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1.
Saúde debate ; 43(spe7): 22-35, Dez. 2019. tab, graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1127405

RESUMEN

RESUMO O objetivo do artigo foi analisar percepções de especialistas brasileiros(as) em saúde sobre as possibilidades de o País cumprir os Objetivos do Desenvolvimento Sustentável (ODS) até 2030, sobretudo no que se refere às metas do 'ODS 3 - Saúde e Bem-Estar'. Definiu-se como 'especialista' o autor principal de artigo no campo da saúde pública, publicado entre setembro de 2012 e 2017, em periódicos indexados na plataforma Web of Science (WoS). Suas percepções foram levantadas pela técnica de investigação a distância, com a aplicação de instrumento eletrônico de pesquisa, recebido e devolvido por e-mail, por 884 respondentes (universo da pesquisa), no período de 22 de janeiro a 09 de fevereiro de 2018 (campo da pesquisa). Os especialistas respondentes, que apresentam 'médio' e 'alto' conhecimento sobre os ODS, consideram como 'baixas' as possibilidades de o Brasil cumprir algum dos 17 objetivos. Para eles, o País deveria priorizar o ODS 4 (Educação de Qualidade) e 1 (Erradicação da Pobreza), também considerados como aqueles que mais contribuiriam para a consecução do ODS 3 (Saúde e Bem-Estar). Como recomendações de políticas que viabilizariam a consecução das nove metas do ODS 3, os especialistas respondentes evidenciaram a 'redução da pobreza', a 'universalização da atenção básica' e a 'educação' da população.


ABSTRACT The objective of this article is to analyze Brazilian health specialists' perceptions of the possibilities of country achieving the Sustainable Development Goals (SDGs) by 2030, especially in regard to the targets of SDG 3 - Good Health and Well-Being. Specialists are defined as the main author of an article in the field of public health, published between September 2012 and 2017 in periodicals indexed in the Web of Science (WoS) platform. Their perceptions were collected using a distance research technique, with the use of an electronic research instrument, received and returned by e-mail, by 884 respondents (research universe), Between 22 January and 2 February 2018 (field of research). Respondents, with a 'medium' and 'high' knowledge of SDGs, considered Brazil's possibilities of achieving any of the 17 objectives as 'low.' For them, the country should prioritize SDG 4 (Quality Education) and 1 (End Poverty), also seen as those that would contribute most to achieving SDG 3 (Health and Welfare). In terms of policy recommendations that could help achieve the nine targets of SDG 3, respondents stressed 'poverty reduction', 'universal primary care' and 'education' as priorities.

2.
Ciênc. Saúde Colet ; 24(12): 4579-4586, dez. 2019.
Artículo en Español | LILACS | ID: biblio-1055763

RESUMEN

Resumen El presente artículo indaga sobre la participación popular en salud en barrios de la periferia de La Plata (Argentina) en un contexto de vaciamiento de las políticas sociales de acuerdo a las normativas neoliberales que rigen con fuerza creciente en el país y en el continente. En este marco de crisis económica que afecta particularmente a la salud pública, los movimientos sociales se organizan para defenderla, al mismo tiempo que resisten el empobrecimiento cotidiano y construyen alternativas de salud popular y colectiva. El trabajo, sostenido en una investigación etnográfica, se propone reconstruir los modos en que los sujetos reconfiguran los modos de pensar la salud y la participación política en la vida cotidiana de los territorios a través de distintas tácticas y estrategias de cuidado y construcción político-comunitarias.


Abstract This article investigates the popular participation in health in neighborhoods of the periphery of La Plata (Argentina) in a context of emptying of social policies according to the neo-liberal regulations that govern with increasing force in the country and in the continent. In this framework of economic crisis that especially affects public health, social movements are organized to defend, while resisting daily impoverishment and building popular and collective health alternatives. The work, sustained in an ethnographic investigation, aims to reconstruct the ways in which the subjects reconfigure the ways of thinking about health and political participation in the daily life of the territories through different tactics and strategies of care and community-political construction.


Asunto(s)
Humanos , Política , Justicia Social , Características de la Residencia , Salud Pública , Participación de la Comunidad/métodos , Recesión Económica , Argentina , Sector Público/economía , Sector Público/organización & administración , Sector Privado/economía , Investigación Cualitativa , Derecho a la Salud/tendencias , Promoción de la Salud/métodos , Accesibilidad a los Servicios de Salud , Seguro de Salud/economía , Seguro de Salud/organización & administración , Antropología Cultural , Programas Nacionales de Salud/organización & administración
3.
BMJ Open ; 9(11): e028361, 2019 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-31699716

RESUMEN

INTRODUCTION: Cultivating child health and development creates long-term impact on the well-being of the individual and society. The Amazon of Peru has high levels of many risk factors that are associated with poor child development. The use of 'community health agents' (CHAs) has been shown to be a potential solution to improve child development outcomes. Additionally, mobile information and communication technology (ICT) can potentially increase the performance and impact of CHAs. However, there is a knowledge gap in how mobile ICT can be deployed to improve child development in low resource settings. METHODS AND ANALYSIS: The current study will evaluate the implementation and impact of a tablet-based application that intends to improve the performance of CHAs, thus improving the child-rearing practices of caregivers and ultimately child health and development indicators. The CHAs will use the app during their home visits to record child health indicators and present information, images and videos to teach key health messages. The impact will be evaluated through an experimental cluster randomised controlled trial. The clusters will be assigned to the intervention or control group based on a covariate-constrained randomisation method. The impact on child development scores, anaemia and chronic malnutrition will be assessed with an analysis of covariance. The secondary outcomes include knowledge of healthy child-rearing practices by caregivers, performance of CHAs and use of health services. The process evaluation will report on implementation outcomes. The study will be implemented in the Amazon region of Peru with children under 4. The results of the study will provide evidence on the potential of a mHealth tool to improve child health and development indicators in the region. ETHICS AND DISSEMINATION: The study received approval from National Hospital 'San Bartolome' Institutional Ethics Committee on 8 November 2018 (IRB Approval #15463-18) and will be disseminated via peer-reviewed publications. TRIAL REGISTRATION NUMBER: ISRCTN43591826.


Asunto(s)
Desarrollo Infantil , Agentes Comunitarios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Visita Domiciliaria/estadística & datos numéricos , Telemedicina/métodos , Niño , Salud del Niño , Análisis por Conglomerados , Agentes Comunitarios de Salud/educación , Humanos , Área sin Atención Médica , Estado Nutricional , Perú , Ensayos Clínicos Controlados Aleatorios como Asunto
4.
Cien Saude Colet ; 24(12): 4579-4586, 2019 Dec.
Artículo en Español, Inglés | MEDLINE | ID: mdl-31778507

RESUMEN

This article investigates the popular participation in health in neighborhoods of the periphery of La Plata (Argentina) in a context of emptying of social policies according to the neo-liberal regulations that govern with increasing force in the country and in the continent. In this framework of economic crisis that especially affects public health, social movements are organized to defend, while resisting daily impoverishment and building popular and collective health alternatives. The work, sustained in an ethnographic investigation, aims to reconstruct the ways in which the subjects reconfigure the ways of thinking about health and political participation in the daily life of the territories through different tactics and strategies of care and community-political construction.


Asunto(s)
Participación de la Comunidad/métodos , Recesión Económica , Política , Salud Pública , Características de la Residencia , Justicia Social , Antropología Cultural , Argentina , Promoción de la Salud/métodos , Accesibilidad a los Servicios de Salud , Humanos , Seguro de Salud/economía , Seguro de Salud/organización & administración , Programas Nacionales de Salud/organización & administración , Sector Privado/economía , Sector Público/economía , Sector Público/organización & administración , Investigación Cualitativa , Derecho a la Salud/tendencias
5.
Cad Saude Publica ; 35(10): e00234618, 2019.
Artículo en Portugués | MEDLINE | ID: mdl-31596403

RESUMEN

This article evaluates access to the Papanicolaou test in the Family Health Strategy (FHS) in municipalities in a health region. Cervical cancer control depends on a well-organized Family Health Strategy, so assessment of access to the Papanicolaou test reflects the quality of care at this level. This is a qualitative study with data produced in 10 focus groups, totaling 70 participants in four municipalities. We analyzed the organizational, symbolic, and technical dimensions of access to the Pap test, with cervical cancer control as the marker. The results indicate that living in rural areas was a barrier to access to the Papanicolaou test and exacerbated the inequalities. Nurses were the principal reference for access to the Pap test. The absence of necessary items for collecting cervical cytopathology specimens was a barrier to access in all the municipalities. There were obstacles to access for women with disabilities and lesbian women, with care that was fragmented and out of sync with individual characteristics. The numerous obstacles to access to the Papanicolaou test exposed the selectiveness of the Family Health Strategy in the health region, since it reproduced the invisibility of women with greater social vulnerability and exacerbated the existing inequalities.


Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en el Estado de Salud , Prueba de Papanicolaou/estadística & datos numéricos , Neoplasias del Cuello Uterino/patología , Frotis Vaginal/estadística & datos numéricos , Brasil , Detección Precoz del Cáncer , Salud de la Familia , Femenino , Grupos Focales , Humanos , Tamizaje Masivo , Atención Primaria de Salud , Salud Rural , Factores Socioeconómicos , Neoplasias del Cuello Uterino/prevención & control
6.
Phys Med Rehabil Clin N Am ; 30(4): 847-865, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31563175

RESUMEN

Access to appropriate and affordable assistive technology is a human right, and a public health and development priority. This article elaborates on these aspects and illustrates the various opportunities and barriers to achieving equitable access to assistive technology through 4 specific country snapshots. In Brazil, mobility aids are provided through universal health coverage in rehabilitation reference centers in urban areas. A community-based rehabilitation pilot project in Argentina demonstrates how to reach an excluded indigenous community. A rapidly developing national legal framework in Colombia with imminent implementation challenges is showcased, as is a technology transfer model in India.


Asunto(s)
Países en Desarrollo , Personas con Discapacidad/rehabilitación , Planificación en Salud , Política de Salud , Accesibilidad a los Servicios de Salud , Dispositivos de Autoayuda/tendencias , Humanos , Innovación Organizacional , Dispositivos de Autoayuda/economía
8.
Estud. interdiscip. envelhec ; 24(2): 61-79, set. 2019. tab
Artículo en Portugués | LILACS, Index Psicología - Revistas | ID: biblio-1096119

RESUMEN

A qualidade de vida é um conjunto de fatores subjetivos e objetivos, que deve ser avaliada, sobretudo no envelhecimento, para compreender as necessidades de vida e saúde dos idosos e propor estratégias de melhoria da qualidade de vida de cada indivíduo. Objetivo: analisar os fatores relacionados à qualidade de vida damulher idosa na cidade de Guanambi (BA), no ano de 2016. Materiais e Métodos: estudo quantitativo, transversal e de caráter descritivo, realizado com 550 idosas. Os instrumentos utilizados na coleta de dados foram um formulário semi-estruturado de diagnóstico situacional e o World Health Organization Quality of Life (WHOQOL-Bref) para mensurar a qualidade de vida desse segmento populacional. A análise foi realizada por meio da estatística univariada, com cálculos de Qui-Quadrado χ2 , e regressão logística simples. Resultados: As idosas eram em sua maioria analfabetas, aposentadas, sem cônjuge, negras, vivendo em lares multigeracionais e 68,2% com uma percepção positiva quanto a sua qualidade de vida, mesmo vivendo em situações adversas. Os fatores que estiveram relacionados à qualidade de vida foram os sociodemográficos, condições de saúde e o estilo de vida, sendo que esses fatores apresentados negativamente contribuem para maior incapacidade, vulnerabilidade e dependência da idosa. Conclusão: O bem-estar da idosa é afetado pela redução de recursos nas dimensões educacionais, psicossociais e econômicas, com isso, a pesquisa sinalizou a necessidade de implantação de ações, voltadas para assistência de saúde, atividades recreativas e de socialização, que possibilitem autonomia e independência, para a melhoria da qualidade de vida. (AU)


Quality of life is a set of subjective and objective factors, which should be evaluated, especially in aging, to understand the life and health needs of older adults and propose strategies to improve the quality of life of each individual. Objectives: to analyze the factors related to the quality of life of older women in the city of Guanambi, BA, in the year 2016. Materials and Methods: a quantitative cross-sectional study with a descriptive character, carried out with 550 older women. The instruments used in the data collection were a semi-structured form of situational diagnosis and the World Health Organization Quality of Life (WHOQOL-Bref) to measure the quality of life of this population segment. The analysis was performed using univariate statistics, with chi-square χ2 calculations, and simple logistic regression. Results: The older adults were mostly illiterate, retired, without spouses, black, living in multigenerational households and 68.2% with a positive perception about their quality of life, even living in adverse situations. The factors that were related to quality of life were sociodemographic, health conditions and lifestyle, and these factors negatively contribute to greater incapacity, vulnerability and dependence of the older adults. Conclusion: The well-being of the older adults is affected by the reduction of resources in the educational, psychosocial and economic dimensions, with this, the research signaled the need to implement actions aimed at health care, recreation and socialization activities, which allow autonomy and independence, to improve the quality of life. (AU)


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Calidad de Vida/psicología , Salud del Anciano , Brasil , Estudios Transversales
9.
Guatemala; MSPAS; sept. 2019. 46 p.
Monografía en Español | LILACS | ID: biblio-1025886

RESUMEN

Este modelo: "de atención y gestión basado en la estrategia atención primaria en salud renovada", tiene como prioridad las intervenciones en el marco de la prevención de la enfermedad, promoción de la salud y vigilancia epidemiológica, con el objetivo de incidir en determinantes de la salud, contribuyendo con el desarrollo de las comunidades y promoviendo la reducción de daños a la población. Fundamentalmente el modelo de acciones extramuros, considera la implementación de acciones fuera de los establecimientos de salud, que permitan identificar las necesidades de la comunidad y establecer medidas preventivas que contribuyan a mejorar la salud de la población de manera oportuna. Por lo que, el personal de salud debe facilitar el acceso a los servicios a la población de acuerdo a los riesgos de la salud identificados en el análisis de situación de salud, a la demanda y oferta para establecer acciones oportunas.


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Recién Nacido , Preescolar , Adolescente , Administración de los Servicios de Salud , Gestión de la Salud Poblacional , Indicadores de Salud Comunitaria/organización & administración , Planificación en Salud/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Necesidades y Demandas de Servicios de Salud/organización & administración , Servicios Preventivos de Salud , Infraestructura Sanitaria/normas , Técnicos Medios en Salud/organización & administración , Prevención de Enfermedades , Servicios de Vigilancia Epidemiológica , Gestión de la Información en Salud , Asistencia Sanitaria Culturalmente Competente/organización & administración , Enfermedades no Transmisibles/prevención & control , Guatemala , Implementación de Plan de Salud/organización & administración , Promoción de la Salud , Investigación sobre Servicios de Salud , Visita Domiciliaria/tendencias , Equipos de Administración Institucional/organización & administración
10.
Lancet Glob Health ; 7(10): e1448-e1457, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31405780

RESUMEN

BACKGROUND: On Dec 1, 2006, Mexico's public health-care insurance scheme, Seguro Popular, implemented the Medical Insurance Century XXI (SMSXXI) programme, to provide insurance to children younger than 5 years without social security. SMSXXI aims to increase access to health services, decrease out-of-pocket health expenses (OOPHE), and reduce health inequities. SMSXXI covers uninsured, primarily low-income, populations who might be most at risk of the financial and health consequences of costly medical interventions. METHODS: We assessed the effects of SMSXXI on health outcomes and financial protection for Mexico's children using multiple nationally representative surveys and administrative data sources spanning 2001-16. The identification of effects relied on detailed hospital-level affiliation data mapping the geographical expansion of SMSXXI's coverage across the country over time. The units of analysis included hospitals, households, and children. Primary outcomes were neonatal and infant mortality, self-reported morbidity (health status, influenza, and diarrhoea), and child's height. Secondary outcomes were OOPHE, hospital discharges, and quality of service provision. Effects controlled for fixed and time-variant confounders using double-difference and triple-difference estimation strategies. Where feasible, we also estimated effects using exogenous variation in programme eligibility rules that limited enrolment in SMSXXI to children born after Dec 1, 2006. FINDINGS: SMSXXI was not associated with early (<1 week) neonatal mortality, but was associated with a reduction in late (<28 days) neonatal mortality by 0·139 deaths per 1000 livebirths (95% CI 0·032-0·246), or 7% (2-12) relative to the comparison base of 1·98 deaths per 1000 livebirths in 2006. SMSXI was associated with a reduction in infant mortality from conditions covered by the programme by 0·147 deaths per 1000 livebirths (0·023-0·271), or 5% (1-10) relative to the comparison base of 2·73 deaths per 1000 livebirths. The effects were largest in high baseline mortality areas. Long-term health effects, 8 years after the onset of SMSXXI, were reflected in a 0·434 cm (0·404-0·459) height increase for birth cohorts exposed to the programme and an average effect on height of 0·879 cm (0·821-0·932) for low-income populations. About 3-6 years after SMSXXI started, children reported having better health status and lower incidence of influenza and diarrhoea. The programme led to a 14% reduction (7-28) in OOPHE, primarily from hospital-related expenses. No effects were detected on hospital discharges, suggesting that SMSXXI might not have increased use. INTERPRETATION: SMSXXI promoted access to covered interventions and encouraged better primary care. The programme also promoted increased supply and quality of care by improving human and physical resources sensitive to unmet needs. Increased resource availability and improved supply of health care, rather than increased use, contributed to reduce infant mortality and improved long-term health as proxied by self-reported morbidity and child height. Consistent with the programme's focus on uninsured and low-income populations, the effects on mortality, long-term health status, and OOPHE were concentrated in vulnerable groups. FUNDING: Inter-American Development Bank.


Asunto(s)
Salud del Niño/estadística & datos numéricos , Salud del Lactante/estadística & datos numéricos , Cobertura Universal del Seguro de Salud/estadística & datos numéricos , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , México/epidemiología , Estudios Retrospectivos
11.
Cien Saude Colet ; 24(6): 2185-2191, 2019 Jun 27.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31269177

RESUMEN

Based on Brazil's commitment to the fulfillment of the Agenda 2030 and its 17 Sustainable Development goals (ODS), the State Secretariat for health of the Federal District, sought partnerships to address the ODS 3-Health and welfare "securing healthy and promote welfare for all, at all ages". Because it is an ODS that permeates all others, governmental actions directed to health and well-being are of extreme relevance to the success in the implementation of Agenda 2030. In this article we present the initiatives for the activation of social networks in the locality called the Estrutural city, in the Federal District, as a strategy for measuring health determinants, the implementation of a monitoring approach and cooperative evaluation of risk situations and social and environmental vulnerability of the territory, having the prospect of making it healthy and sustainable from the reference of the new local production process and the Agenda 2030 of the development goals sustainable.


Asunto(s)
Determinantes Sociales de la Salud , Red Social , Desarrollo Sostenible , Brasil , Ciudades , Objetivos , Humanos
12.
J Med Ethics ; 45(8): 497-503, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31331951

RESUMEN

Following the recent condemnation of the National Health Service charging regulations by medical colleges and the UK Faculty of Public Health, we demonstrate that through enactment of this policy, the medical profession is betraying its core ethical principles. Through dissection of the policy using Beauchamp and Childress' framework, a disrespect for autonomy becomes evident in the operationalisation of the charging regulations, just as a disregard for confidentiality was apparent in the data sharing Memorandum of Understanding. Negative consequences of the regulations are documented to highlight their importance for clinical decision makers under the principles of beneficence and non-maleficence. Exploration of the principle of justice illuminates the core differentiation between the border-bound duties of the State and borderless duties of the clinician, exposing a fundamental tension.


Asunto(s)
Determinación de la Elegibilidad/ética , Emigración e Inmigración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Justicia Social/ética , Medicina Estatal , Beneficencia , Estudios de Casos y Controles , Toma de Decisiones , Determinación de la Elegibilidad/legislación & jurisprudencia , Emigración e Inmigración/legislación & jurisprudencia , Emigración e Inmigración/estadística & datos numéricos , Regulación Gubernamental , Accesibilidad a los Servicios de Salud/ética , Historia del Siglo XX , Humanos , Obligaciones Morales , Autonomía Personal , Relaciones Médico-Paciente , Bienestar Social , Medicina Estatal/ética , Medicina Estatal/legislación & jurisprudencia , Reino Unido/epidemiología , Poblaciones Vulnerables/etnología , Indias Occidentales/epidemiología
13.
Int J Equity Health ; 18(1): 80, 2019 05 31.
Artículo en Inglés | MEDLINE | ID: mdl-31151452

RESUMEN

BACKGROUND: Implementation research is increasingly used to identify common implementation problems and key barriers and facilitators influencing efficient access to health interventions. OBJECTIVE: To develop and propose an equity-based framework for Implementation Research (EquIR) of health programs, policies and systems. METHODS: A systematic search of models and conceptual frameworks involving equity in the implementation of health programs, policies and systems was conducted in Medline (PubMed), Embase, LILACS, Scopus and grey literature. Key characteristics of models and conceptual frameworks were summarized. We identified key aspects of equity in the context of seven Latin American countries-focused health programs We gathered information related to the awareness of inequalities in health policy, systems and programs, the potential negative impact of increasing inequalities in disadvantaged populations, and the strategies used to reduce them. RESULTS: A conceptual framework of EquIR was developed. It includes elements of equity-focused implementation research, but it also links the population health status before and after the implementation, including relevant aspects of health equity before, during and after the implementation. Additionally, health sectors were included, linked with social determinants of health through the "health in all policies" proposal affecting universal health and the potential impact of the public health and public policies. CONCLUSION: EquIR is a conceptual framework that is proposed for use by decision makers and researchers during the implementation of programs, policies or health interventions, with a focus on equity, which aims to reduce or prevent the increase of existing inequalities during implementation.


Asunto(s)
Equidad en Salud , Política de Salud , Promoción de la Salud , Servicios de Salud , Disparidades en Atención de Salud , Investigación , Formación de Concepto , Atención a la Salud , Humanos , América Latina , Pobreza , Determinantes Sociales de la Salud , Factores Socioeconómicos , Cobertura Universal del Seguro de Salud , Poblaciones Vulnerables
14.
Rev Gaucha Enferm ; 40: e20180062, 2019 Jun 10.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31188983

RESUMEN

OBJECTIVE: To understand the motives behind the actions of harm reducers when working with drug users. METHOD: Qualitative research conducted in the municipality in Rio Grande do Sul (RS), Brazil, in May 2017, by means of phenomenological interviews with 17 harm reducers. We analyzed and interpreted the data using the social phenomenology of Alfred Schütz. RESULTS: Data analysis led to the following three categories: expectation of changes in the user's sphere of life, motivation at work from the recognition of their actions, and relationship with others as a life-learning experience. CONCLUSION: The reasons harm reducers work with drug users are related to the family, search for a home, employment, access to health care, rights, and stigma, as well as the positive results of their work, personal satisfaction, and learning with drug users.


Asunto(s)
Consumidores de Drogas , Reducción del Daño , Entrevista Psicológica , Motivación , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Brasil , Empleo/psicología , Familia , Femenino , Accesibilidad a los Servicios de Salud , Vivienda , Humanos , Masculino , Persona de Mediana Edad , Satisfacción Personal , Investigación Cualitativa , Estigma Social , Trabajadores Sociales/psicología , Adulto Joven
15.
BMC Oral Health ; 19(1): 126, 2019 06 25.
Artículo en Inglés | MEDLINE | ID: mdl-31238976

RESUMEN

BACKGROUND: User satisfaction represents a patient-centered measure that should be used to assess the quality of oral health services. This study investigated the differences in user satisfaction with public oral health services according to the sociodemographic user profile and the quality of oral health services in primary health care in Brazil. METHODS: Secondary data from a national program obtained through interviews with users were analyzed. Satisfaction was based on the Swan' model relating to perceptions regarding the service performance, assessment of overall satisfaction and the intention to avoid the service in the future. The exploratory variables were demographic characteristics of the users and the quality of the primary service from the user's viewpoint, considering the dimensions: access; receptivity of spontaneous demand; integral health care; bonding, accountability, and coordination of care. RESULTS: A total of 37,262 users participated, and 65.51% reported satisfaction with the oral health service, that was higher among those > 20 years old and beneficiaries of the Family Grant Program and lower among users with a higher level of schooling and those who reported being employed. Users who rated oral health service positively were more satisfied. CONCLUSIONS: Socioeconomically disadvantaged user was more satisfied with oral health services and the satisfaction increased with age. The improvement in the quality of oral health services in primary care can result in greater satisfaction.


Asunto(s)
Servicios de Salud Dental/organización & administración , Salud Bucal , Satisfacción del Paciente , Satisfacción Personal , Atención Primaria de Salud/organización & administración , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud , Investigación sobre Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Calidad de la Atención de Salud , Encuestas y Cuestionarios , Adulto Joven
16.
Ciênc. Saúde Colet ; 24(6): 2185-2191, jun. 2019. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1011805

RESUMEN

Resumo A partir do compromisso assumido pelo Brasil para o cumprimento da Agenda 2030 e de seus 17 Objetivos de Desenvolvimento Sustentável (ODS), a Secretaria de Saúde do Distrito Federal (SES/DF) e a Fundação Oswaldo Cruz - Fiocruz Brasília, constituíram parceria para tratar do ODS 3: "Assegurar uma vida saudável e promover o bem-estar para todas e todos, em todas as idades". Por se tratar de um ODS que permeia os demais, as ações governamentais direcionadas à saúde e bem-estar são de extrema relevância para o êxito na implementação da Agenda 2030. Neste artigo, descrevem-se as iniciativas para a ativação de redes sociotécnicas na localidade denominada Cidade Estrutural, no Distrito Federal, como estratégia para a implementação da Agenda 2030, tendo a perspectiva de tornar o território Saudável e Sustentável a partir da referência do novo processo de produção local. Neste sentido, adotou-se um modelo de inteligência cooperativa que pode mensurar os determinantes de saúde para o monitoramento e a avaliação das situações de risco e vulnerabilidade social e ambiental, de modo que o território possa ter informações sobre si mesmo.


Abstract Based on Brazil's commitment to the fulfillment of the Agenda 2030 and its 17 Sustainable Development goals (ODS), the State Secretariat for health of the Federal District, sought partnerships to address the ODS 3-Health and welfare "securing healthy and promote welfare for all, at all ages". Because it is an ODS that permeates all others, governmental actions directed to health and well-being are of extreme relevance to the success in the implementation of Agenda 2030. In this article we present the initiatives for the activation of social networks in the locality called the Estrutural city, in the Federal District, as a strategy for measuring health determinants, the implementation of a monitoring approach and cooperative evaluation of risk situations and social and environmental vulnerability of the territory, having the prospect of making it healthy and sustainable from the reference of the new local production process and the Agenda 2030 of the development goals sustainable.


Asunto(s)
Humanos , Red Social , Determinantes Sociales de la Salud , Desarrollo Sostenible , Brasil , Ciudades , Objetivos
17.
Health Promot Int ; 34(Supplement_1): i4-i10, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30900726

RESUMEN

This Statement represents the voice of participants in the 22nd IUHPE World Conference on Health Promotion, held in Curitiba, Brazil, in May 2016. The Brazilian political context at that time greatly influenced the drafting of the Curitiba Statement, which was considered by many participants as an opportunity to categorically express that Brazilian democracy was threatened, as well as the danger of fiscal austerity implemented by many governments of the world. The conference organizers also perceived the launching of this Statement as an opportunity to influence the WHO Shanghai Declaration, since it very strongly stated the influence of commercial interests and corporate practices of the market that are harmful to health. The Curitiba Statement gathers 120 suggestions made by conference participants and focuses on how strengthening health promotion and equity can improve people's lives. The 21 recommendations were summarized and resulted in appeals to International Organizations, all levels of Governments, Health Sector, Citizens, Health Professionals and Researchers. Unlike a declaration from government summit that are restricted by governments negotiations from different ideological spectrum, the Curitiba Statement was developed in a free environment to foster professional activism. We reaffirm that the objectives of Health Promotion in the Sustainable Development will only be fully achieved by incorporating these four fundamental principles: democracy, social justice, social mobilization and equity. Health Promotion in the twenty-first century needs new narratives and inputs from professional associations, which can be more assertive and to influencing the official declarations of government.


Asunto(s)
Salud Global , Política de Salud , Derechos Humanos , Brasil , Promoción de la Salud , Humanos , Política , Justicia Social , Factores Socioeconómicos
18.
Health Promot Int ; 34(Supplement_1): i37-i45, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30900729

RESUMEN

Global health faces a broad spectrum of old and new challenges. Besides epidemiological problems, political conflicts, economic crisis and austerity policies are jeopardizing progress towards Universal Health Coverage (UHC), affecting the most vulnerable populations. During the 22nd International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion held in Curitiba, Brazil, in 2016, challenges and threats for global health, in addition to a wide range of innovative experiences in health promotion, were discussed with participants from 65 countries. At the end of the conference, a public statement was approved claiming for Democracy and Human Rights in all countries around the world as essential conditions for the promotion of health and equity. In this paper, we explore challenges, threats and innovations in global health promotion. We use scientific literature, analysis of the current situation of the Brazilian health system, and material presented during the 22nd IUHPE World Conference. Also, we discuss strategies to strengthen health systems, policies and practices through the approach of STI and illustrative local experiences presented at the congress mentioned above, including examples developed in the city of Curitiba. We conclude that STI is crucial to support strengthening local health systems, design effective intersectoral public policies, scaling up innovative initiates, and skilling staff in addressing the contemporary challenges. Finally, the Declaration of the 22nd World Conference on Health Promotion of the IUHPE is a fundamental policy statement based on the prioritization of democracy and human rights as essential conditions for the promotion of health and equity.


Asunto(s)
Salud Global , Promoción de la Salud/tendencias , Brasil , Promoción de la Salud/métodos , Derechos Humanos , Humanos , Política , Política Pública
19.
Health Promot Int ; 34(Supplement_1): i56-i64, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30900730

RESUMEN

The article, a critical essay, presents the notion of an emancipatory promotion of health (EPH), which seeks to relate the field of public health in theoretical and practical terms with the reinvention of utopias and relevant social struggles of our time principally in the Global South, a metaphor designating the peripheral or semiperipheral regions of the modern world-system. This is a relevant topic in the face of the planetary socio-ecological crisis and the debate on economic development, democracy and sustainability at a moment especially critical for the Brazilian reality and other countries. In particular, the contributions of peoples and social movements from rural, forests and water-dominated regions in Brazil to the emancipatory practices of health are discussed. The article is mainly based on two theoretical and methodological references, the Political Ecology and post-colonial approaches. The first focuses its analysis on the intensification of the social metabolism and environmental conflicts in the global capitalist economy, based on an unfair and unsustainable international trade that generates numerous socio-environmental conflicts, mainly in the Global South, that is, the peripheral countries that export agricultural and mineral commodities to richer ones. The second reference broadens and integrates the critique of capitalism with colonialism and patriarchy, understood as the three axes of oppression resulting from the Eurocentric modernity project. The challenge here is to deconstruct and reconstruct through an intercultural dialogue new conceptions of society, economy, nature, development, work and health. Such references help us to understand the importance of indigenous, peasant and Afro-descendant struggles for an emancipatory health promotion.


Asunto(s)
Desarrollo Económico , Promoción de la Salud , Brasil , Países en Desarrollo , Salud Global , Humanos , Grupos Minoritarios , Política , Factores Socioeconómicos , Desarrollo Sostenible
20.
Health Promot Int ; 34(Supplement_1): i46-i55, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30900731

RESUMEN

One of the criticisms against the Sustainable Development Goals (SDGs) or 2030 Agenda is how they are decontextualized from national realities. To verify this, we worked to identify possible interfaces between the deliberations that took place at Brazilian national conferences and the 2030 Agenda, in the context of urban territories. A qualitative study was conducted using thematic analysis of the final documents produced by the national conferences on health, food and nutrition security, environment and solidarity economy (2013-2015). The study considered all 17 SDGs and the results are presented in the five Ps categories. (i) People: discussions related to this category presented more convergences than any other. (ii) Planet: water was discussed in terms of its rational use and preservation, and as a right. Patterns of consumption, production and climate change were linked to the debate on food. (iii) Partnerships: varying views were presented, some regarding them as a threat against guaranteed rights and others as a way to strengthen the national agenda. (iv) Prosperity: discussions focused on economic growth and industrialization associated to the redistribution of wealth and overcoming inequities. Cities were considered strategic in rural-urban relations. (v) Peace: the term was absent, but 'justice' was discussed in terms of rights, fair taxation and the inclusion of people in vulnerable situations. Our results demonstrated that the 2030 Agenda clearly converges with Brazil's social demands. They enabled contextualizing the SDGs and qualified the debates on their implementation, which indicate the adherence to principles of the health promotion field.


Asunto(s)
Promoción de la Salud/normas , Participación Social , Desarrollo Sostenible , Brasil , Ciudades , Conservación de los Recursos Naturales , Desarrollo Económico/tendencias , Salud Global , Objetivos , Derechos Humanos , Humanos , Justicia Social
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