RESUMO
BACKGROUND: Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save--through early response activities--resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. METHODS: Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. RESULTS: Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems.The country case studies--conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the different cost components (vector control; surveillance; information, education and communication; direct medical and indirect costs), as percentage of total costs, differed across the respective countries. Resources used for dengue disease control and treatment were country specific. CONCLUSIONS: The evidence so far collected further confirms the methodological challenges in this field: 1) to define technically dengue outbreaks (what do we measure?) and 2) to measure accurately the costs in prospective field studies (how do we measure?). Currently, consensus on the technical definition of an outbreak is sought through the International Research Consortium on Dengue Risk Assessment, Management and Surveillance (IDAMS). Best practice guidelines should be further developed, also to improve the quality and comparability of cost study findings. Modelling the costs of dengue outbreaks and validating these models through field studies should guide further research.
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Efeitos Psicossociais da Doença , Dengue/economia , Surtos de Doenças/economia , Análise Custo-Benefício , Dengue/epidemiologia , Dengue/prevenção & controle , Surtos de Doenças/prevenção & controle , República Dominicana/epidemiologia , Humanos , Indonésia/epidemiologia , Peru/epidemiologia , Vietnã/epidemiologiaRESUMO
BACKGROUND: The increasing frequency and intensity of dengue outbreaks in endemic and non-endemic countries requires a rational, evidence based response. To this end, we aimed to collate the experiences of a number of affected countries, identify strengths and limitations in dengue surveillance, outbreak preparedness, detection and response and contribute towards the development of a model contingency plan adaptable to country needs. METHODS: The study was undertaken in five Latin American (Brazil, Colombia, Dominican Republic, Mexico, Peru) and five in Asian countries (Indonesia, Malaysia, Maldives, Sri Lanka, Vietnam). A mixed-methods approach was used which included document analysis, key informant interviews, focus-group discussions, secondary data analysis and consensus building by an international dengue expert meeting organised by the World Health Organization, Special Program for Research and Training in Tropical Diseases (WHO-TDR). RESULTS: Country information on dengue is based on compulsory notification and reporting ("passive surveillance"), with laboratory confirmation (in all participating Latin American countries and some Asian countries) or by using a clinical syndromic definition. Seven countries additionally had sentinel sites with active dengue reporting, some also had virological surveillance. Six had agreed a formal definition of a dengue outbreak separate to seasonal variation in case numbers. Countries collected data on a range of warning signs that may identify outbreaks early, but none had developed a systematic approach to identifying and responding to the early stages of an outbreak. Outbreak response plans varied in quality, particularly regarding the early response. The surge capacity of hospitals with recent dengue outbreaks varied; those that could mobilise additional staff, beds, laboratory support and resources coped best in comparison to those improvising a coping strategy during the outbreak. Hospital outbreak management plans were present in 9/22 participating hospitals in Latin-America and 8/20 participating hospitals in Asia. CONCLUSIONS: Considerable variation between countries was observed with regard to surveillance, outbreak detection, and response. Through discussion at the expert meeting, suggestions were made for the development of a more standardised approach in the form of a model contingency plan, with agreed outbreak definitions and country-specific risk assessment schemes to initiate early response activities according to the outbreak phase. This would also allow greater cross-country sharing of ideas.
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Dengue/epidemiologia , Surtos de Doenças , Ásia/epidemiologia , Medicina Baseada em Evidências , Humanos , América Latina/epidemiologia , Modelos Estatísticos , Vigilância da População/métodos , Medição de RiscoAssuntos
Infecção por Zika virus/epidemiologia , América/epidemiologia , Brasil/epidemiologia , Viroses do Sistema Nervoso Central/epidemiologia , Viroses do Sistema Nervoso Central/prevenção & controle , Comportamento Ritualístico , Surtos de Doenças , Feminino , Humanos , Islamismo , Microcefalia/epidemiologia , Microcefalia/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Saúde Pública , Arábia Saudita , Esportes , Viagem , Infecção por Zika virus/prevenção & controleAssuntos
Surtos de Doenças , Islamismo , Esportes , Viagem , Vacinas Virais/administração & dosagem , Vacinas Virais/provisão & distribuição , Febre Amarela/epidemiologia , Febre Amarela/prevenção & controle , África Ocidental/epidemiologia , China/epidemiologia , Surtos de Doenças/prevenção & controle , Saúde Global , Humanos , Oriente Médio , Febre Amarela/transmissãoRESUMO
BACKGROUND: Early warning systems (EWSs) are of increasing importance in the context of outbreak-prone diseases such as chikungunya, dengue, malaria, yellow fever, and Zika. A scoping review has been undertaken for all 5 diseases to summarize existing evidence of EWS tools in terms of their structural and statistical designs, feasibility of integration and implementation into national surveillance programs, and the users' perspective of their applications. METHODS: Data were extracted from Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Latin American and Caribbean Health Sciences Literature (LILACS), PubMed, Web of Science, and WHO Library Database (WHOLIS) databases until August 2019. Included were studies reporting on (a) experiences with existing EWS, including implemented tools; and (b) the development or implementation of EWS in a particular setting. No restrictions were applied regarding year of publication, language or geographical area. FINDINGS: Through the first screening, 11,710 documents for dengue, 2,757 for Zika, 2,706 for chikungunya, 24,611 for malaria, and 4,963 for yellow fever were identified. After applying the selection criteria, a total of 37 studies were included in this review. Key findings were the following: (1) a large number of studies showed the quality performance of their prediction models but except for dengue outbreaks, only few presented statistical prediction validity of EWS; (2) while entomological, epidemiological, and social media alarm indicators are potentially useful for outbreak warning, almost all studies focus primarily or exclusively on meteorological indicators, which tends to limit the prediction capacity; (3) no assessment of the integration of the EWS into a routine surveillance system could be found, and only few studies addressed the users' perspective of the tool; (4) almost all EWS tools require highly skilled users with advanced statistics; and (5) spatial prediction remains a limitation with no tool currently able to map high transmission areas at small spatial level. CONCLUSIONS: In view of the escalating infectious diseases as global threats, gaps and challenges are significantly present within the EWS applications. While some advanced EWS showed high prediction abilities, the scarcity of tool assessments in terms of integration into existing national surveillance systems as well as of the feasibility of transforming model outputs into local vector control or action plans tends to limit in most cases the support of countries in controlling disease outbreaks.
Assuntos
Infecções por Vírus de RNA/epidemiologia , Humanos , Vigilância da População/métodos , Medição de RiscoRESUMO
Short administration periods of a health ministry can jeopardize the implementation and effectiveness of state policies due to changes in management orientation, altering the natural learning process, or other factors. The aim of this article was to determine and compare the tenure length of the ministry of health in Peru, describe its characteristics and discuss its relationship with public health achievements. Between 1935 and 2021, the average tenure was of 13,7 months and the median was 11 months, the longest was found to be 67 months, by Constantino Carvallo, and the shortest was one day, by Javier Correa. The length of ministerial tenure in Peru has a wide range of variation (1 day up to 67 months), it is shorter compared to that of other countries and is decreasing since 2016. Although longer tenures would not be sufficient to guarantee health achievements, it might contribute to the sustainability of health-related actions and have a positive effect on long-term policies.
Los periodos breves en la gestión de un ministerio de salud pueden poner en riesgo la implementación y la efectividad de políticas de Estado por cambios en la orientación de la gestión, por un proceso natural de aprendizaje, o por otros factores. El propósito de este artículo fue determinar y comparar la duración de la gestión ministerial en salud en Perú, describir sus características y discutir su relación con los logros en salud pública. Entre 1935 y 2021, la media de duración de la gestión fue de 13,7 meses y la mediana fue de 11 meses, siendo la más extensa de 67 meses, de Constantino Carvallo, y la más breve de un día, de Javier Correa. La duración de la gestión ministerial en el Perú tiene un amplio rango de variación (1día hasta 67 meses), es menor comparada con la de otros países, y está disminuyendo desde el 2016. Si bien, una duración mayor a la encontrada no sería suficiente para garantizar los logros en salud, podría contribuir en el sostenimiento de las acciones de salud y tener un efecto positivo en las políticas de largo plazo.
Assuntos
Saúde Pública , PeruRESUMO
The relentless spread of coronavirus disease 2019 (COVID-19) and its penetration into the least developed, fragile, and conflict-affected countries (LDFCAC) is a certainty. Expansion of the pandemic will be expedited by factors such as an abundance of at-risk populations, inadequate COVID-19 mitigation efforts, sheer inability to comply with community mitigation strategies, and constrained national preparedness. This situation will reduce the benefits achieved through decades of disease control and health promotion measures, and the economic progress made during periods of global development. Without interventions, and as soon as international travel and trade resume, reservoirs of COVID-19 and other vaccine-preventable diseases in LDFCAC will continue 'feeding' developed countries with repeated infection seeds. Assuring LDFCAC equity in access to medical countermeasures, funds to mitigate the pandemic, and a paradigm change in the global development agenda, similar to the post-World War II Marshall Plan for Europe, are urgently needed. We argue for a paradigm change in strategy, including a new global pandemic financing mechanism for COVID-19 and other future pandemics. This approach should assist LDFCAC in gaining access to and membership of a global interdisciplinary pandemic taskforce to enable in-country plans to train, leverage, and maintain essential functioning and also to utilize and enhance surveillance and early detection capabilities. Such a task force will be able to build on and expand research into the management of pandemics, protect vulnerable populations through international laws/treaties, and reinforce and align the development agenda to prevent and mitigate future pandemics. Lifting LDFCAC from COVID-related failure will offer the global community the best economic dividends of the century.
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COVID-19/prevenção & controle , SARS-CoV-2 , Comitês Consultivos , Países em Desenvolvimento , Saúde Global , HumanosRESUMO
The COVID-19 pandemic can no longer be mitigated by a nationwide approach of individual nations alone. Given its scale and accelerating expansion, COVID-19 requires a coordinated and simultaneous Whole- of-World approach that galvanizes clear global leadership and solidarity from all governments of the world. Considering an 'all hands-on deck' concept, we present a comprehensive list of tools and entities responsible for enabling them, as well a conceptual framework to achieve the maximum impact. The list is drawn from pandemic mitigation tools developed in response to past outbreaks including influenza, coronaviruses, and Ebola, and includes tools to minimize transmission in various settings including person-to-person, crowd, funerals, travel, workplace, and events and gatherings including business, social and religious venues. Included are the roles of individuals, communities, government and other sectors such as school systems, health, institutions, and business. While individuals and communities have significant responsibilities to prevent person-to-person transmission, other entities can play a significant role to enable individuals and communities to make use of the tools. Historic and current data indicate the role of political will, whole-of-government approach, and the role of early introduction of mitigation measures. There is also an urgent need to further elucidate the immunologic mechanisms underlying the epidemiological characteristics such as the low disease burden among women, and the role of COVID-19 in inducing Kawasaki-like syndromes in children. Understanding the role of and development of anti-inflammatory strategies based on our understanding of pro-inflammatory cytokines (IL1, IL-6) is also critical. Similarly, the role of oxygen therapy as an anti-inflammatory strategy is evident and access to oxygen therapy should be prioritized to avoid the aggravation of COVID-19 infection. We highlight the need for global solidarity to share both mitigation commodities and infrastructure between countries. Given the global reach of COVID-19 and potential for repeat waves of outbreaks, we call on all countries and communities to act synergistically and emphasize the need for synchronized pan-global mitigation efforts to minimize everyone's risk, to maximize collaboration, and to commit to shared progress.
Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , COVID-19 , Surtos de Doenças , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2RESUMO
Infectious disease outbreaks pose major threats to human health and security. Countries with robust capacities for preventing, detecting and responding to outbreaks can avert many of the social, political, economic and health system costs of such crises. The Global Health Security Index (GHS Index)-the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries-recently found that no country is sufficiently prepared for epidemics or pandemics. The GHS Index can help health security stakeholders identify areas of weakness, as well as opportunities to collaborate across sectors, collectively strengthen health systems and achieve shared public health goals. Some scholars have recently offered constructive critiques of the GHS Index's approach to scoring and ranking countries; its weighting of select indicators; its emphasis on transparency; its focus on biosecurity and biosafety capacities; and divergence between select country scores and corresponding COVID-19-associated caseloads, morbidity, and mortality. Here, we (1) describe the practical value of the GHS Index; (2) present potential use cases to help policymakers and practitioners maximise the utility of the tool; (3) discuss the importance of scoring and ranking; (4) describe the robust methodology underpinning country scores and ranks; (5) highlight the GHS Index's emphasis on transparency and (6) articulate caveats for users wishing to use GHS Index data in health security research, policymaking and practice.
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Saúde Global , Medidas de Segurança/organização & administração , Benchmarking/organização & administração , Betacoronavirus , COVID-19 , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Humanos , Liderança , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , SARS-CoV-2RESUMO
OBJECTIVES.: To determine the ratio of microcephaly in newborns in level II and III health facilities of the Ministry of Health (MINSA) of Peru for the period 2005-2013. MATERIALS AND METHODS.: A secondary analysis of the databases of the Perinatal Information System was carried out during 2005-2013. Microcephaly was identified applying World Health Organization (WHO), Fenton, mixed (WHO-Fenton), and proportionality criteria. The ratios and indices of microcephaly were estimated per 10,000 live births (LB) by region and concordance was compared, using the WHO parameter as a reference. RESULTS.: The ratio of microcephaly during 2005 to 2013 was 3.4%, the average rate of microcephaly was 335 per 10,000 LBs according to the WHO criterion. The mixed parameter showed a substantial concordance (Kappa of 0.635), while the proportionality parameter showed a reasonable concordance (Kappa of 0.298). CONCLUSIONS.: The ratio of microcephaly in MINSA Level II and III health facilities was higher than that reported in other countries in the region before the appearance of Zika in the Americas. The frequency variations observed with those of other countries and among Peruvian regions could be explained by different factors, such as the technique for measuring head circumference, data capture, constitutional factors, and social determinants. We suggest standardizing measurements and their recording, harmonizing diagnostic criteria, and establishing health strategies to strengthen the epidemiological surveillance of the causes of microcephaly.
OBJETIVOS.: Determinar la proporción de microcefalia en recién nacidos en establecimientos de salud (EESS) de nivel II y III del Ministerio de Salud (MINSA) de Perú durante el periodo 2005-2013. MATERIALES Y MÉTODOS.: Se realizó un análisis secundario de las bases de datos del Sistema Informático Perinatal durante 2005-2013. La identificación de microcefalia se realizó aplicando los criterios de la Organización Mundial de la Salud (OMS), de Fenton, mixto (OMS-Fenton) y de proporcionalidad. Se estimaron las proporciones y tasas de microcefalia por 10 000 nacidos vivos (NV) por regiones y se comparó la concordancia, considerando al parámetro de OMS como referencia. RESULTADOS.: La proporción de microcefalia durante el 2005 a 2013 fue de 3,4%, la tasa promedio de microcefalia fue de 335 por 10 000 NV según el criterio de OMS. El parámetro mixto mostró una concordancia sustancial (Kappa de 0,635), mientras que el de proporcionalidad mostró una concordancia razonable (Kappa de 0,298). CONCLUSIONES.: La proporción de microcefalia en EESS de nivel II y III del MINSA fue mayor a lo reportado en otros países de la región antes de la aparición del Zika en las Américas. Las variaciones de las frecuencias observadas con las de otros países y entre las regiones peruanas, se podrían explicar por diferentes factores, como la técnica de medición del perímetro cefálico, captura de datos, factores constitucionales y determinantes sociales. Sugerimos estandarizar las mediciones y su registro, uniformizar los criterios de diagnóstico y establecer las estrategias sanitarias para fortalecer la vigilancia epidemiológica de las causas de la microcefalia.
Assuntos
Microcefalia/epidemiologia , Infecção por Zika virus/epidemiologia , Adulto , Feminino , Cabeça/anatomia & histologia , Humanos , Recém-Nascido , Masculino , Peru/epidemiologia , Gravidez , Determinantes Sociais da Saúde , Adulto JovemRESUMO
Biosecurity and biosafety measures are designed to mitigate intentional and accidental biological risks that pose potentially catastrophic consequences to a country's health system, security, and political and economic stability. Unfortunately, biosecurity and biosafety are often under-prioritized nationally, regionally, and globally. Security leaders often deemphasize accidental and deliberate biological threats relative to other challenges to peace and security. Given emerging biological risks, including those associated with rapid technological advances and terrorist and state interest in weapons of mass destruction, biosecurity deserves stronger emphasis in health and security fora. The Global Biosecurity Dialogue (GBD) was initiated to align national and regional donor initiatives toward a common set of measurable targets. The GBD was launched by the Nuclear Threat Initiative (NTI), with support from Global Affairs Canada's Weapons Threat Reduction Program and the Open Philanthropy Project, and in coordination with the government of The Netherlands as the 2018-19 Chair of the Global Health Security Agenda (GHSA) Action Package Prevent-3 (APP3) on Biosafety and Biosecurity. The GBD provides a multisectoral forum for sharing models, enabling new actions to achieve biosecurity-related targets, and promoting biosecurity as an integral component of health security. The GBD has contributed to new national and continent-wide actions, including the African Union and Africa Centres for Disease Control and Prevention's new regional Initiative to Strengthen Biosafety and Biosecurity in Africa. Here we present the GBD as a model for catalyzing action within APP3. We describe how the benefits of this approach could expand to other GHSA Action Packages and international health security initiatives.
Assuntos
Bioterrorismo/prevenção & controle , Contenção de Riscos Biológicos/métodos , Surtos de Doenças/prevenção & controle , Saúde Global , Cooperação Internacional , Medidas de Segurança/organização & administração , Fortalecimento Institucional/métodos , Fortalecimento Institucional/organização & administração , Política de Saúde , HumanosRESUMO
BACKGROUND: Research has been conducted on interventions to control dengue transmission and respond to outbreaks. A summary of the available evidence will help inform disease control policy decisions and research directions, both for dengue and, more broadly, for all Aedes-borne arboviral diseases. METHOD: A research-to-policy forum was convened by TDR, the Special Programme for Research and Training in Tropical Diseases, with researchers and representatives from ministries of health, in order to review research findings and discuss their implications for policy and research. RESULTS: The participants reviewed findings of research supported by TDR and others. Surveillance and early outbreak warning. Systematic reviews and country studies identify the critical characteristics that an alert system should have to document trends reliably and trigger timely responses (i.e., early enough to prevent the epidemic spread of the virus) to dengue outbreaks. A range of variables that, according to the literature, either indicate risk of forthcoming dengue transmission or predict dengue outbreaks were tested and some of them could be successfully applied in an Early Warning and Response System (EWARS). Entomological surveillance and vector management. A summary of the published literature shows that controlling Aedes vectors requires complex interventions and points to the need for more rigorous, standardised study designs, with disease reduction as the primary outcome to be measured. House screening and targeted vector interventions are promising vector management approaches. Sampling vector populations, both for surveillance purposes and evaluation of control activities, is usually conducted in an unsystematic way, limiting the potentials of entomological surveillance for outbreak prediction. Combining outbreak alert and improved approaches of vector management will help to overcome the present uncertainties about major risk groups or areas where outbreak response should be initiated and where resources for vector management should be allocated during the interepidemic period. CONCLUSIONS: The Forum concluded that the evidence collected can inform policy decisions, but also that important research gaps have yet to be filled.
Assuntos
Infecções por Arbovirus/prevenção & controle , Infecções por Arbovirus/transmissão , Surtos de Doenças/prevenção & controle , Projetos de Pesquisa , Aedes/virologia , Animais , Dengue/prevenção & controle , Saúde Global , Planejamento em Saúde , Humanos , Insetos Vetores , Vigilância da População , Medição de Risco , Fatores de RiscoRESUMO
BACKGROUND: Extensive uptake of mobile phones offers an unprecedented opportunity to improve global healthcare delivery, especially among underserved populations. Mobile health (mHealth) has been increasingly recognized as a promising approach to addressing challenges in global maternal-child health and may play an important role in accelerating progress towards improved outcomes. However, more evidence guiding development of mHealth interventions is needed. The current study explores factors that may support or hinder adoption and use of a proposed mHealth intervention to improve caregiver home management of common childhood illnesses in order to shape program development. METHODS: Elicitation interviews were conducted with a convenience sample of 25 mothers recruited from a larger cluster-randomized survey sample in the Cono Norte region of Arequipa, Peru. Interview data were analyzed in Spanish to preserve important cultural nuances. RESULTS: Thematic analysis revealed potential facilitators of and barriers to uptake of the proposed mHealth program. Potential facilitators of caregiver participation include opportunity to engage in two-way communication with healthcare providers, development of instrumental and support knowledge to care for sick children, and healthcare challenges faced in a resource-poor community. Potential barriers include preference for in-person healthcare visits, program cost, text messaging abilities, and concern around program legitimacy. CONCLUSIONS: This study underscores the potential for mHealth to improve global healthcare delivery in the area of maternal-child health. It demonstrates that mHealth interventions can meet the needs of vulnerable populations by offering novel approaches to promoting evidence-based care. This in-depth understanding of factors that may influence participation and use of this proposed mHealth program will help shape development of the intervention in this community.
RESUMO
This article describes the concept of global health security and its development over time. It emphasizes the need to control challenges against global health such as those produced by biologic agents both natural and intentional. It presents world initiatives that have developed during the last two decades and the contribution of Peru to the Global Health Security Agenda (GHSA) and the Monitoring and Evaluation Framework. In order to accelerate the implementation of the International Health Regulations Peru has played an important role to accelerate the implementation of International Health Regulations (IHR), participating with a group of countries, World Health Organization (WHO), and GHSA in the creation of the Joint External Evaluation Tool (JEE).
Assuntos
Surtos de Doenças , Saúde Global , Cooperação Internacional , Humanos , Peru , Organização Mundial da SaúdeRESUMO
Los periodos breves en la gestión de un ministerio de salud pueden poner en riesgo la implementación y la efectividad de políticas de Estado por cambios en la orientación de la gestión, por un proceso natural de aprendizaje, o por otros factores. El propósito de este artículo fue determinar y comparar la duración de la gestión ministerial en salud en Perú, describir sus características y discutir su relación con los logros en salud pública. Entre 1935 y 2021, la media de duración de la gestión fue de 13,7 meses y la mediana fue de 11 meses, siendo la más extensa de 67 meses, de Constantino Carvallo, y la más breve de un día, de Javier Correa. La duración de la gestión ministerial en el Perú tiene un amplio rango de variación (1día hasta 67 meses), es menor comparada con la de otros países, y está disminuyendo desde el 2016. Si bien, una duración mayor a la encontrada no sería suficiente para garantizar los logros en salud, podría contribuir en el sostenimiento de las acciones de salud y tener un efecto positivo en las políticas de largo plazo.
Short administration periods of a health ministry can jeopardize the implementation and effectiveness of state policies due to changes in management orientation, altering the natural learning process, or other factors. The aim of this article was to determine and compare the tenure length of the ministry of health in Peru, describe its characteristics and discuss its relationship with public health achievements. Between 1935 and 2021, the average tenure was of 13,7 months and the median was 11 months, the longest was found to be 67 months, by Constantino Carvallo, and the shortest was one day, by Javier Correa. The length of ministerial tenure in Peru has a wide range of variation (1 day up to 67 months), it is shorter compared to that of other countries and is decreasing since 2016. Although longer tenures would not be sufficient to guarantee health achievements, it might contribute to the sustainability of health-related actions and have a positive effect on long-term policies.
RESUMO
This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.
Assuntos
Medicina Baseada em Evidências , Política de Saúde , Humanos , PeruAssuntos
Infecções por Coronavirus , Coronavirus , Pandemias , Pneumonia Viral , Aeroportos , América , Ásia , Betacoronavirus , COVID-19 , Europa (Continente) , Humanos , Prevalência , SARS-CoV-2RESUMO
En Perú la anemia infantil es un problema de salud pública. Se están desarrollando diferentes estrategias preventivas, entre ellas el uso de las redes sociales. Hay poca evidencia disponible sobre las mejores formas de interactuar con las audiencias en este espacio. Este trabajo tuvo como objetivo explorar la percepción de los usuarios de las redes sociales del Ministerio de Salud del Perú sobre un video que promueve la alimentación para reducir el riesgo de anemia infantil y estimar el alcance y la interacción que consiguió a través de las redes sociales. Se hizo un estudio de carácter cuali-cuantitativo exploratorio de una intervención con un video musical del Ministerio de Salud, difundido a través de las redes sociales (Facebook, Twitter y Youtube). La mayoría de los usuarios (58/77) que comentaron el video en Facebook tuvo una percepción positiva. A los cuatro meses de seguimiento se logró el mayor alcance en Facebook (364 000 reproducciones), que triplicó lo alcanzado de forma conjunta en Twitter y Youtube. Durante la primera semana se logró el mayor alcance. La mayor tasa de interacción a los cuatro meses se produjo en Facebook (7,1 por ciento) seguida de Twitter (5,2 por ciento) y Youtube (0,3 por ciento). El mayor alcance y tasa de interacción del video estudiado fue a través de Facebook. La percepción fue positiva; sin embargo, la tasa de interacción fue baja. Las redes sociales son una forma de comunicación veloz, pero efímera, con un gran potencial en salud pública(AU)
Childhood anemia is a public health problem in Peru. A variety of preventive strategies are being developed, among them the use of social networks. Little evidence is available about the best ways to interact with audiences in this space. The purpose of the study was to explore the perception of users of social networks of the Peruvian Ministry of Health about a video promoting food to reduce the risk of childhood anemia and estimate the scope and interaction it achieved through the social networks. An exploratory qualitative-quantitative study was conducted of an intervention based on a music video disseminated by the Ministry of Health in the social networks Facebook, Twitter and YouTube. Most of the users commenting on the video (58 / 77) in Facebook reported a positive perception. The largest number of replays was reached at four months' follow-up in Facebook (364 000 replays), trebling the results of Twitter and YouTube together. The broadest scope was achieved during the first week. The highest interaction rate at four months occurred in Facebook (7.1 percent), followed by Twitter (5.2 percent) and YouTube (0.3 percent). The greatest scope and interaction rate of the study video occurred in Facebook. Perception was positive, but the interaction rate was low. Social networks are a swift though ephemeral form of communication with a great potential in public health(AU)