The Maritime Declaration of Health (MDH) as a tool to detect maritime traffic-related health risks: analysis of MDH forms submitted to Spanish ports, October 2014 to March 2015.

The international maritime traffic of people and goods has often contributed to the spread of pathogens affecting public health. The Maritime Declaration of Health (MDH), according to the International Health Regulations (IHR) (2005), is a document containing data related to the state of health on board a ship during passage and on arrival at port. It is a useful tool for early detection of public health risks. The main objective of our study was to evaluate compliance with the model provided in the IHR, focusing on the format and degree of completion of MDH forms received at Spanish ports. We reviewed the content of 802 MDH forms submitted to nine Spanish ports between October 2014 and March 2015. Study results show that 22% of MDH forms presented did not comply with the recommended model and 39% were incomplete. The proportion of cargo ships with correct and complete MDH forms was lower than passenger ships; thus, the nine health questions were answered less frequently by cargo ships than passenger ships (63% vs 90%, p value < 0.001). The appropriate demand and usage of MDH forms by competent authorities should improve the quality of the document as a tool and improve risk assessment.

Evacuation of Refugees from Afghanistan: Health Control at the Spanish Border in the Context of the COVID-19 Pandemic.

Following the announcement of the retreat of troops from Afghanistan, the Spanish Government organised the so-called "Antigone Operation" for the evacuation of Afghan collaborators. The most relevant ministries were involved in the response. The Ministry of Health, through the Foreign Health Department, performed the health control on arrival. The whole operation was conducted at an air base. It included the health control of refugees composed of temperature measurement, a basic visual control and a coronavirus disease (COVID-19) rapid antigen test for those over 12 years of age; the assessment of their basic needs (food and hygiene); identification and security procedures; and the initial administrative processing. The refugees were accommodated in a temporary facility at the base, where they waited to be transferred to their final destinations. Between 19 and 27 August 2021, 2168 refugees arrived on 17 flights; 680 of them were children under 12 years of age. One thousand four hundred and ninety-nine rapid antigen tests were performed, with one positive result. "Antigone Operation" is unprecedented in Spain and is one of the most complex operations carried out in recent years. The COVID-19 pandemic required the establishment of a health control system on arrival, performed by Foreign Health, which contributed significantly to the overall success of the operation.

[The Public Health Services Port-folio in the National Health System: the contribution of the Central Government of Spain]. / La cartera de Servicios de Salud Pública en el Sistema Nacional de Salud: la aportación de la Administración General del Estado.

This paper concentrates on the port folio of public health services in the National Health System, with an inventory of those provided by the central level of government in the currently decentralized context of Spain. There is an important activity in public health, with some dispersion among different bodies and organisations. Most of the current activities of the central level of government concentrate in monitoring health levels and their determinants, managing information systems and health alerts and warnings, but with an involvement in policy development, both as a counterpart of the European Union and as an active agent with both regional levels of government and other organisations influencing public health. Besides, this level of government assures some essential services with little visibility for the general population as they are mostly delivered to other public administrations or to professional groups.

La cartera de servicios de salud pública en el Sistema Nacional de Salud: la aportación de la Administración General del Estado / The public health services port-folio in the National Health System: the contribution of the Central Government of Spain

Este documento formula algunas reflexiones sobre la cartera de servicios de salud pública del Sistema Nacional de Salud, elaborando un inventario de la aportación de la Administración General del Estado a la misma, en el contexto descentralizado actualmente vigente en España. Se aprecia la existencia de una importante actividad en salud pública, con cierta dispersión entre diversas dependencias. Buena parte de las actuales actividades de la Administración General del Estado se centran en la monitorización del estado de salud y sus determinantes, gestionando diversos sistemas de información y de alerta, pero con un importante papel en el desarrollo de políticas, como interlocutora de la Unión Europea y como catalizadora con las comunidades autónomas y otras organizaciones que influyen en la salud pública. Además, este nivel de la administración garantiza una serie de servicios esenciales que pueden ser poco visibles para la ciudadanía por prestarse la mayoría a otras administraciones o a grupos profesionales(AU)

This paper concentrates on the port folio of public health services in the National Health System, with an inventory of those provided by the central level of government in the currently decentralized context of Spain. There is an important activity in public health, with some dispersion among different bodies and organisations. Most of the current activities of the central level of government concentrate in monitoring health levels and their determinants, managing information systems and health alerts and warnings, but with an involvement in policy development, both as a counterpart of the European Union and as an active agent with both regional levels of government and other organisations influencing public health. Besides, this level of government assures some essential services with little visibility for the general population as they are mostly delivered to other public administrations or to professional groups(AU)