chile para su posterior escalamiento al ámbito nacional. Método: Se efectuó un estudio cualitativo, con base en una revisión documental sustentada en documentos normativos emitidos por el Ministerio de Salud y 23 entrevistas semiestructuradas a tomadores de decisiones, profesionales de salud y usuarias. Se realizó un análisis de contenido usando el programa Atlas-ti 8. Resultados: A nivel normativo, se identificaron acciones relacionadas con la implementación de la iniciativa, y a nivel de proceso se identificaron los aciertos, las dificultades y las resistencias que experimentaron los equipos involucrados en el piloto durante su implementación. A pesar de que la implementación de la iniciativa no fue planificada, tuvo efectos positivos para el bienestar de las mujeres y el desempeño de los profesionales de atención implicados en el proceso. Conclusiones: Esta experiencia es un punto de partida para planear la implementación nacional con base en estrategias bien definidas. Los resultados aportan una experiencia documentada para quienes desean desarrollar iniciativas o programas de atención a mujeres en situación de postaborto.
Objective: To analyze the implementation process of a quality post-abortion care initiative in three hospitals in Santiago de Chile for its subsequent scale up at the national level. Method: A qualitative study was carried out, based on a documentary review supported by governmental normative documents issued by the Ministry of Health and 23 semi-structured interviews with decision-makers, health providers and users. Content analysis was performed using the Atlas-ti 8 software. Results: At the regulatory level, actions related to the implementation of the initiative were identified, and at the process level, the success, difficulties and resistance experienced by the teams involved in the pilot during its implementation were identified. Although the implementation of the initiative was not planned, it had positive effects on the well-being of the women and the performance of the care providers involved in the process. Conclusions: This experience is a starting point to plan implementation at the national level with well-defined strategies. Our results provide a documented experience for those who wish to develop post-abortion care initiatives or programs.
Asunto(s)
Humanos , Femenino , Atención a la Salud/legislación & jurisprudencia , Chile , Estudios de Evaluación como Asunto , Legislación de Dispositivos Médicos/organización & administraciónRESUMEN
OBJECTIVE: Describe the perceptions of key actors regarding the disruption of health services for populations that ceased to be prioritized because of the COVID-19 pandemic-pregnant women, newborn, children, adolescents, and women-in countries of Latin America and the Caribbean (LAC) during the first stage of the pandemic. METHODS: In this cross-sectional study, a 35-question survey was administered to key actors in 19 LAC countries between July and September 2020. The respondents were asked for their personal perceptions regarding the situation of social and health services in their country before and during the pandemic. They were also asked for a projection of the situation during the post-pandemic period. RESULTS: In the 691 responses received, the main perception was that coverage in the services analyzed had been high before the pandemic, although their quality was not as highly rated. Both the coverage and quality of services were thought to have declined for adolescents and women. The majority of respondents predicted that all services will continue to function at lower than usual coverage levels for another three months (53.1%) and another 12 months (41.3%). Guaranteeing coverage and access to health services was considered the main policy challenge going forward. The next most needed initiatives noted were financing for actions to support women, children, and adolescents, and protection against violence and promotion of measures to combat it. CONCLUSIONS: Although the pandemic has struck all countries, its effect on the delivery of services in the populations analyzed differs from country to country and according to the types of service. It is essential to invest in national information systems that will make it possible to monitor the different services and identify the populations that need to be prioritized.
OBJETIVOS: Descrever a percepção de atores-chave na interrupção dos serviços de saúde para populações não priorizadas na pandemia grávidas, recém-nascidos, crianças, adolescentes e mulheres em países da América Latina e do Caribe (ALC) durante a primeira fase da pandemia de COVID-19. MÉTODOS: Estudo transversal. Foi realizada uma pesquisa com atores relevantes de 19 países da ALC entre julho e setembro de 2020, com 35 perguntas sobre a percepção pessoal do estado dos serviços sociais e de saúde em seus países antes e durante a pandemia, bem como uma projeção para depois dela. RESULTADOS: Nas 691 respostas, predominou a percepção de que a cobertura dos serviços analisados era alta antes da pandemia, embora a qualidade fosse vista como mais baixa. Notou-se uma redução na cobertura e na qualidade dos serviços a adolescentes e mulheres. A maioria estimou que todos os serviços seguiriam com uma menor cobertura tanto em 3 como em 12 meses (53,1% e 41,3%, respectivamente). Garantir a cobertura e o acesso aos serviços de saúde é o principal desafio político para o futuro, seguido do financiamento de iniciativas para mulheres, crianças e adolescentes, e da proteção e promoção contra a violência. CONCLUSÕES: Embora a pandemia tenha afetado todos os países, o abalo na provisão de serviços para as populações analisadas é heterogêneo entre os países e os tipos de serviço. É preciso investir em sistemas de informação nacionais que permitam monitorar os distintos serviços e identificar as populações que não foram priorizadas.