Representaciones de masculinidades en las políticas públicas de salud en Chile.

OBJETIVO: comprender las representaciones de las masculinidades en las políticas públicas de salud en Chile. MÉTODO: desde un diseño metodológico cualitativo, se realizó una revisión documental de programas y políticas del área de la salud sexual y reproductiva, salud mental, violencia y ciclo vital, incluyendo adicionalmente el análisis de 10 entrevistas realizadas a trabajadores de la salud, actores claves y expertos. Se realizó un análisis de contenido temático, utilizando software NVivo. RESULTADOS: los principales resultados constatan que la presencia masculina es menor que la femenina en las políticas públicas de salud, y que las representaciones de los varones suelen tener una perspectiva socio-comportamental donde se concibe que la masculinidad es perjudicial para la salud. CONCLUSIÓN: los hallazgos instan a incluir una mirada inclusiva de hombres y masculinidades, su contexto social y capacidad de cambio a fin de poder abordar vulnerabilidades y necesidades específicas de la salud de hombres en Chile.

Rol de enfermería en el apoyo en duelo en familias de personas con cáncer / Nursing role in bereavement support for cancer patients relatives

Objetivo: Explorar el rol del profesional de enfermería de unidades oncológicas en el acompañamiento del proceso de duelo en familiares de personas con cáncer.Método: Estudio con metodología cualitativa con enfoque de estudio narrativo. Participaron 10 profesionales de enfermería oncológica. Se utilizó la entrevista semiestructurada y se realizó un análisis de contenido temático según Thomas, logrando la saturación de datos.Resultados: Diez profesionales de enfermería con al menos 2 años de experiencia en el área de oncología aportaron su vivencia de 6 hospitales de Santiago de Chile. Se obtuvieron 8 categorías emergentes, 6 de ellas se centran en las funciones de los profesionales de enfermería a lo largo del proceso de enfermedad, una categoría enfatiza en los factores que influyen en su quehacer profesional y una categoría destaca las características de los profesionales al realizar el acompañamiento.Conclusiones: Las/os enfermeras/os desarrollan sus funciones del rol en base a la contención, educación, protección del bienestar, soporte, guía, entre otras, las cuales comienzan en el momento del diagnóstico de cáncer y perduran durante todo el proceso de la enfermedad hasta el momento de fallecimiento; sin embargo, no se realiza un apoyo formal durante el transcurso del duelo de las familias. (AU)

Objetive: To explore the professional role of oncology nurses in bereavement support for cancer patient relatives.Methods: A qualitative study with a narrative approach. Ten oncology nurses were included in the study. A semi-structured interview was performed and a thematic content analysis was carried out according to Thomas, achieving data saturation.Results: Ten nursing professionals with at least 2 years of experience in the area of oncology contributed their experience at 6 hospitals in Santiago de Chile. Eight categories emerged from the analysis: 6 of them focused on nursing functions throughout the disease process, 1 category emphasized the factors that influence professional work, and 1 category highlighted the characteristics of professionals when performing the accompaniment.Conclusions: Nurses develop their role functions regarding patient relatives based on containment, education, welfare protection, support and guidance, among others, which begin at the moment of cancer diagnosis and last throughout the course of disease until death. However, there is no formal support during a family’s bereveament process. (AU)

Educational level, gender and health practices regarding COVID-19 in N'Djamena, Chad: A cross-sectional study.

COVID-19 is affecting different countries and populations unequally. In this sense, sub-Saharan countries represent a particularly vulnerable context due to their unique demographic and health circumstances. A holistic approach to Covid-19 is urged, one that considers the social-cultural contexts of people's lives. Using Social Determinants of Health (SDH) as framework, we explore which variables could explain the differences in health practices regarding the prevention of COVID-19 in Chad, in order to propose recommendations that allow communities to better face future health crises. The study was designed as a cross-sectional survey conducted in N'Djamena, Chad, using a convenience sampling technique that included 2,330 participants. A regression model was fitted to assess the relationship between educational level, gender, and health practices regarding COVID-19. 2,269 participants completed the survey successfully. Participants mean age was 31.04, 61.52% were male, and 40.55% had precarious jobs. 21.38% of participants answered right all questions regarding knowledge and 37.19% followed all preventive measures. Findings show that safe practices regarding COVID-19 depend on right knowledge. Gender influences knowledge mainly through its influence on education. Vulnerability is given by women's reduced access to education. The SDH approach provide with an exploratory explanation and some recommendations aimed at local authorities. Access to education for all men and women must be improved to increase health practices and better deal with future health crises.

Perceptions of barriers and facilitators to implement programs for prevention of mother-to-child transmission of HIV-Mozambique.

OBJECTIVE: To understand the perspectives of pregnant and postpartum women living with HIV in Sofala, Mozambique, regarding barriers and facilitators to following Prevention of Mother-to-Child Transmission (PMTCT) recommendations. METHOD: Qualitative study conducted in three health centers and with a peer support group of women living with HIV, between October 2020 and March 2021. We applied purposeful sampling, semi-structured interviews, and content analysis. RESULTS: Among the barriers that emerged were the social stigma associated with HIV-positive status and fear of discrimination, side effects of medications, economic barriers, and denial of diagnosis/treatment. As facilitating factors: peer support networks and inspiration, innate concern for health and family. Finally, they recommend that the community should become more educated about HIV. CONCLUSION: The results of this study give a broad understanding of the experience of women living with HIV in this province, making it possible to focus strategies in improving the care of women in PMTCT programs in Mozambique.

Predictors of COVID-19 vaccine hesitancy in Chad: A cross-sectional study.

Vaccination against the COVID-19 virus is currently the best option to combat the SARS-CoV-2 pandemic worldwide. However, in addition to logistical and economic barriers, hesitancy to be vaccinated threatens to jeopardize efforts to contain the disease. An increasing number of people in Africa are delaying or rejecting recommended vaccines. Since their launch, COVID-19 vaccines have frequently faced rejection worldwide. In this study, we interviewed 5,174 participants from Chad that were representative of the general population, on their perception of COVID-19 vaccines. The survey was conducted from April to May 2021, before the rollout of the COVID-19 vaccination. We found that 47.9% of respondents were willing to receive the COVID-19 vaccine, 29.8% were undecided and 22.3% would not accept the vaccine. We found that urban residents were much more likely to refuse the vaccine than rural residents. We also observed that distrust of COVID-19 vaccines and mistaken beliefs played a crucial role in the reluctance to be vaccinated. Hesitancy to vaccinate against COVID-19 was strongly associated with lack of knowledge, and acceptance of vaccination was primarily associated with fear of the disease. Finally, we identified population profiles among the undecided and the refractors, which will help in developing strategies to combat COVID-19 vaccine resistance.

Perceptions of barriers and facilitators to implement programs for prevention of mother-to-child transmission of HIV-Mozambique / Apreciações sobre barreiras e facilidades para implementar programas de prevenção da transmissão de mae a filho do HIV-Moçambique / Percepciones sobre barreras y facilitadores para implementar programas de prevención de transmisión materno-infantil de VIH-Mozambique

Abstract Objective: To understand the perspectives of pregnant and postpartum women living with HIV in Sofala, Mozambique, regarding barriers and facilitators to following Prevention of Mother-to-Child Transmission (PMTCT) recommendations. Method: Qualitative study conducted in three health centers and with a peer support group of women living with HIV, between October 2020 and March 2021. We applied purposeful sampling, semi-structured interviews, and content analysis. Results: Among the barriers that emerged were the social stigma associated with HIV-positive status and fear of discrimination, side effects of medications, economic barriers, and denial of diagnosis/treatment. As facilitating factors: peer support networks and inspiration, innate concern for health and family. Finally, they recommend that the community should become more educated about HIV. Conclusion: The results of this study give a broad understanding of the experience of women living with HIV in this province, making it possible to focus strategies in improving the care of women in PMTCT programs in Mozambique.

RESUMO Objetivo: Compreender as perspectivas das mulheres grávidas ou puérperas vivendo com HIV em Sofala, Moçambique, sobre as barreiras e facilidades para seguir as recomendações para a Prevenção da Transmissão Materno-Infantil (PMTCT). Método: estudo qualitativo realizado em três centros de saúde e com um grupo de apoio de pares de mulheres vivendo com HIV, entre outubro de 2020 e março de 2021. Aplicou-se amostra intencional, entrevistas semiestruturadas e análise de conteúdo. Resultados: O estigma social associado a ser HIV positivo e o medo da discriminação, efeitos colaterais dos medicamentos, barreiras econômicas e negação do diagnóstico/tratamento surgiram como barreiras. Como fatores facilitadores: redes de apoio e inspiração dos pares, preocupação inata com a saúde e a família. Finalmente, eles recomendam que a comunidade se eduque mais sobre o HIV. Conclusão: Os resultados deste estudo proporcionam uma compreensão ampla da experiência das mulheres que vivem com o HIV nesta província, possibilitando centrarse em estratégias para melhorar o atendimento às mulheres nos programas de PTMI em Moçambique.

RESUMEN Objetivo: Comprender las perspectivas de las mujeres embarazadas o en posparto viviendo con VIH en Sofala, Mozambique, respecto a las barreras y facilitadores para seguir las recomendaciones para la Prevención de Transmisión Materno Infantil (PTMI). Método: estudio cualitativo realizado en tres centros de salud y con un grupo de apoyo entre pares de mujeres viviendo con VIH, entre octubre de 2020 y marzo de 2021. Aplicamos muestreo intencional, entrevistas semiestructuradas y análisis de contenido. Resultados: Surgieron como barreras el estigma social que conlleva la condición de ser VIH positivo y el miedo a la discriminación, los efectos secundarios de los medicamentos, barreras económicas y la negación al diagnóstico/tratamiento. Como factores facilitadores: redes de apoyo e inspiración de pares, innata preocupación por la salud y la familia. Finalmente, ellas recomiendan que la comunidad se eduque más en materia de VIH. Conclusión: Los resultados de este estudio dan una comprensión amplia acerca de la experiencia de mujeres viviendo con VIH en esta provincia, posibilitando focalizar estrategias para mejorar la atención de las mujeres en los programas de PTMI en Mozambique.

Knowledge, Attitudes and Practices Regarding COVID­19 in N'Djamena, Chad.

The first African COVID-19 case was reported in Egypt in February 2020. Since then, Sub-Saharan countries have struggled to respond to the pandemic. Among them, Chad is characterized by a high rate of poverty and mortality, a high burden of infectious diseases, insufficient epidemiological surveillance and underdeveloped infrastructure. In this study, we explore the knowledge, attitudes and practices (KAPs) regarding COVID-19 within the Chadian population, to determine whether there are more vulnerable groups of the population that require greater attention from authorities. This study was designed as a cross-sectional survey conducted in N'Djamena, Chad, using a convenience sampling technique that included 2269 participants. The study was conducted in May and August 2020. Questions regarding technical concepts were answered incorrectly by most participants (83.65%). The population had better knowledge about concrete aspects of the pandemics, such as prevention measures and contagion. Regarding attitudes, 34.55% participants were very concerned about the possibility of being infected, 81.27% were unsatisfied/very unsatisfied with their social relationships after the pandemic began, and 68.44% thought that the pandemic was a disturbing/very disturbing issue. As for practices, 49.41% of men followed all preventive measures compared to 32.07% of women, and 3.04% of people with vulnerable jobs did not respect any of preventive measures compared to 1.19% of people without this condition. Gender, job conditions and educational level impact KAPs within the Chadian population. It is suggested that local authorities in Chad should consider these variables when developing health strategies.

Duelo perinatal: perspectivas de los profesionales de la salud / Perinatal grief: perspectives of health professionals

INTRODUCCIÓN: Los profesionales tienen un rol significativo en el proceso del duelo perinatal, y la relación que construyan con los padres será decisiva para facilitar u obstaculizar su cuidado. OBJETIVO: Comprender la perspectiva de los profesionales de la salud con relación al duelo perinatal. MÉTODO: Se realizó una búsqueda bibliográfica en las bases de datos CINAHL, CUIDEN, PsycINFO, PubMed y Google Académico. Se realizó un análisis temático de estos, permitiendo delimitar categorías temáticas comunes. RESULTADOS: Se obtuvieron 46 artículos cientificos con menos de 10 años de antiguedad. Se identificaron tres categorias para abordar la experiencia vivida: 1) Sentimientos experimentados por los profesionales, como ansiedad, culpa, resignación, síntomas físicos, frustración y evitación; 2) Necesidades sentidas de apoyo, entre estas, soporte emocional, capacitación formal y experiencia laboral que permitan afrontar de mejor forma el duelo con las familias y el equipo; 3) Facilitadores del proceso, donde se destacan la capacitación, años de trayectoria profesional, confianza en si mismo, apoyo de los pares, equipo multidisciplinario, creencia religiososa y apoyo institucional. CONCLUSIÓN: El duelo perinatal es una situación dramática para los padres, los cuales demandan un cuidado sensible. Y los profesionales desempeñan un rol clave en el apoyo integral a los padres, siendo un proceso exigente tanto en lo personal como en lo profesional. Se sugiere formación de pregrado y postgrado, fomentando el diálogo y apoyo entre los equipos. De esta forma se beneficiarán los padres, su familia y los profesionales, los cuales podrán otorgar un cuidado efectivo y de calidad en situación de duelo perinatal.

INTRODUCCIÓN: Professionals play a significant role in the perinatal mourning. The relationship they established with parent in this process is critical in facilitating or hindering the quality of health care in this context. OBJETIVO: to understand the perspective of health care professionals in relation to perinatal grief. METHOD: A literature review was carried out in CINAHL, CUIDEN, PsycINFO, PubMed and the Google Scholar databases. A thematic analysis of the selected articles was carried out, allowing to define common thematic categories in these articles. RESULTS: 46 scientific articles, published in the last ten years, were obtained. Three topics were identified: 1) feelings experienced by professionals, including anxiety, guilt, anger, resignation, physical symptoms, frustration, avoidance and emotional pain; 2) needs related to support, such as emotional support, formal training and work experience that allows for a better approach with families and parents; and 3) facilitators of the process, where training, years of professional experience, self-confidence, peer support, multidisciplinary team, religious beliefs and institutional support stand out. CONCLUSION: Perinatal grief is a complex situation for parents who demand sensitive care. Professionals play a key role in comprehensive support for them, being a demanding process both personally and professionally. Undergraduate and postgraduate training is suggested, encouraging dialogue and support among teams. This would benefit family and professionals, providing effective and quality care in a situation of perinatal grief.

Development of an instrument to measure the cultural competence of health care workers.

OBJECTIVE: To validate an instrument measuring the cultural competence in health care workers from Chile. METHODS: Using Sue & Sue's theoretical model of cultural competence, we designed a scale, which was assessed by health care workers and experts. Subsequently, the scale was applied to a sample of 483 different health care workers, during 2018 in Santiago de Chile. The analysis included: exploratory and confirmatory factor analysis, estimation of reliability, and analysis of measurement bias. Finally, the level of cultural competence was calculated for every professional who participated in this study. RESULTS: The final scale include 14 items that are grouped into three dimensions concordant with the theoretical model: sensitivity to own prejudices, cultural knowledge, and skills to work in culturally diverse environments. This scale showed good fit in factor models, adequate reliability and lack of evidence of measurement bias. Regarding the performance of health care workers, sensitivity showed a lower level compared with the other dimensions evaluated. CONCLUSION: The scale for measuring the level of cultural competence in health care workers (EMCC-14) is a reliable instrument, with initial support for its validity, which can be used in the Chilean context. Additionally, the results of this study could guide some possible interventions in the health sector to strengthen the level of cultural competence.

Development of an instrument to measure the cultural competence of health care workers / Desarrollo de un instrumento para medir competencia cultural en trabajadores de Salud

ABSTRACT OBJECTIVE To validate an instrument measuring the cultural competence in health care workers from Chile. METHODS Using Sue & Sue's theoretical model of cultural competence, we designed a scale, which was assessed by health care workers and experts. Subsequently, the scale was applied to a sample of 483 different health care workers, during 2018 in Santiago de Chile. The analysis included: exploratory and confirmatory factor analysis, estimation of reliability, and analysis of measurement bias. Finally, the level of cultural competence was calculated for every professional who participated in this study. RESULTS The final scale include 14 items that are grouped into three dimensions concordant with the theoretical model: sensitivity to own prejudices, cultural knowledge, and skills to work in culturally diverse environments. This scale showed good fit in factor models, adequate reliability and lack of evidence of measurement bias. Regarding the performance of health care workers, sensitivity showed a lower level compared with the other dimensions evaluated. CONCLUSION The scale for measuring the level of cultural competence in health care workers (EMCC-14) is a reliable instrument, with initial support for its validity, which can be used in the Chilean context. Additionally, the results of this study could guide some possible interventions in the health sector to strengthen the level of cultural competence.

RESUMEN OBJETIVO Validar un instrumento de medición de competencia cultural en trabajadores de salud de Chile. MÉTODOS Utilizando el modelo teórico de Sue y Sue, se diseñó un instrumento de medición el cual fue evaluado por trabajadores de salud y expertos. Este instrumento se aplicó a una muestra diversa de 483 proveedores de salud, durante 2018 en Santiago de Chile. Se realizó análisis factorial exploratorio, confirmatorio, estimación de confiabilidad y análisis de sesgo de medición. Se estimó el nivel de competencia cultural alcanzado por los profesionales. RESULTADOS El instrumento final contó con 14 ítems los cuales se agruparon en tres dimensiones: sensibilidad a los propios prejuicios, conocimiento cultural y habilidades para trabajar en entornos culturalmente diversos. Esta herramienta mostró buen ajuste en los modelos factoriales, adecuada confiabilidad y ausencia de evidencias de sesgo de medición. Los trabajadores de salud evaluados exhibieron un bajo nivel de sensibilidad a los propios prejuicios en comparación con las otras dimensiones evaluadas. CONCLUSIONE La Escala de Medición de Competencia Cultural en trabajadores de salud (EMCC-14) es una herramienta confiable, con soporte inicial para su validez, que puede usarse en el contexto Chileno. Además, los resultados de este estudio podrían guiar algunas posibles intervenciones en el sector de la salud para fortalecer el nivel de competencia cultural.

Voluntades anticipadas: desafíos éticos en el cuidado del paciente / Advance Directives: Ethical Challenges in Patient Care / Diretivas antecipadas de vontade: desafios éticos no cuidado do paciente

Resumen Las voluntades anticipadas en salud tienen como finalidad que la persona manifieste de manera anticipada su voluntad sobre los cuidados y el tratamiento de su salud, lo cual le permite expresar personalmente y de forma previa sus preferencias. Esta revisión de la literatura tiene por objetivo describir el concepto y la estructura de las voluntades anticipadas, así como los aspectos éticos involucrados durante el cuidado del paciente. Con las palabras clave "Advanced Health Care Directive" AND "Ethical Implication" y sus símiles en español (voluntades anticipadas, implicaciones éticas), se revisaron cinco bases de datos: ProQuest, Philosophy (JSTOR), PubMed, Web of Science y SciELO; las publicaciones se agruparon entre los años 2010 y 2018. Se obtuvieron 31 artículos de los cuales se realizó una lectura crítica. Los resultados de esta revisión fueron agrupados en las siguientes categorías: concepto, estructura, situaciones clínicas donde se aplican las voluntades anticipadas, fortalezas y limitaciones; así como los aspectos éticos involucrados. Actualmente, son más comunes las vivencias relacionadas con las situaciones al final de la vida, donde la persona pierde su capacidad de decidir y no puede manifestar sus deseos, por lo que es imposible conocer su voluntad. Gran parte de los profesionales de la salud no tienen capacitación adecuada sobre el desarrollo y la aplicación de las voluntades anticipadas, escenario que se convierte en una oportunidad para la investigación y profundización sobre el tema. Las voluntades anticipadas son una herramienta que proporciona al equipo de salud información fidedigna de los valores y deseos del paciente, por lo que es importante capacitar a estos profesionales para brindar una atención respetuosa y de calidad.

Abstract Advance healthcare directives are intended for the individual to personally express their will and preferences about healthcare and treatment ahead of time. This literature review aims to describe the concept and structure of advance directives and the ethical aspects involved in patient care. Using the keywords "Advance Healthcare Directive" AND "Ethical Implication" and its Spanish equivalents (voluntades anticipadas, implicaciones éticas), five databases were accessed: ProQuest, Philosophy (JSTOR), PubMed, Web of Science and Scielo. Publications were narrowed down to the 2010-2018 period. Thirty-one articles were obtained and read critically. Results of this review were grouped into the following categories: concept, structure, clinical situations in which advance directives apply, strengths and limitations, as well as the ethical aspects involved. End of life-related experiences in which a person loses their ability to make decisions and cannot express their wishes, so it is impossible to know their will, are more common nowadays. Most health workers are not appropriately trained in the preparation and application of advance directives, which becomes an opportunity to research and delve deeper into the subject. Advance directives are a tool that gives health workers reliable information on a patient's values and wishes, so it is vital to train them to provide respectful quality care.

Resumo As diretivas antecipadas de vontade na saúde têm como finalidade que o paciente manifeste, de maneira antecipada, sua vontade e preferências sobre os cuidados e o tratamento de sua saúde. Esta revisão da literatura tem como objetivo descrever o conceito e a estrutura das diretivas antecipadas de vontade, bem como os aspectos éticos envolvidos durante o cuidado do paciente. Com as palavras-chave "advanced health care directive" AND "ethical implication" e seus equivalentes em espanhol ("voluntades anticipadas", "implicaciones éticas"), foram revisadas cinco bases de dados: ProQuest, Philosophy (JSTOR), PubMed, Web of Science e SciELO; as publicações são de 2010 a 2018. Foram obtidos 31 artigos, dos quais foi realizada uma leitura crítica. Os resultados desta revisão foram agrupados nas seguintes categorias: conceito, estrutura, situações clínicas em que são aplicadas as diretivas antecipadas de vontade, fortalezas, limitações, bem como aspectos éticos envolvidos. Atualmente, são mais comuns as vivências relacionadas com as situações no final da vida, em que a pessoa perde sua capacidade de decidir e não pode manifestar seus desejos, portanto é impossível conhecer sua vontade. Grande parte dos profissionais da saúde não tem capacitação adequada sobre o desenvolvimento e a aplicação das diretivas antecipadas de vontade, o que se torna uma oportunidade para pesquisar e aprofundar sobre o tema. As diretivas antecipadas de vontade são uma ferramenta que proporciona, à equipe de saúde, informação fidedigna dos valores e desejos do paciente, por isso é importante capacitar os profissionais para oferecer uma atenção respeitosa e de qualidade.

[Social determinants of the health of international migrant children in Chile: qualitative evidence.] / Determinantes sociales de la salud de niños migrantes internacionales en Chile: evidencia cualitativa.

OBJECTIVE: To explore the social determinants of health (SDH) of international migrant children, from the perceptions of caregivers, health workers and local authorities in eight municipalities in Chile. MATERIALS AND METHODS: A secondary analysis of data was conducted from a qualitative study that took place between 2014 and 2017. The original study involved semi-structured interviews and focus groups. The secondary thematic analysis of data included all emerging issues related to international migrant children and their living conditions, including use of health services. RESULTS: Findings were grouped according to the model of social determinants of health, which allow a reflection on living conditions of international migrant children and their health situation. CONCLUSIONS: This research shows the impact of SDH on international migrant children in Chile, highlighting relevant issues around this group.

OBJETIVO: Explorar los determinantes sociales de la salud (DSS) de niños migrantes, a partir de las percepciones de cuidadores y trabajadores autoridades de salud en las zonas más densas de población migrante en Chile. MATERIAL Y MÉTODOS: Se realizó un análisis de datos secundario de un estudio realizado entre los años 2014 y 2017 desde un paradigma cualitativo de investigación. El estudio original incluyó entrevistas semiestructuradas y grupos focales. El análisis temático secundario de datos contempló todos los temas emergentes referidos a niños migrantes y condiciones de vida, incluyendo utilización de servicios de salud. RESULTADOS: Los DDS fueron agrupados de acuerdo con el Modelo de Determinantes Sociales de la Salud, el cual permite reflexionar en torno a las condiciones de vida de niños migrantes y su situación de salud. CONCLUSIONES: Esta investigación muestra el impacto de los DSS en salud de niños migrantes en Chile, resaltando temáticas relevantes en torno a este grupo.

Barriers and Facilitators perceived by the health team for the implementation of pre and post ductal saturometry as a method of detection of congenital heart diseases in newborns, prior to discharge. / Barreras y Facilitadores percibidos por el equipo de salud para la implementación de saturometría pre y post ductal como método de detección de cardiopatías congénitas en recién nacidos, previo al alta.

OBJECTIVE: To describe the main barriers and facilitators perceived by the health care workers for the implementation of Pre- and Post-Ductal Oxygen Saturation (SPPD) as a detection method of Con genital Heart Disease in newborns, prior to hospital discharge. MATERIAL AND METHOD: From a cons tructivist research paradigm, a case study was carried out in three public hospitals in the Metropoli tan Region, Chile, two of them are high-complexity hospitals. The first one, the NEW Hospital, has recently started its activity, and the second one, the OLD Hospital, has been operating for many years. The third one, the RURAL Hospital, is a low-complexity institution, located near Santiago. Data were collected through individual semi-structured interviews and focus groups to Nursing Technicians (TENS), Midwives and Physicians. The interviews were recorded and transcribed. Thematic content analysis is performed using the NVivo11 qualitative software. The investigation was approved by the Ethics Committee recognized by the hospitals involved. RESULTS: In the NEW Hospital, where the SPPD was implemented more than a year ago, barriers are detected at execution level, especially in oximeter inputs and on weekends. In the OLD Hospital and the RURAL Hospital, in which the SPPD was not implemented, the main perceived barriers are concentrated in insufficient knowledge about their usefulness, economic aspects, work overload, and organizational aspects. In the NEW Hospital, the main facilitators for the application of SPPD were its simplicity, economy, and the fact that it is an important contribution to the safety of newborns discharged. CONCLUSION: The disposition regar ding the practice of PPDS as a screening, varies in the 3 hospitals explored. To achieve this goal it is recommended to overcome organizational, management and economic barriers. Although there is a need to train the personnel in charge of screening, there is good disposition given the importance for the health of the RN. The flow of referral after screening for positive SPPD is quite clear.

Salud sexual y reproductiva de hombres jóvenes en Chile: resultados de un estudio cualitativo

[RESUMEN]. Objetivo. Describir, a partir de las percepciones de adolescentes y personal de atención de salud, las formas en que los adolescentes varones se relacionan con la atención de salud sexual y reproductiva, las transformaciones percibidas en este ámbito y las estrategias desplegadas por Espacios Amigables para la atención de salud adolescente para acercarse a ellos. Métodos. Estudio cualitativo etnográfico en Espacios Amigables para la atención de adolescentes y jóvenes de cinco municipios de la Región Metropolitana de Chile. Se utilizaron las técnicas de entrevistas semiestructuradas (N = 38), grupos de discusión (N = 5) y observación participante. Resultados. Se identifica una falta de perspectiva de masculinidades en la atención de salud sexual y reproductiva en adolescentes, que se percibe como un ámbito enfocado principalmente para el género femenino. La mayoría de los adolescentes varones percibe a los servicios de salud como distantes y acuden principalmente en casos de emergencia. Se identifica una baja asistencia de hombres a servicios de salud sexual y reproductiva en Espacios Amigables ubicados en centros de atención primaria de salud. Sin embargo, aquellos ubicados fuera de estos como, por ejemplo, un centro exclusivo de atención de salud adolescente y servicios integrados en las escuelas, convocan a mayor número de varones. Conclusiones. Una mayor oferta de servicios de salud sexual y reproductiva para adolescentes no necesariamente implica un aumento en el acceso de hombres. Para que esto suceda, es importante invitarlos desde temáticas que les resulten de interés, acercar los servicios de salud hacia donde ellos están, potenciar el trabajo intersectorial, e incorporar un enfoque de masculinidades para su atención.

[ABSTRACT]. Objective. To describe, based on the perceptions of adolescents and health service staff, the ways in which adolescent boys interact with sexual and reproductive health services, the changes perceived in this area over time, and the Espacios Amigables strategy (‘Friendly Spaces’ for adolescent health) to reach out to boys. Methods. An ethnographic, qualitative study was conducted in Friendly Spaces for adolescent and young adult health in five municipalities belonging to Chile’s Metropolitan Region. The research methods used were semi-structured interviews (N = 38), discussion groups (N = 5), and participant observation. Results. A masculinities perspective was [TN: “un enfoque de masculinidades”. Or simply: “Masculine perspectives were…”] felt to be missing in adolescent sexual and reproductive health care, which is perceived to be an area geared primarily toward females. Most adolescent boys perceive health services as distant and visit them only in case of emergency. Male attendance is low at sexual and reproductive health services in Friendly Spaces within primary health care centers. However, services outside these centers attract boys in larger numbers, for example, one that is exclusively devoted to providing adolescent health care and integrated services in schools. Conclusions. Greater provision of adolescent sexual and reproductive health services does not necessarily translate into increased male access. For such an increase to occur, it is important to engage boys in addressing issues that capture their interest, bring health services closer to them, strengthen intersectoral work, and incorporate a masculinities perspectives in their care.

[RESUMO]. Objetivo. Descrever, a partir das percepções dos jovens e do pessoal de saúde, as formas como os adolescentes do sexo masculino se relacionam com a atenção de saúde sexual e reprodutiva, as transformações percebidas neste âmbito e as estratégias para atenção de saúde do adolescente por espaços amigáveis para o alcance deste grupo. Métodos. Foi realizado um estudo qualitativo etnográfico em espaços amigáveis para atenção de saúde de adolescentes e jovens em cinco municípios da região metropolitana do Chile. Foram empregados os métodos de entrevistas semiestruturadas (N = 38) e grupos de discussão (N = 5) e a técnica de observação participante. Resultados. Foi verificada a falta de uma perspectiva de masculinidades na atenção de saúde sexual e reprodutiva para adolescentes, que se percebe como sendo voltada principalmente ao sexo feminino. A maioria dos adolescentes e jovens percebe os serviços de saúde como distantes e recorrem a eles sobretudo em situações de emergência. Foi observada pouca assistência ao sexo masculino nos serviços de saúde sexual e reprodutiva em espaços amigáveis situados em unidades de atenção primária à saúde. No entanto, a frequência dos jovens é maior nos espaços localizados fora destas unidades, como em um centro exclusivo de atenção de saúde do adolescente e serviços integrados em escolas. Conclusões. Uma maior oferta de serviços de saúde sexual e reprodutiva para adolescentes não implica necessariamente maior acesso do sexo masculino. Para isso, é importante atrair os jovens com assuntos do interesse deles, acercar os serviços de saúde de onde eles estão, reforçar o trabalho intersetorial e incorporar um enfoque de masculinidades à atenção.

Determinantes sociales de la salud de niños migrantes internacionales en Chile: evidencia cualitativa / Social determinants of the health of international migrant children in Chile: qualitative evidence

Resumen: Objetivo: Explorar los determinantes sociales de la salud (DSS) de niños migrantes, a partir de las percepciones de cuidadores y trabajadores/autoridades de salud en las zonas más densas de población migrante en Chile. Material y métodos: Se realizó un análisis de datos secundario de un estudio realizado entre los años 2014 y 2017 desde un paradigma cualitativo de investigación. El estudio original incluyó entrevistas semiestructuradas y grupos focales. El análisis temático secundario de datos contempló todos los temas emergentes referidos a niños migrantes y condiciones de vida, incluyendo utilización de servicios de salud. Resultados: Los DDS fueron agrupados de acuerdo con el Modelo de Determinantes Sociales de la Salud, el cual permite reflexionar en torno a las condiciones de vida de niños migrantes y su situación de salud. Conclusión: Esta investigación muestra el impacto de los DSS en salud de niños migrantes en Chile, resaltando temáticas relevantes en torno a este grupo.

Abstract: Objective: To explore the social determinants of health (SDH) of international migrant children, from the perceptions of caregivers, health workers and local authorities in eight municipalities in Chile. Materials and methods: A secondary analysis of data was conducted from a qualitative study that took place between 2014 and 2017. The original study involved semi-structured interviews and focus groups. The secondary thematic analysis of data included all emerging issues related to international migrant children and their living conditions, including use of health services. Results: Findings were grouped according to the model of social determinants of health, which allow a reflection on living conditions of international migrant children and their health situation. Conclusion: This research shows the impact of SDH on international migrant children in Chile, highlighting relevant issues around this group.