Estrategia de cooperación de país entre OPS/OMS y el Uruguay, 2023 - 2027

La OPS renueva su compromiso con el Uruguay a través de una Estrategia de Cooperación Técnica que firman el Ministerio de Salud Pública y la Representación de OPS/OMS en el país. La nueva estrategia, período 2023- 2027, es la visión estratégica de mediano plazo para apoyar el logro de los objetivos sanitarios del país. El 13.° Plan General de Trabajo de la OMS, la Agenda de Salud Sostenible para las Américas 2018-2030 y el Plan Estratégico de OPS 2020-2025 son los marcos mundiales y regionales que orientan los esfuerzos de los países para alcanzar los Objetivos de Desarrollo Sostenible relacionados con la salud. La estrategia de cooperación se instala en estos marcos y en consonancia con las prioridades nacionales definidas en los Objetivos Sanitarios Nacionales 2030 y con el Marco de Cooperación de Naciones Unidas para el Desarrollo Sostenible, herramienta que armoniza la cooperación técnica de todo el Sistema de Naciones Unidas en Uruguay. Uruguay realizó la transición de la categoría de país de renta medio-alta a país catalogado de renta alta. Cuenta con una trayectoria de estabilidad política, democrática y social. En el ámbito de la salud pública y del sistema de salud, el país es referencia en la Región de las Américas con una reforma sectorial exitosa que tiene ya catorce años de aplicación y una solidez institucional que le permitió gestionar con acierto la pandemia por Covid-19. En el período 2000-2020, la mortalidad infantil se redujo de 16,5 a 6,9 por cada 1 000 nacidos vivos. El país tiene una transición epidemiológica temprana: en 2020 el 15,5 % del total de la población tenía 65 años y más. Las enfermedades no transmisibles, sus factores de riesgo y mortalidad son de alta prevalencia en el país. La alimentación es de alerta, sobre todo si se considera a la población de 0 a 5 años donde el 80 % consume más calorías de las adecuadas. La prevalencia de sobrepeso y obesidad es de 12,3 % en la franja 0 a 4 años.

Liberating Structures in Strategic Planning: Methods to Foster Engagement.

This paper describes the innovative approach of using liberating structures to the development of the AUR 2023 strategic plan, and lessons learned in their application. The 2023 strategic plan built on the results and approach of the prior 2015 plan. Similar to the 2015 strategic plan, traditional tools such as a SWOT analysis and strategic retreat were used. In addition, the 2023 process included tools called liberating structures and was iteratively co-produced through a series of virtual meetings over 18 months. Advantages of liberating structures included increased creativity and speed in moving through meeting tasks, increased number of meaningful contributions from AUR members and increased engagement from participants during discussions and meetings. The 2023 AUR strategic plan is provided along with examples of completed goals and those under early implementation. Lessons learned from using these tools for strategic planning can be applied to other society and group meetings. Moving forward, the 2023 strategic plan will be a living document, which will be reviewed at each Board of Directors meeting and periodically adapted.

Estrategias para garantizar la seguridad del paciente crítico / Strategies to ensure the critical patient safety

Objetivo: Identificar las estrategias para garantizar la seguridad del paciente crítico. Método: Revisión integradora, cuya búsqueda fue realizada en mayo del 2022 haciendo uso de las fuentes de datos: MEDLINE, SciELO, WOS, LILACS, Scopus e IBECS. El análisis y síntesis se construyó a partir de los resultados encontrados, buscando agruparlos por categorías en función de la similitud de contenido. Resultados: Se encontraron 377 artículos, luego se procedió a aplicar los criterios de inclusión y la lectura exhaustiva, resultando una muestra de 13 artículos. Los resultados fueron clasificados en cinco categorías: Prevención de la neumonía asociada a la ventilación mecánica; Seguridad en la administración y gestión de medicamentos; Prevención de las lesiones por presión; Programa educativo orientado a la seguridad del paciente en cuidados intensivos, y Reflexiones del equipo de salud con respecto a cultura de seguridad.Conclusiones: Este estudio contribuye a identificar de forma integral las diversas estrategias cuyos resultados demostraron un cambio positivo en la prevención de eventos adversos y el fortalecimiento en la seguridad en la atención sanitaria (AU)

Objective: Identify the strategies to guarantee the safety of the critically ill patient. Method: Integrative review, search carried out in May 2022 using the data sources: MEDLINE, SciELO, WOS, LILACS, Scopus and IBECS. The analysis and synthesis were built from the results found, seeking to group them by categories based on the similarity of content. Results: 377 articles were found, thenthe inclusion criteriaand exhaustive reading were applied, resulting in a sample of 13 articles. The results were classified into five categories: Prevention of pneumonia associated with mechanical ventilation; Safety in the administration of management of medicines; Prevention of pressure injuries; Educational program oriented to patient safety in intensive care and; Reflections of the health team regarding safety culture. Conclusions: This study contributes to comprehensively identify the various strategies whose results demonstrated a positive change in the prevention of adverse events and strengthening of safety in health care (AU)

Regulatory Framework, Challenges, and Initial Strategic Planning for Advanced Therapy Products (PTAs) Development in Brazil.

Advanced Therapies are a class of innovative complex biological products used for therapeutic purposes, encompassing cell therapy, tissue engineering, and gene therapy products. These are promising therapeutic strategies for several complex diseases with low or non-existent therapeutic alternatives. The proper transposition of basic research in this area into medicinal products must comply with regulatory requirements. Here we review the main regulatory recommendations, emphasizing on the Brazilian regulation. The critical points are the manufacturing process, challenges in characterizing the product, development of non-clinical trials, lack of adequate animal models representative of the clinical situation, and absence of valid and measurable therapeutic endpoints. Based on that, we propose a framework for strategic planning of pre-clinical studies in this field. The detailed example involves producing a nonviral vector-based gene editing product, but the regulations and methods may be extrapolated for developing different types of advanced therapies.

WHO Country Cooperation Strategy, Ukraine 2024–2030 / CCS Ukraine

The World Health Organization’s Country Cooperation Strategy (CCS), Ukraine 2024–2030 – also known within Ukraine as the Ukraine Programme of Work – charts a course to a healthier future for Ukraine. It aligns with Ukraine’s health priorities, fosters resilience and, through partnership, aims to make a measurable difference. At its foundation, the CCS holds a people-centred, human rights approach to health care, and is guided by innovation, quality data and adaptability.

Отчет о 37-м совещании Европейской региональной комиссии по сертификации ликвидации полиомиелита

На 37-м совещании Европейской региональной комиссии по сертификации ликвидации полиомиелита (РКС),которое прошло 7-8 сентября 2023 г., были рассмотрены ежегодно обновляемые данные о статусе национальных программ ликвидации полиомиелита в 2022 г. представленные государствами-членами Европейского региона ВОЗ.На основании предоставленных данных РКС сделала вывод, что в 2022 г. в Европейском регионе ВОЗ отсутствовала передача дикого полиовируса (ДПВ), а эпизоды и вспышки, вызванные вакцино-родственным полиовирусом,контролировались надлежащим образом. РКС также пришла к выводу, что в Боснии и Герцеговине и Украине сохраняется высокий риск возникновения устойчивой вспышки полиомиелита в случае завоза ДПВ или возникновения циркулирующего вакцино-родственного полиовируса в первую очередь из-за низкого уровня коллективного иммунитета.

Plan estratégico de integración en salud 2023-2030 / Strategic health integration plan 2023-2030

La presente publicación incorpora ampliamente algunas dimensiones relevantes con las que hasta el momento se venía trabajando como el cambio climático y las desigualdades sociales en salud. luna agenda en común de las prioridades en salud pública de los seis países andinos. Incluye cinco líneas estratégicas 1. Posicionamiento de la salud como eje central del desarrollo humano, 2. Promoción del derecho a la salud con justicia social y ambiental, 3. Reducción de las desigualdades e inequidades en salud, 4. Integración y cooperación regional, 5. Fortalecimiento institucional. El Plan, parte de un diagnóstico que muestra cómo la pandemia afectó la garantía del derecho a la vida, la salud y el bienestar, pero aclarando que los efectos de dicha pandemia fueron más funestos donde la estructura de desigualdades exacerbó el riesgo de enfermar. Por ello, los datos muestran que los países con alta desigualdad y sistemas de protección débiles han tenido altos índices de contagios y letalidad.

NINDS Health Equity Strategic Planning Process Overview, High-Level Recommendations, and Guide.

Neurologic mortality is increasing in the United States and is occurring in an inequitable manner. There is a major need for innovative research strategies to eliminate these inequities. In 2020, the National Institute of Neurological Disorders and Stroke (NINDS) embarked on a health equity strategic planning process, which culminated in a 3-day public workshop and research recommendations provided by a working group of its National Advisory Neurological Disorders and Stroke Council (NANDSC WG) to the NINDS. This Neurology® supplement is dedicated to the NINDS health equity strategic planning process. As cochairs of the NANDS WG, we developed this summary to provide an overview of the process and a guide for navigating this special issue. Detailed recommendations from the NANDS WG are distributed throughout various articles in this supplement and supported with extensive commentary on the state of the science in health equity. Consolidated high-level recommendations from this process are presented at the end of this article.

Assessing Use, Usefulness, and Application of the High Impact Practices in Family Planning Briefs and Strategic Planning Guides.

BACKGROUND: In global health, persistent barriers and challenges to bridging the gap between research and practice remain critical to address in most health areas. The High Impact Practices (HIPs) briefs and strategic planning guides aim to bridge the know-do gap in family planning (FP) by facilitating research utilization and knowledge sharing and also providing a summary of experiential knowledge from experts. The purpose of this qualitative study was to assess the use, usefulness, and application of these 2 knowledge products developed by the HIP Partnership for decision-makers and implementers in low- and middle-income countries (LMICs). METHODS: This research used in-depth interviews with FP stakeholders from various LMICs to assess the use, usefulness, and application of 2 HIP products for FP decision-makers and implementers. The analysis was shaped by an adapted logic model framework to assess HIP product reach, engagement, usefulness, learning, and action. RESULTS: We interviewed 35 FP professionals from January to March 2021. Participants reported that HIP products have a wide reach, have garnered positive engagement, and were useful. Participants generally liked the current format of the HIP products and reported using them to inform program design, guide discussions with partners, enhance personal knowledge, support advocacy work, and strengthen the guidance they provide to colleagues in the field. The participants shared important feedback to improve the development and dissemination of HIP products, particularly a need to enhance local access and use. CONCLUSION: The study highlighted the importance of knowledge products, such as the HIP briefs and strategic planning guides, to make evidence and experiential knowledge accessible to a wide audience. These can be valuable tools for policymakers and program implementers to ensure public health practices are evidence-based and integrate experiential knowledge.

Strategic Planning: Moving From Plan to Implementation.

Successful organizations depend on strategic thinkers who understand strategic planning and strategic management. These strategic leaders can proactively manage the constant environmental changes to position their organizations for a competitive advantage and avoid acting in a reactive and defensive manner. However, while organizations are often adept at developing extensive strategic plans, implementation of the plan is often poor or without a definitive strategy. This article addresses key strategies for successful implementation of changes to bring about sustainable cultural change in an organization to meet the organization's overall strategic goals, specifically through the use of implementation science.

Changed Perceptions: Lessons Learned Regarding Nurse's Postpandemic Concerns.

Through a unique set of timings, a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis of a nursing department was conducted with the staff nurses of a large medical center in late 2019 and again in 2022. The intent of the 2019 analysis was bifold, to obtain rich input from nursing staff to apprise the 2020 Nursing Strategic Plan and to inform the hospital-wide core councils and the nursing unit councils on focused project work identified as Weaknesses and Threats. When the pandemic hit, work on strategic planning was paused to manage the unparalleled impact that COVID-19 had on the organization. In 2022, nursing leadership realized they had an opportunity to repeat the SWOT analysis, not only to inform the 2023 Nursing Strategic Plan but also to determine whether the perceptions of staff nurses regarding the SWOT in the nursing department had changed postpandemic. A thematic analysis provided the structure to analyze the perceptions of nurses pre- and postpandemic. This article presents our reflections for nurse leaders to consider when addressing the positive (Strengths/Opportunities) and negative (Weaknesses/Threats) perceptions of nurses in a postpandemic health care environment.

Evaluation of the Pan American Health Organization Response to COVID-19 2020–2022. Volume II. Annexes

This document is the companion publication to 'Evaluation of the Pan American Health Organization Response to COVID-19 2020-2022. Volume I Final Report', which reflects the findings that covered the period from January 2020 to August 2022. It provides information on PAHO’s support to its Member States in accordance with the World Health Organization, and COVID-19 Strategic Preparedness and Response Plan. The data collected during the evaluation was consolidated and analyzed at strategic, organizational, and operational levels. It focuses on PAHO as an organization, and whilst it does not assess Member States’ responses to the pandemic, it provides information on how PAHO collaborated with and supported Member States during the response. In addition to presenting information related to the COVID-19 pandemic in the Americas and PAHO’s programmatic response, the report provides information on key achievements, on the enabling and limiting factors, gaps and lessons that have emerged from PAHO’s response to COVID-19 pandemic, which serve to inform preparedness for and response to future public health emergencies. Finally, evidence-based recommendations are provided for corrective actions to strengthen future pandemic responses, while building a resilient recovery in the Region. These recommendations are focused on PAHO’s governance and management, specialized regional mechanisms, diversified funding models, and use of new technologies.

Evaluación de la respuesta de la Organización Panamericana de la Salud a la COVID-19 2020-2022. Volumen I. Informe final

En el presente informe se presentan las conclusiones sobre la evaluación de la respuesta de la Organización Panamericana de la Salud (OPS) a la pandemia de COVID‑19 en la Región de las Américas en el período comprendido entre enero del 2020 y agosto del 2022. En el informe se presenta información sobre el apoyo de la OPS a los Estados Miembros de conformidad con el plan estratégico de preparación y respuesta frente a la COVID‑19 de la Organización Mundial de la Salud. Los datos recopilados durante la evaluación se consolidaron y analizaron a nivel estratégico, organizacional y operativo. Se centra en la OPS como organización y, si bien no se evalúan las respuestas de los Estados Miembros a la pandemia, se presenta información sobre la manera en que la OPS colaboró con los Estados Miembros y les brindó apoyo durante la respuesta. Además de brindar información relacionada con la pandemia de COVID‑19 en la Región de las Américas y la respuesta programática de la OPS, en el informe se presenta información sobre los logros clave, así como sobre los factores facilitadores y limitantes, las brechas y las enseñanzas que han surgido de la respuesta de la OPS a la pandemia de COVID‑19, que sirven para documentar la preparación y la respuesta a futuras emergencias de salud pública. Finalmente, se presentan recomendaciones basadas en la evidencia sobre medidas correctivas que fortalezcan la respuesta a futuras pandemias, a la vez que se forja una recuperación resiliente en la Región. Estas recomendaciones se centran en la gobernanza y gestión de la OPS, los mecanismos regionales especializados, la diversificación de los modelos de financiamiento y el uso de nuevas tecnologías.

Evaluation of the Pan American Health Organization Response to COVID-19 2020–2022. Volume I. Final Report

The report on the evaluation of the Pan American Health Organization (PAHO) response to the COVID-19 pandemic in the Region of the Americas reflects the findings that covered the period from January 2020 to August 2022. It provides information on PAHO’s support to its Member States in accordance with the World Health Organization, and COVID-19 Strategic Preparedness and Response Plan. The data collected during the evaluation was consolidated and analyzed at strategic, organizational, and operational levels. It focuses on PAHO as an organization, and whilst it does not assess Member States’ responses to the pandemic, it provides information on how PAHO collaborated with and supported Member States during the response. In addition to presenting information related to the COVID-19 pandemic in the Americas and PAHO’s programmatic response, the report provides information on key achievements, on the enabling and limiting factors, gaps and lessons that have emerged from PAHO’s response to COVID-19 pandemic, which serve to inform preparedness for and response to future public health emergencies. Finally, evidence-based recommendations are provided for corrective actions to strengthen future pandemic responses, while building a resilient recovery in the Region. These recommendations are focused on PAHO’s governance and management, specialized regional mechanisms, diversified funding models, and use of new technologies.

Estrategias para mejorar el flujo de ingresos y estancias hospitalarias: adaptación del cuestionario Appropriateness Evaluation Protocol (AEP): estudio Delphi / Strategies to improve the flow of admissions and hospital stays: A Delphi study of an adaptation of the Appropriateness Evaluation Protocol

Introducción y objetivo La herramienta Appropriateness Evaluation Protocol (AEP) analiza las estancias e ingresos hospitalarios inadecuados. El objetivo de este estudio fue adaptar el cuestionario AEP para analizar la adecuación de los ingresos y las estancias hospitalarias en nuestra realidad asistencial. Método Se desarrolló un estudio utilizando el método Delphi en el que participaron 15 expertos en gestión clínica y en asistencia hospitalaria. Los ítems del formulario inicial se conformaron a partir de la herramienta AEP tal y como fue definida en su primera versión. En la primera ronda los participantes aportaron nuevos ítems que consideraron relevantes en nuestra realidad actual. En las rondas 2 y 3 evaluaron 80 ítems según su relevancia mediante la utilización de una escala Likert del 1 al 4 (máxima utilidad). De acuerdo al diseño de nuestro estudio los ítems del AEP se consideraron adecuados si la media de la puntuación una vez evaluados por los expertos, era igual o superior a 3. Resultados Los participantes definieron un total de 19 nuevos ítems. Finalmente 47 ítems obtuvieron una puntuación media igual o superior a 3. El cuestionario resultante modificado consta de 17 ítems en «causas de admisiones adecuadas», 5 en «causas de admisiones inadecuadas», 15 en «causas de estancias adecuadas» y 10 en «causas de estancias inadecuadas». Conclusiones La identificación de ítems prioritarios para determinar la adecuación de los ingresos y las estancias prolongadas en nuestro medio y según la opinión de los expertos, podría definir un futuro instrumento para su utilización en nuestro entorno (AU)

Introduction and aim The Appropriateness Evaluation Protocol (AEP) tool analyzes inappropriate hospital stays and admissions. This study aimed to adapt the AEP questionnaire in order to analyze the appropriateness of hospital admissions and stays in our healthcare reality. Methods A study was conducted using the Delphi method in which 15 experts in clinical management and hospital care participated. The initial questionnaire items were taken from the first version of the AEP. In the first round, the participants contributed new items that they considered relevant in our current reality. In rounds 2 and 3, they evaluated 80 items according to their relevance using a Likert scale from 1 to 4 (maximum usefulness). Pursuant to the study's design, AEP items were considered adequate if the mean score according to the experts’ evaluation was greater than or equal to 3. Results The participants defined a total of 19 new items. In the end, 47 items earned a mean score greater than or equal to 3. The resulting modified questionnaire include 17 items in “Reasons for Appropriate Admissions”, 5 in “Reasons for Inappropriate Admissions”, 15 in “Reasons for Appropriate Hospital Stays”, and 10 in “Reasons for Inappropriate Hospital Stays”. Conclusions The identification according to expert opinion of priority items to determine the appropriateness of admissions and extended stays could be used in the future to help create an instrument to be used in our setting (AU)