Three urgent needs in the battle against COVID-19: specific medications, information and acceptance of Pandemic / Três necessidades urgentes na batalha contra covid-19: medicamentos específicos, informações e aceitação da pandemia

The first confirmed case of COVID-19 was notified to the Brazilian Ministry of Health on February 26, 2020. On November 20, 2021, by the end of Epidemiological Week-46 (EW-46) 257,168,692 confirmed cases of COVID-19 reported worldwide. Among the countries with the highest number of accumulated cases the United States of America ranks number one (47,701,872), followed by India (34,510,413), Brazil (22,012,150), the United Kingdom (9,857,658), and Russia (9,135,149). Concerning deaths, 5,146,467 were confirmed worldwide until November 20, 2021. The United States was the country with the highest accumulated number of deaths (771,013), followed by Brazil (612,587), India (465,662), Mexico (292,145), and Russia (257,891).

O primeiro caso confirmado de COVID-19 foi notificado ao Ministério da Saúde (MS) do Brasil em 26 de fevereiro de 2020. Até o final da Semana Epidemiológica (SE) 46 de 2021, no dia 20 de novembro de 2021, foram confirmados 257.168.692 casos de covid-19 no mundo. Os Estados Unidos foram o país com o maior número de casos acumulados (47.701.872), seguido pela Índia (34.510.413), Brasil (22.012.150), Reino Unido (9.857.658) e Rússia (9.135.149). Em relação aos óbitos, foram confirmados 5.146.467 no mundo até o dia 20 de novembro de 2021. Os Estados Unidos foram o país com maior número acumulado de óbitos (771.013), seguido do Brasil (612.587), Índia (465.662), México (292.145) e Rússia (257.891)

Preconception Care to Improve Pregnancy Outcomes: The Science

INTRODUCTION: In the last decades, improvements in the care of pregnancy and child development have been observed worldwide. However, pregnancy problems remain high in most countries. There was a concentration of care in the prenatal period as the primary approach for improving pregnancy results. Currently, attention to the care of pregnant women, women who have recently given birth, and newborns are focused on the care of preconception to improve the results of pregnancy and improve the outcomes of child growth and developmentOBJECTIVE: Describe the evidence for preconception care (PCC) and information to the health care provider, as well as describe instruments to present health care providers with PCC, its definition, its components, recommended interventions, and the scientific basis for recommendationsMETHODS: There was a search for published and unpublished literature related to scientific evidence for the effectiveness of PCC in improving pregnancy results. The search was carried out based on Pubmed and using data scraping techniques, in the material available on the internet and disseminated by international organizations, such as the World Health Organization and reports by government agenciesRESULTS: It is reported that the literature on the scientific basis for PCC is fragmented, and most publications discuss evidence of one or a few interventions, with the majority of reports considering PCC for specific populations, such as women with chronic health problems and couples with infertility. However, these publications do not offer a realistic view of the proposed PCC interventions, with the scientific evidence that supports them. The general aspects of the existing literature and the recommended preconceived care interventions are described, together with the quality of the scientific evidence and the strength of the recommendations behind each of these interventionsCONCLUSION: Many clinical interventions have been identified that could be offered to women before conception to help avoid adverse outcomes. Most of these interventions have scientific evidence to support their role in improving pregnancy outcomes. Therefore, it is recommended that clinical care providers incorporate evidence-based prejudice services in their daily care of women of reproductive age, in an effort to improve women's health before and during pregnancy, as well as improve pregnancy outcomes for women and their children

INTRODUÇÃO: As Nas últimas décadas, foram observadas melhorias no cuidado à gravidez e no desenvolvimento infantil em todo o mundo. No entanto, os problemas de gravidez continuam altos na maioria dos países. Houve uma concentração de cuidados no período pré-natal como a principal abordagem para melhorar os resultados da gravidez. Atualmente, a atenção aos cuidados de mulheres grávidas, mulheres que deram à luz recentemente e recém-nascidos está focada no cuidado de preconcepção para melhorar os resultados da gravidez e os resultados do crescimento e desenvolvimento infantilOBJETIVO: Descrever as evidências para os cuidado preconcepção (PCC) e informações para o profissional da saúde, bem como descrever instrumentos para apresentar aos profissionais de saúde o PCC, sua definição, seus componentes, intervenções recomendadas e a base científica para recomendaçõesMÉTODO: Houve uma pesquisa de literatura publicada relacionada a evidências científicas para a eficácia do PCC na melhoria dos resultados da gravidez. A pesquisa foi realizada com base no Pubmed e utilizando técnicas de raspagem de dados, no material disponível na internet e divulgado por organizações internacionais, como a Organização Mundial da Saúde e relatórios de órgãos governamentaisRESULTADOS: Relata-se que a literatura sobre a base científica do PCC é fragmentada e a maioria das publicações discute evidências de uma ou poucas intervenções, com a maioria dos relatórios considerando o PCC para populações específicas, como mulheres com problemas crônicos de saúde e casais com infertilidade. No entanto, essas publicações não oferecem uma visão realista das intervenções propostas do PCC, com as evidências científicas que as apoiam. Os aspectos gerais da literatura existente e as intervenções preconcebidas recomendadas são descritas, juntamente com a qualidade das evidências científicas e a força das recomendações por trás de cada uma dessas intervençõesCONCLUSÃO: Muitas intervenções clínicas foram identificadas que poderiam ser oferecidas às mulheres antes da concepção para ajudar a evitar resultados adversos. A maioria dessas intervenções possui evidências científicas para apoiar seu papel na melhoria dos resultados da gravidez. Portanto, recomenda-se que os prestadores de cuidados clínicos incorporem serviços de preconcepção baseados em evidências em seus cuidados diários a mulheres em idade reprodutiva, em um esforço para melhorar a saúde das mulheres antes e depois da gravidez. durante a gravidez, bem como melhorar os resultados da gravidez para mulheres e filhos

Preconception care: developing and implementing regional and national programs

INTRODUCTION: During the past few decades, health workers have come to agree that there is a very important place for preconception care (PCC) in improving maternal and infant pregnancy outcomes. The United States Centers for Disease Control and Prevention (CDC) and the World Health Organization issued recommendations encouraging countries to develop and implement preconception care programs. The reports include an in-depth discussion of the rationale and scientific evidence behind PCC as well as definitions, goals, components and recommended interventions to be included in PCC. These reports also offer very broad guidelines but do not offer details on how to develop and implement preconception care programsOBJECTIVE: The CDC and WHO reports identify the need for multi-sectoral engagement in developing and implementing preconception care programs and propose some activities and strategies to be considered in developing PCC programs. However, the recommendations fall short of specifying real steps that countries and regions should take in implementing PCC programs. In this publication we propose action steps for developing and implementing regional or national preconception care programsMETHODS: We reviewed the published and unpublished literature (using PubMed and the Internet) to identify reports that describe processes for developing and implementing PCC programs. We used information from the literature along with experiences we gained through our work and interaction with States and developing countries to prepare a detailed description of the steps involved in developing and implementing a PCC programRESULTS: We found very little in terms of "tools" for program managers and providers to use when developing and implementing PCC programs. We prepared a guide, including a summary of steps and a proposed timeline, for program directors to use for developing and implementing PCC programsCONCLUSION: Developing and implementing a sustainable PCC program should address issues related to educating the public, providers and policy makers about the benefits of PCC. It also includes establishing an infrastructure within the departments of health and ensuring resources to build, guide, monitor and evaluate the PCC program. Finally, implementation of a successful program depends heavily on the proper training of public health and clinical care providers in the delivery of the services included in the program

INTRODUÇÃO: Nas últimas décadas, os profissionais de saúde chegaram a um acordo sobre a importância dos cuidados preconcepção na melhoria dos resultados da gravidez materna e infantil. Os Centros dos Estados Unidos para Controle e Prevenção de Doenças (CDC) e a Organização Mundial da Saúde emitiram recomendações incentivando os países a desenvolver e implementar programas de assistência preconcepção. Os relatórios incluem uma discussão aprofundada da lógica e das evidências científicas por trás do PCC, bem como definições, objetivos, componentes e intervenções recomendadas a serem incluídas no PCC. Esses relatórios também oferecem diretrizes muito amplas, mas não oferecem detalhes sobre como desenvolver e implementar programas de assistência preconcepçãoOBJETIVO: Os relatórios do CDC e da OMS identificam a necessidade de envolvimento multissetorial no desenvolvimento e implementação de programas de assistência pré-conceitual e propõem algumas atividades e estratégias a serem consideradas no desenvolvimento de programas do PCC. No entanto, as recomendações não especificam as medidas reais que os países e regiões devem adotar na implementação de programas de assistência preconcepção. Neste artigo, propomos etapas de ação para o desenvolvimento e implementação de programas regionais ou nacionais de assistência pré-conceitualMÉTODO: Foi revisada a literatura publicada usando o PubMed para identificar relatórios que descrevem processos para o desenvolvimento e implementação de programas de assistência preconcepção. As informações da literatura foram utilizadas, juntamente com as experiências adquiridas por meio de nosso trabalho e interação com os Estados e os países em desenvolvimento, para preparar uma descrição detalhada das etapas envolvidas no desenvolvimento e na implementação de um programa de assistência preconcepçãoRESULTADOS: Pouco foi encontrado em termos de "ferramentas" para os gerentes e provedores de programas usarem ao desenvolver e implementar programas de assistência preconcepção. Este artigo foi preparado como um guia, incluindo um resumo das etapas e um cronograma proposto, para os diretores de programas usarem no desenvolvimento e na implementação de programas de assistência preconcepçãoCONCLUSÃO: O desenvolvimento e implementação de um programa sustentável do PCC deve abordar questões relacionadas à educação do público, fornecedores e formuladores de políticas sobre os benefícios do PCC. Também inclui o estabelecimento de uma infraestrutura nos departamentos de saúde e a garantia de recursos para construir, orientar, monitorar e avaliar o programa PCC. Finalmente, a implementação de um programa bem-sucedido depende muito do treinamento adequado dos prestadores de serviços de saúde pública e atendimento clínico na prestação dos serviços incluídos no programa

Preconception care to improve pregnancy outcomes: clinical practice guidelines

INTRODUCTION: There is scientific evidence that the health of women before pregnancy contributes to the maternal and infant outcomes of pregnancy. There is also scientific evidence that the health of women of reproductive age may be improved through the provision of Preconception Care (PCC). Preconception care includes interventions to assess, identify, address, and modify a woman's health conditions and risks to ensure that these health conditions and risks do not negatively affect the outcome of her pregnancy. Many of the medical conditions, environmental exposures, personal behaviors, and psychosocial risks associated with negative pregnancy outcomes have been identified and there are recommendations for including these conditions in PCC servicesOBJECTIVE: Our purpose is to present a tool for clinical care providers involved in delivering PCC services. We try to answer the following questions: what do providers actually do when a woman of reproductive age arrives at their offices? What questions to ask? What examinations to conduct? What laboratory tests to perform? And, what education and counselling to offer?METHODS: We reviewed published and un-published literature related to the scientific evidence for the effectiveness of PCC in improving pregnancy outcomes. We searched PubMed for published articles, and we searched the internet for unpublished reports prepared by international organizations such as the World Health Organization and reports from governmental agencies. We summarized the information and presented a comprehensive overview of actions that providers should take to address various risk behaviors, exposures and health conditionsRESULTS: Several scientists, countries, and international organizations have proposed answers to the above questions. However, there has been no consistency and there is not a single publication that includes a comprehensive compilation of the proposed actions. We summarized the recommended actions that clinical care providers should take in addressing various health conditions, risk behaviors, and exposuresCONCLUSION: It is recommended that all providers screen all women for their intentions to become pregnant and to provide them with appropriate services. Women should be referred to specialized care when risk behaviors and medical conditions that go beyond the skills and abilities of the primary care provider are identified

INTRODUÇÃO: Existem evidências científicas de que a saúde das mulheres antes da gravidez contribui para os resultados maternos e infantis da gravidez. Há também evidências científicas de que a saúde das mulheres em idade reprodutiva pode ser melhorada através da prestação de cuidados preconcepção. Os cuidados preconcepção incluem intervenções para avaliar, identificar, abordar e modificar as condições e riscos de saúde de uma mulher para garantir que essas condições e riscos não afetem negativamente o resultado de sua gravidez. Muitas condições médicas, exposições ambientais, comportamentos pessoais e riscos psicossociais associados a resultados negativos da gravidez foram identificados e existem recomendações para a inclusão dessas condições nos serviços de assistência preconcepçãoOBJETIVO: O objetivo deste estudo é servir como uma ferramenta para os prestadores de cuidados clínicos envolvidos na prestação de serviços de cuidados preconcepção. Tentamos responder às seguintes perguntas: o que os profissionais realmente fazem quando uma mulher em idade reprodutiva chega a seus escritórios? Que perguntas fazer? Quais exames realizar? Quais exames laboratoriais devem ser realizados? E que educação e aconselhamento oferecer?MÉTODO: Revisamos a literatura publicada e não publicada relacionada à evidência científica para a eficácia dos cuidados preconcepção na melhoria dos resultados da gravidez. Pesquisamos no PubMed por artigos publicados e pesquisamos na Internet relatórios não publicados preparados por organizações internacionais como a Organização Mundial da Saúde e relatórios de agências governamentais. Resumimos as informações e apresentamos uma visão abrangente das ações que os fornecedores devem adotar para abordar vários comportamentos de risco, exposições e condições de saúdeRESULTADOS: Vários cientistas, países e organizações internacionais propuseram respostas para as perguntas acima. No entanto, não houve consistência e não há uma única publicação que inclua uma compilação abrangente das ações propostas. Resumimos as ações recomendadas que os prestadores de cuidados clínicos devem adotar para lidar com várias condições de saúde, comportamentos de risco e exposiçõesCONCLUSÃO: Recomenda-se que todos os profissionais examinem todas as mulheres quanto à sua intenção de engravidar e forneçam-lhes os serviços adequados. As mulheres devem ser encaminhadas para atendimento especializado quando forem identificados comportamentos de risco e condições médicas que vão além das habilidades do prestador de cuidados primários

Health Disparities: Challenges, Opportunities, and What You Can Do About It / Desigualdades na saúde: desafios, oportunidades e o que você pode fazer sobre isso

Racial disparities in health outcomes, access to health care, insurance coverage, and quality of care in the United States have existed for many years. The Development and implementation of effective strategies to reduce or eliminate health disparities are hindered by our inability to accurately assess the extent and types of health disparities due to the limited availability of race/ethnicity-specific information, the limited reliability of existing data and information, and the increasing diversity of the American population. Variations in racial and ethnic classification used to collect data hinders the ability to obtain reliable and accurate health-indicator rates and in some instances cause bias in estimating the race/ethnicity-specific health measures. In 1978, The Office of Management and Budget (OMB) issued "Directive 15" titled "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" and provided a set of clear guidelines for classifying people by race and ethnicity. Access to health care, behavioral and psychosocial factors as well as cultural differences contribute to the racial and ethnic variations that exist in a person's health. To help eliminate health disparities, we must ensure equal access to health care services as well as quality of care. Health care providers must become culturally competent and understand the differences that exist among the people they serve in order to eliminate disparities. Enhancement of data collection systems is essential for developing and implementing interventions targeted to deal with population-specific problems. Developing comprehensive and multi-level programs to eliminate healthcare disparities requires coordination and collaboration between the public (Local, state and federal health departments), private (Health Insurance companies, private health care providers), and professional (Physicians, nurses, pharmacists, laboratories, etc) sectors.

Disparidades raciais nos resultados de saúde, acesso a cuidados de saúde, cobertura de seguro e qualidade de atendimento nos Estados Unidos existem há muitos anos. O desenvolvimento e a implementação de estratégias efetivas para reduzir ou eliminar as disparidades de saúde são dificultadas pela nossa incapacidade de avaliar com precisão a extensão e os tipos de disparidades de saúde devido à disponibilidade limitada de informações específicas de raça / etnia, confiabilidade limitada dos dados e informações existentes. e a crescente diversidade da população americana. Variações na classificação racial e étnica usadas para coletar dados dificultam a obtenção de índices confiáveis e precisos de indicadores de saúde e, em alguns casos, causam viés na estimativa de medidas de saúde específicas de raça / etnia. Em 1978, o Escritório de Administração e Orçamento (OMB) publicou a "Diretriz 15" intitulada "Normas Raciais e Étnicas para Estatísticas Federais e Relatórios Administrativos" e forneceu um conjunto de diretrizes claras para classificar as pessoas por raça e etnia. O acesso a cuidados de saúde, factores comportamentais e psicossociais, bem como diferenças culturais, contribuem para as variações raciais e étnicas que existem na saúde de uma pessoa. Para ajudar a eliminar as disparidades de saúde, devemos garantir a igualdade de acesso aos serviços de saúde, bem como a qualidade do atendimento. Os prestadores de cuidados de saúde devem tornar-se culturalmente competentes e compreender as diferenças existentes entre as pessoas que servem para eliminar as disparidades. O aprimoramento dos sistemas de coleta de dados é essencial para desenvolver e implementar intervenções direcionadas para lidar com problemas específicos da população. O desenvolvimento de programas abrangentes e multiníveis para eliminar as disparidades na atenção à saúde exige coordenação e colaboração entre os setores público, privado e profissional (departamentos de saúde locais, estaduais e federais), privados (empresas de seguro-saúde, provedores privados de saúde) e profissionais (médicos e enfermeiros), farmacêuticos, laboratórios, etc).

Childhood mortality: still a global priority

Mortality of children under-5 continues to be a global priority. In 2012, 6.6 million children under-5 died worldwide; more than half of these deaths are due to diseases that are preventable and treatable through simple, affordable interventions. In response to the United Nations' Millennium Development Goal (MDGs) which called, through MDG4,to "reduceby two thirds the under-5 child mortality, between 1990 and 2015", global organizations and many countries set targets and developed specific strategies to reduce child mortality and monitor progress.As a result, the number of deaths in children under-5 worldwide declined from 12.4 million in 1990 to 6.6 in 2012. Under-5 child mortality dropped in all regions of the world. However, two major challenges face the international community: The wide disparity in the risk of child death among countries, and the emerging role of neonatal death as a major component of child mortality. In order to continue the progress in reducing under-5 child mortality worldwide, current efforts must continue and new strategies need to be implemented to focus on preventing neonatal deaths as they start to represent a larger proportion of under-5 child deaths. In particular, further reduction in neonatal mortality will depend heavily on improving maternal health (MDG5).The world leaders continue to support the MDGs. In 2010, in a major push to accelerate progress on women's and children's health, a number of Heads of State and Government from developed and developing countries, along with the private sector, foundations, international organizations, civil society and research organizations, pledged over $40 billion in resources over the next five years...(AU)

Childhood mortality: still a global priority

Mortality of children under-5 continues to be a global priority. In 2012, 6.6 million children under-5 died worldwide; more than half of these deaths are due to diseases that are preventable and treatable through simple, affordable interventions. In response to the United Nations' Millennium Development Goal (MDGs) which called, through MDG4,to "reduceby two thirds the under-5 child mortality, between 1990 and 2015", global organizations and many countries set targets and developed specific strategies to reduce child mortality and monitor progress.As a result, the number of deaths in children under-5 worldwide declined from 12.4 million in 1990 to 6.6 in 2012. Under-5 child mortality dropped in all regions of the world. However, two major challenges face the international community: The wide disparity in the risk of child death among countries, and the emerging role of neonatal death as a major component of child mortality. In order to continue the progress in reducing under-5 child mortality worldwide, current efforts must continue and new strategies need to be implemented to focus on preventing neonatal deaths as they start to represent a larger proportion of under-5 child deaths. In particular, further reduction in neonatal mortality will depend heavily on improving maternal health (MDG5).The world leaders continue to support the MDGs. In 2010, in a major push to accelerate progress on women's and children's health, a number of Heads of State and Government from developed and developing countries, along with the private sector, foundations, international organizations, civil society and research organizations, pledged over $40 billion in resources over the next five years...

The evolving role of public health in the delivery of health care

Health care is conventionally regarded as the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Some examples of public health measures include ensuring a safe and healthy environment, clean water, safe workplaces; promotion of healthy behaviors such as hand washing and breast feeding; and, preventing infectious diseases such as delivery of vaccinations and distribution of condoms to control the spread of sexually transmitted diseases. How we define the quality of public health at any given time must be compatible with future generations enjoying health in an equivalent way. Public health practitioners must also integrate sustain ability in the definition of public health.

Parents' Death and its Implications for Child Survival.

Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and socioeconomic status of mothers and fathers have significant impact on the health and survival of their children. We conducted a literature review to explore the impact of the death of parents on the survival and wellbeing of their children and the mechanisms through which this impact is mediated. Studies have generally concluded that the death of a mother significantly increased the risk of death of her children, especially during the early years; the effect continues but is significantly reduced with increasing age through the age of 15 years. The effect of the loss of a father had less impact than the effect of losing a mother although it too had negative consequences for the survival prospect of the child. A mother's health, education, socioeconomic status, fertility behavior, environmental health conditions, nutritional status and infant feeding, and the use of health services all play an important role in the level of risk of death of her children. Efforts to achieve the Millennium Development Goal No. 4 of reducing children's under-5 mortality in developing countries by two thirds by 2015 should include promoting the health and education of women.

Parents' death and its implications for child survival

Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and socioeconomic status of mothers and fathers have significant impact on the health and survival of their children.We conducted a literature review to explore the impact of the death of parents on the survival and wellbeing of their childrenand the mechanisms through which this impact is mediated. Studies have generally concluded that the death of a mother significantly increased the risk of death of her children, especially during the early years; the effect continues but is significantly reduced with increasing age through the age of 15 years. The effect of the loss of a father had less impact than the effect of losing a mother although it too had negative consequences for the survival prospect of the child. A mother's health, education, socioeconomic status, fertility behavior, environmental health conditions, nutritional status and infant feeding, and the use of health services all play an important role in the level of risk of death of her children. Efforts to achieve the Millennium Development Goal No. 4 of reducing children's under-5 mortality in developing countries by two thirds by 2015 should include promoting the health and education of women.(AU)

Parents' death and its implications for child survival

Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and socioeconomic status of mothers and fathers have significant impact on the health and survival of their children.We conducted a literature review to explore the impact of the death of parents on the survival and wellbeing of their childrenand the mechanisms through which this impact is mediated. Studies have generally concluded that the death of a mother significantly increased the risk of death of her children, especially during the early years; the effect continues but is significantly reduced with increasing age through the age of 15 years. The effect of the loss of a father had less impact than the effect of losing a mother although it too had negative consequences for the survival prospect of the child. A mother's health, education, socioeconomic status, fertility behavior, environmental health conditions, nutritional status and infant feeding, and the use of health services all play an important role in the level of risk of death of her children. Efforts to achieve the Millennium Development Goal No. 4 of reducing children's under-5 mortality in developing countries by two thirds by 2015 should include promoting the health and education of women.

La informática aplicada a la salud reproductiva posibilita una mejor práctica clínica: [revisión] / Better clinical practice made possible by IT in reproductive health: [review]

En abril de 2006, los US Centers for Disease Control and Prevention (CDC) publicaron normativas clínicas acerca de la salud reproductiva con el objetivo de promover mejoras en la evolución de los embarazos en Estados Unidos. La integración de la salud reproductiva en la práctica cotidiana todavía representa un desafío para los médicos clínicos. Esto se debe en parte a la percepción de que la salud reproductiva es una prestación agregada en lugar de un aspecto integral de la atención primaria de las mujeres en edad fértil. La provisión de estas prestaciones por los sistemas de atención primaria se ha limitado debido a la falta de promoción de métodos clínicos que contribuyan a la evaluación del riesgo y los procesos de intervención. Las novedades en el contexto de la informática aplicada a la salud expanden las posibilidades de perfeccionar los importantes servicios de la salud reproductiva en la actividad médica cotidiana. Una revisión de estos avances informáticos relacionados con la salud reproductiva podría contribuir a la optimización de estos servicios por parte de los médicos clínicos.(AU)

La informática aplicada a la salud reproductiva posibilita una mejor práctica clínica: [revisión] / Better clinical practice made possible by IT in reproductive health: [review]

En abril de 2006, los US Centers for Disease Control and Prevention (CDC) publicaron normativas clínicas acerca de la salud reproductiva con el objetivo de promover mejoras en la evolución de los embarazos en Estados Unidos. La integración de la salud reproductiva en la práctica cotidiana todavía representa un desafío para los médicos clínicos. Esto se debe en parte a la percepción de que la salud reproductiva es una prestación agregada en lugar de un aspecto integral de la atención primaria de las mujeres en edad fértil. La provisión de estas prestaciones por los sistemas de atención primaria se ha limitado debido a la falta de promoción de métodos clínicos que contribuyan a la evaluación del riesgo y los procesos de intervención. Las novedades en el contexto de la informática aplicada a la salud expanden las posibilidades de perfeccionar los importantes servicios de la salud reproductiva en la actividad médica cotidiana. Una revisión de estos avances informáticos relacionados con la salud reproductiva podría contribuir a la optimización de estos servicios por parte de los médicos clínicos.

Reduccion de la morbilidad y mortalidad materna en las Américas: guia para la vigilancia epidemiologica de la muerte materma / Reduction of maternal morbility and mortality in the Américas: guidelines for epidemiological surveillance on maternal mortality

Esta Guia presenta los lineamientos generales para la vigilancia epidemiologica de la muerte materna. El objeto principal del Sistema de Vigilancia de la Mortalidad Materna (SVEMM) es contribuir al mejor conocimiento de los factores medicos-sociales que determinan las muertes maternas y proveer informacion para el desarrollo de estrategias para mejorar la salud de la mujerEl proposito principal de esta Guia es ofrecer a los paise en una forma resumida, y lenguaje simple, las orientaciones mas importantes para establecer un SVEMM o perfeccionarlo en aquellos países que ya cuenten con el