RESUMEN
BACKGROUND: The organization and operation of the epidemiological monitoring carried out at several Primary Care facilities in Cuba was assessed by means of a study conducted for the purpose of ascertaining the effectiveness of the monitoring in question and of contributing to further improve the mechanisms thereof and thus improve the health conditions of the population. This assessment was implemented at eight Polyclinics in the city of Havana throughout the 1998-1999 period. METHOD: By means of the implementation of an integral methodology, an assessment was made of the three factors involved in the monitoring system at the facilities in question, that is, the organization, the process and the results thereof. For this purpose, a survey which quantified some aspects of the system (sensitivity, opportunity, representativeness, usefulness) and a semi-structured survey of epidemiologists and other physicians involved in the monitoring in question in addition to the users of the system was used. RESULTS: The assessment of the organization revealed the monitoring organization to be adequate. In the assessment of the process, sensitivity was found to be low at some polyclinics, problems existing at many of them with regard to the opportunity and flexibility of the system. The assessment of the results of the monitoring revealed them to be satisfactory as regards their effectiveness for detecting acute events, as well as in the perception of the users with regard to the usefulness of these results for solving the problems pinpointed. CONCLUSIONS: The monitoring done at the polyclinics assessed is indicative of there being an adequate organization of the monitoring, although some shortcomings were found to exist with regard to the fulfillment of some aspects of the monitoring. This however has no bearing on the results for the system as a whole, which is capable of detecting any epidemiological situation of importance and of suggesting appropriate measures for controlling the situation.
Asunto(s)
Vigilancia de la Población , Atención Primaria de Salud , Cuba/epidemiología , Instituciones de Salud , Humanos , Encuestas y CuestionariosRESUMEN
Given the development of public health, hygiene and epidemiology in Cuba and their linking with primary care, and particularly, the novel approach to health surveillance in its different implementation alternatives, it is necessary to develop new forms and methods for surveillance evaluation at this level. The paper is aimed at presenting methodological proposal for assessing surveillance in primary health care. We made a literature review of known documents, guides or manuals which have been published in Cuba and in other countries and we interviewed a group of experts in this field. An initial instrument was worked out and tested in three health areas of the capital and afterwards, it was modified accordingly. The process of assessment was divided into 4 aspects: structure, process or functioning, results or usefulness and economic evaluation. To assess functioning of surveillance, we took the analysis of its attributes into account, i.e., simplicity, flexibility, acceptability, sensitivity positive predictive value, representativity, opportunity and also integrality and responsiveness capacity. We described steps to be implemented and elements to be considered. Generally, the evaluation should be carried out in a week. The cost of implementing each evaluating process is estimated at 40 Official Announcement. V Workshop of university libraries of Latin and the Caribbean. Upon finishing the evaluation, a report should be submitted with the comprehensive assessment and recommendations for the evaluated level.
Asunto(s)
Vigilancia de la Población , Atención Primaria de Salud , Cuba , Humanos , Atención Primaria de Salud/normasRESUMEN
El presente manual va dirigido a los maestros, los profesores, las auxiliares pedagógicas y otros educadores y educadoras de los distintos tipos y niveles de enseñanza, así médicos, enfermeros, técnicos y otros trabajadores y trabajadoras de la salud y los profesores y trabajadores del sector de agua y saneamiento, además a los actores de las organizaciones comunitarias y la población en general. El manual es aplicable previa adaptación a otras zonas rurales ubicadas en parques nacionales, reservas de la biosfera, otras áreas protegidas y sistemas montañosos de Cuba(AU)
