Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.540
Filtrar
1.
Pan Afr Med J ; 39: 197, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34603578

RESUMEN

The COVID-19 pandemic has changed the world in so many ways since 2019 when the first case was recorded. COVID-19 pandemic has impacted negatively on economy, health, education and infrastructure globally. COVID-19 vaccine was developed with the aim of stopping the pandemic and allowing the rebuilding of our societies and economies. The vaccine was rolled out in December 2020 and the distribution plan appears to be skewed in favour of high income countries. This paper highlights the need for consideration of the principles of equity and universal health coverage in the distribution plan of the vaccine. It emphasizes the need to ensure that the interests of citizens of developing and low income countries are well protected. The paper concludes that issues of disparity in economic status of countries entering agreement with the vaccine manufacturing companies, absence of logistic support among others should not be a barrier to ensuring equitable access to vaccine for all consistent with the sustainable development goal 3.7.


Asunto(s)
Vacunas contra la COVID-19/provisión & distribución , COVID-19/prevención & control , Disparidades en Atención de Salud/economía , Cobertura Universal del Seguro de Salud/economía , Vacunas contra la COVID-19/economía , Países en Desarrollo , Industria Farmacéutica/economía , Salud Global , Equidad en Salud , Accesibilidad a los Servicios de Salud/economía , Humanos , Factores Socioeconómicos
2.
Artículo en Español | PAHO-IRIS | ID: phr-54977

RESUMEN

[RESUMEN]. Alcanzar la equidad en salud y abordar los determinantes sociales de la salud son aspectos fundamentales para alcanzar las metas en materia de salud y relacionadas con la salud de la Agenda para el Desarrollo Sostenible 2030 y sus Objetivos de Desarrollo Sostenible. Los marcos de referencia para la salud, como la Agenda de Salud Sostenible para las Américas 2018-2030, hacen hincapié en la reducción de las desigualdades en salud y en “no dejar a nadie atrás” en el desarrollo sostenible a nivel nacional. La equidad en salud incluye la promoción de la salud universal y el enfoque de atención primaria de salud, con un acceso equitativo de todas las personas a servicios de salud oportunos, de calidad, integrales y centrados en las personas y la comunidad que no ocasionen empobrecimiento. La rendición de cuentas por esos avances es igualmente importante, y un signo distintivo de una gobernanza adecuada. Los gobiernos tienen la responsabilidad primordial de reducir las desigualdades en salud y deben rendir cuentas de sus políticas y su desempeño. La sociedad civil es una parte interesada fundamental para promover un desarrollo nacional sostenible y equitativo, y debe formar parte de los mecanismos eficaces de rendición de cuentas. La Coalición Caribe Saludable —la única alianza regional del Caribe de organizaciones de la sociedad civil dedicada a prevenir y controlar las enfermedades no transmisibles, una prioridad de sanitaria importante acrecentada por las desigualdades— ha desempeñado un papel importante en hacer que los gobiernos rindan cuentas de la promoción de la equidad en salud. En este estudio se examinan los factores que han contribuido al éxito de la Coalición Caribe Saludable, con énfasis en la labor realizada en el marco de sus cinco pilares estratégicos —rendición de cuentas, promoción de la causa, desarrollo de capacidad, comunicación y sostenibilidad— así como los retos, las enseñanzas extraídas y otras consideraciones para lograr una mayor eficacia.


[ABSTRACT]. Achieving health equity and addressing the social determinants of health are critical to attaining the health and health-related targets of the 2030 Agenda for Sustainable Development and its Sustainable Development Goals. Frameworks for health, including the Sustainable Health Agenda for the Americas 2018 – 2030, emphasize reduction of health inequities and “leaving no one behind” in national sustainable development. Health equity includes advancing universal health and the primary health care approach, with equitable access for all people to timely, quality, comprehensive, people- and community-centered services that do not cause impoverishment. Equally important, and a hallmark of good governance, is accountability for such advances. Governments have primary responsibility for reducing health inequities and must be held accountable for their policies and performance. Civil society has been recognized as a key partner in advancing sustainable and equitable national development. Effective accountability mechanisms should include civic engagement. The Healthy Caribbean Coalition (HCC), the only Caribbean regional alliance of civil society organizations working to prevent and control noncommunicable diseases—a major health priority fueled by inequities—has played a significant role in holding governments accountable for advancing health equity. This case study examines factors contributing to the success of the HCC, highlighting work under its five strategic pillars— accountability, advocacy, capacity development, communication, and sustainability—as well as challenges, lessons learned, and considerations for greater effectiveness.


[RESUMO]. Conquistar a equidade em saúde e abordar os determinantes sociais da saúde são essenciais para atingir as metas de saúde e as relacionadas à saúde da Agenda 2030 para o Desenvolvimento Sustentável e seus Objetivos de Desenvolvimento Sustentável. As estruturas para a saúde, incluindo a Agenda de Saúde Sustentável para as Américas 2018-2030, enfatizam a redução das iniquidades em saúde “sem deixar ninguém para trás”, quando se trata do desenvolvimento sustentável nacional. A equidade em saúde inclui impul-sionar a saúde universal e a abordagem da atenção primária à saúde, habilitando o acesso equitativo por todas as pessoas a serviços oportunos, de qualidade, integrais, centrados no atendimento às pessoas e às comunidades de maneira a não causar o empobrecimento. A questão da responsabilidade por tais avanços é igualmente importante, e é um selo de distinção de boa gestão. Os governos são os principais responsáveis pela redução das iniquidades em saúde e precisam ser responsabilizados por suas políticas e por seu desempenho. Reconheceu-se que a sociedade civil desempenha um papel essencial na promoção do desenvolvimento nacional sustentável e equitativo. Para que sejam eficazes, os mecanismos de responsabilização devem incluir a participação cívica. A Coalizão do Caribe Saudável (HCC), a única aliança de organizações da sociedade civil que trabalha na prevenção e no controle de doenças não transmissíveis na região do Caribe — uma grande prioridade de saúde movida pelas iniquidades — tem desempenhado uma função significativa na responsabilização dos governos pelo avanço da equidade em saúde. Este estudo examina os fatores que contribuem para o sucesso da HCC e destaca o trabalho da perspectiva dos cinco pilares estratégicos — responsabilidade, promoção de causa, desenvolvimento das capacidades, comunicação e sustentabilidade —, bem como os desafios, as lições aprendidas e as considerações para que se torne ainda mais eficaz.


Asunto(s)
Equidad en Salud , Sociedad Civil , Gobernanza , Enfermedades no Transmisibles , Región del Caribe , Equidad en Salud , Sociedad Civil , Gobernanza , Enfermedades no Transmisibles , Región del Caribe , Equidad en Salud , Sociedad Civil , Gobernanza , Enfermedades no Transmisibles , Región del Caribe
3.
Artículo en Español | PAHO-IRIS | ID: phr-54976

RESUMEN

[RESUMEN]. Objetivos. Analizar el progreso en las estructuras, mecanismos y estrategias organizativas, así como los factores y las barreras, que favorecen la incorporación de la perspectiva de género en la salud en Guatemala, Guyana y Perú, dado el papel que ello desempeña en el abordaje de las desigualdades de género en la salud como un motor estructural clave de la equidad en salud. Métodos. Se obtuvieron datos a partir de la literatura gris de leyes, políticas o documentos de programas y entrevistas cualitativas semiestructuradas con 37 informantes. El análisis se basó en un marco teórico que incluía siete categorías consideradas esenciales para avanzar la incorporación de la perspectiva de género en el sector de la salud. Resultados. A pesar de los importantes esfuerzos y las experiencias acumuladas respecto de la incorporación de la perspectiva de género en el sector de la salud persisten obstáculos estructurales, como desafíos sociales más amplios para transformar las relaciones de poder desiguales entre los géneros; la complejidad del sistema de salud combinada con una baja capacidad técnica, política y financiera de las estructuras institucionales encargadas de abordar el tema; y la limitada coordinación con las instituciones nacionales dedicadas a la promoción de la mujer (a menudo, débiles). En algunos contextos, los obstáculos se ven agravados por la limitada comprensión de los conceptos básicos subyacentes a la perspectiva de género (a veces exacerbada por una comprensión limitada de la interseccionalidad o el compromiso con los hombres) y la ausencia de indicadores para medir los resultados y el impacto concreto de la incorporación de la perspectiva de género. Conclusiones. Para que la incorporación de la perspectiva de género en la salud sea satisfactoria, se requiere una agenda más estratégica y transformadora, elaborada e implementada en coordinación con las instituciones nacionales de promoción de la mujer y la sociedad civil y vinculada a instancias externas (p. ej., el Comité para la Eliminación de la Discriminación contra la Mujer). Es necesario, asimismo, una distinción más clara entre los enfoques sensibles al género y aquellos transformativos de las relaciones desiguales de género, y una definición de los resultados previstos y los indicadores para medir los avances. Estos podrían entonces documentarse y sistematizarse mejor, lo que permitiría que la perspectiva de género se comprendiera más ampliamente y se pusiera en práctica como instrumento concreto para lograr la equidad en salud.


[ABSTRACT]. Objectives. To analyze progress in organizational structures, mechanisms, strategies, and enabling factors and barriers towards gender mainstreaming (GM) in health in Guatemala, Guyana, and Peru, given GM’s role in addressing gender inequalities in health as a key structural driver of health equity. Methods. Data was obtained through a grey literature review of laws, policies, and/or program documents and semistructured qualitative interviews with 37 informants. Analysis was based on a theoretical framework including 7 categories considered essential to advance GM in the health sector. Results. Despite significant efforts and accumulated experiences of GM in health, structural barriers include: wider societal challenges of transforming gender unequal power relations; health system complexity combined with the low technical, political, and financial capacity of institutional structures tasked with GM; and limited coordination with (often weak) National Women’s Machineries (NWMs). In some contexts, barriers are compounded by limited understanding of basic concepts underlying GM (at times exacerbated by misunderstandings related to intersectionality and/or engagement with men) and the absence of indicators to measure GM’s concrete results and impact. Conclusions. Successful GM requires a more strategic and transformational agenda, developed and implemented in coordination with NWMs and civil society and with reference to external bodies (e.g. Committee on the Elimination of Discrimination against Women) to go beyond process, with clearer distinction between gender sensitivity and gender transformation, and definition of expected results and indicators to measure advances. These then could be better documented and systematized, enabling GM to be more broadly understood and operationalized as a concrete instrument towards health equity.


[RESUMO]. Objetivos. Analisar o progresso nas estruturas organizacionais, mecanismos, estratégias, e fatores habilitadores e barreiras para a integração do gênero (IG) na saúde na Guatemala, na Guiana e no Peru, dado o papel da IG na abordagem das desigualdades de gênero na saúde como um dos principais impulsionadores estruturais da equidade em saúde. Métodos. Os dados foram obtidos por meio de uma análise das leis, políticas e/ou documentos de programa e entrevistas qualitativas semiestruturadas junto a 37 informantes, extraídos da literatura cinza. A análise foi efetuada com base em uma estrutura teórica que incluiu 7 categorias consideradas essenciais para promover a IG no setor da saúde. Resultados. Apesar dos esforços significativos e das experiências acumuladas na IG na saúde, as barreiras estruturais incluem: os desafios sociais mais amplos de transformar relacionamentos desiguais de poder; a complexidade dos sistemas de saúde associada à baixa capacidade técnica, política e financeira das instituições encarregadas pela IG; e a coordenação limitada (e muitas vezes fraca) com as Maquinarias Nacionais de Mulheres (NWM, na sigla em inglês). Em alguns contextos, as barreiras são exacerbadas pela compreensão limitada de conceitos básicos nas bases da IG (às vezes agravadas por mal entendidos relacionados à intersecção com homens e/ou o envolvimento deles); e a ausência de indicadores para medir resultados concretos da IG e seu impacto. Conclusões. Para que a IG ocorra de fato, é necessária uma pauta mais estratégica e transformadora, elaborada e implementada em coordenação com as NWM e a sociedade civil, e fazendo referência a organismos externos (por exemplo, Comitê sobre a Eliminação de todas as Formas de Discriminação contra a Mulher) para que a integração inclua não só o processo, mas que forneça, além disso, uma diferenciação mais clara entre a sensibilidade às questões de gênero e a transformação das relações de gênero, e defina os resultados esperados e os indicadores para medir os avanços. A partir de então, elas poderiam ser melhor documentadas e sistematizadas, permitindo um melhor entendimento sobre a IG e sua operacionalização como instrumento concreto rumo à equidade na saúde.


Asunto(s)
Equidad en Salud , Equidad de Género , Transversalidad de Género , Políticas Inclusivas de Género , Guatemala , Guyana , Perú , Equidad en Salud , Equidad de Género , Transversalidad de Género , Políticas Inclusivas de Género , Perú , Equidad en Salud , Equidad de Género , Transversalidad de Género , Políticas Inclusivas de Género , Guyana
4.
Artículo en Español | PAHO-IRIS | ID: phr-54975

RESUMEN

[RESUMEN]. Objetivo. En el 2010 se propuso el principio del universalismo proporcional como solución para reducir las desigualdades en materia de salud. Aunque tuvo una gran resonancia, no parece haber sido aplicado ampliamente y no existen directrices sobre cómo aplicarlo. Los dos objetivos específicos de esta revisión sistemática exploratoria fueron: 1) describir el contexto teórico en el que se estableció el universalismo proporcional, y 2) describir cómo los investigadores aplican el universalismo proporcional y las cuestiones metodológicas relacionadas. Métodos. Se buscó en todas las bases de datos de la Web of Science los artículos publicados hasta el 6 de febrero del 2020 que tuvieran como tema “universalismo proporcional” o sus sinónimos “universalismo dirigido” o “universalismo progresivo”. Resultados. Esta revisión de 55 artículos permitió obtener una visión global del universalismo proporcional en cuanto a sus fundamentos teóricos y su aplicación práctica. El principio del universalismo proporcional se basa en las teorías sociales del universalismo y el direccionamiento, y propone vincular estos dos aspectos para lograr una reducción efectiva de las desigualdades en materia de salud. Respecto de su aplicación práctica, las intervenciones basadas en este principio son poco frecuentes y dan lugar a diferentes interpretaciones. Todavía existen muchos desafíos metodológicos y éticos en relación con la concepción y evaluación de las intervenciones relacionadas con el universalismo proporcional, incluida la forma de aplicar la proporcionalidad y la identificación de las necesidades. Conclusión. En esta revisión se llevó a cabo un mapeo de la literatura científica disponible sobre el universalismo proporcional y sus conceptos relacionados. Este principio se basa en teorías sociales. Tal como lo destacaron autores que implementaron intervenciones de universalismo proporcional, su aplicación plantea muchos desafíos, desde el diseño hasta la evaluación. El análisis de las aplicaciones del universalismo proporcional presentado en esta revisión respondió a algunos de ellos, pero los desafíos metodológicos restantes requieren ser abordados en futuras investigaciones.


[ABSTRACT]. Objective. In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it. The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues. Methods. We searched for all articles published until 6th of February 2020, mentioning “Proportionate Universalism” or its synonyms “Targeted universalism” OR “Progressive Universalism” as a topic in all Web of Science databases. Results. This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs. Conclusion. This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.


[RESUMO]. Objetivo. Em 2010, o princípio do Universalismo Proporcional (UP) foi proposto como uma solução para reduzir as desigualdades na saúde. Houve uma grande receptividade, mas o princípio parece não ter sido amplamente aplicado e não há diretrizes sobre como implementá-lo. Os dois objetivos específicos desta análise de escopo foram: (1) descrever o contexto teórico no qual o UP foi estabelecido e (2) descrever como os pesquisadores aplicam o UP e questões metodológicas correlatas. Métodos. Buscamos em todas as bases de dados científicas da Web todos os artigos publicados até 6 de fevereiro de 2020 que mencionavam, como tema, o “Universalismo Proporcional” ou seus sinônimos “Universalismo Visado” ou “Universalismo Progressivo”. Resultados. Essa análise de 55 artigos nos permitiu ter uma visão global relacionada com o UP, suas bases teóricas e sua implementação na prática. Os princípios do UP têm suas raízes nas teorias sociais do universalismo e na definição de metas. A proposta é vincular esses dois aspectos para atingir uma redução efetiva das desigualdades em saúde. Com relação ao aspecto prático da implementação, as intervenções de UP foram raras e levaram a diferentes interpretações. Ainda há muitos obstáculos metodológicos e éticos relativos ao conceito e à avaliação das intervenções de UP, inclusive sobre como aplicar o aspecto da proporcionalidade e a identificação das necessidades. Conclusões. Esta análise fez um mapeamento da literatura científica disponível sobre UP e seus conceitos correlatos. O princípio por trás do UP tem suas origens nas teorias sociais. Como destacam os autores que implementaram as intervenções de UP, sua aplicação produz muitas dificuldades, da elaboração à avaliação. A análise das aplicações de UP fornecidas nesta pesquisa permitiu a obtenção de algumas respostas. No entanto, pesquisas futuras poderiam abordar as dificuldades metodológicas remanescentes.


Asunto(s)
Equidad en Salud , Política de Salud , Factores Socioeconómicos , Equidad en Salud , Política de Salud , Factores Socioeconómicos , Equidad en Salud , Política de Salud , Factores Socioeconómicos
5.
Am J Mens Health ; 15(5): 15579883211050523, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34622705

RESUMEN

This paper is a direct response to Smith et al.'s (2020) call for more insight into health equity concerns pertaining to COVID-19 outcomes. The goal of this discussion is to offer the field with an evidence-informed 'avatar' representing the most-impacted group as it pertains to COVID-19 mortality and morbidity. Policy and practice implications are offered as a call to action for public health professionals to support these most impacted and highest risk communities.


Asunto(s)
COVID-19 , Equidad en Salud , Humanos , Masculino , Salud Pública , SARS-CoV-2
6.
Artículo en Inglés | MEDLINE | ID: mdl-34501949

RESUMEN

The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes.


Asunto(s)
COVID-19 , Equidad en Salud , Humanos , Pandemias , SARS-CoV-2 , Justicia Social
7.
BMC Public Health ; 21(1): 1682, 2021 09 16.
Artículo en Inglés | MEDLINE | ID: mdl-34525995

RESUMEN

INTRODUCTION: There is increasing evidence that COVID-19 has unmasked the true magnitude of health inequity worldwide. Policies and guidance for containing the infection and reducing the COVID-19 related deaths have proven to be effective, however the extent to which health inequity factors were considered in these policies is rather unknown. The aim of this study is to measure the extent to which COVID-19 related policies reflect equity considerations by focusing on the global policy landscape around wearing masks and personal protection equipment (PPE). METHODS: A systematic search for published documents on COVID-19 and masks/PPE was conducted across six databases: PubMed, EMBASE, CINAHL, ERIC, ASSIA and Psycinfo. Reviews, policy documents, briefs related to COVID-19 and masks/PPE were included in the review. To assess the extent of incorporation of equity in the policy documents, a guidance framework known as 'PROGRESS-Plus': Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, disability etc.) was utilized. RESULTS: This review included 212 policy documents. Out of 212 policy documents, 190 policy documents (89.62%) included at least one PROGRESS-plus component. Most of the policy documents (n = 163, 85.79%) focused on "occupation" component of the PROGRESS-plus followed by personal characteristics associated with discrimination (n = 4;2.11%), place of residence (n = 2;1.05%) and education (n = 1;0.53%). Subgroup analysis revealed that most of the policy documents (n = 176, 83.01%) were focused on "workers" such as healthcare workers, mortuary workers, school workers, transportation workers, essential workers etc. Of the remaining policy documents, most were targeted towards whole population (n = 30; 14.15%). Contrary to "worker focused" policy documents, most of the 'whole population focused' policy documents didn't have a PROGRESS-plus equity component rendering them equity limiting for the society. CONCLUSION: Our review highlights even if policies considered health inequity during the design/implementation, this consideration was often one dimensional in nature. In addition, population wide policies should be carefully designed and implemented after identifying relevant equity related barriers in order to produce better outcomes for the whole society.


Asunto(s)
COVID-19 , Equidad en Salud , Humanos , Equipo de Protección Personal , Políticas , SARS-CoV-2
8.
Global Health ; 17(1): 112, 2021 09 20.
Artículo en Inglés | MEDLINE | ID: mdl-34544439

RESUMEN

BACKGROUND: During the first year and a half of the COVID-19 pandemic, COVAX has been the world's most prominent effort to ensure equitable access to SARS-CoV-2 vaccines. Launched as part of the Access to COVID-19 Tools Accelerator (Act-A) in June 2020, COVAX suggested to serve as a vaccine buyers' and distribution club for countries around the world. It also aimed to support the pharmaceutical industry in speeding up and broadening vaccine development. While COVAX has recently come under critique for failing to bring about global vaccine equity, influential politicians and public health advocates insist that future iterations of it will improve pandemic preparedness. So far COVAX's role in the ongoing financialization of global health, i.e. in the rise of financial concepts, motives, practices and institutions has not been analyzed. METHODS: This article describes and critically assesses COVAX's financial logics, i.e. the concepts, arguments and financing flows on which COVAX relies. It is based on a review of over 109 COVAX related reports, ten in-depth interviews with global health experts working either in or with COVAX, as well as participant observation in 18 webinars and online meetings concerned with global pandemic financing, between September 2020 and August 2021. RESULTS: The article finds that COVAX expands the scale and scope of financial instruments in global health governance, and that this is done by conflating different understandings of risk. Specifically, COVAX conflates public health risk and corporate financial risk, leading it to privilege concerns of pharmaceutical companies over those of most participating countries - especially low and lower-middle income countries (LICs and LMICs). COVAX thus drives the financialization of global health and ends up constituting a risk itself - that of perpetuating the downsides of financialization (e.g. heightened inequality, secrecy, complexity in governance, an ineffective and slow use of aid), whilst insufficiently realising its potential benefits (pandemic risk reduction, increased public access to emergency funding, indirect price control over essential goods and services). CONCLUSION: Future iterations of vaccine buyers' and distribution clubs as well as public vaccine development efforts should work towards reducing all aspects of public health risk rather than privileging its corporate financial aspects. This will include reassessing the interplay of aid and corporate subsidies in global health.


Asunto(s)
Vacunas contra la COVID-19/provisión & distribución , COVID-19/prevención & control , Salud Global/economía , Equidad en Salud/economía , Pandemias , COVID-19/epidemiología , Humanos , Riesgo
10.
Yearb Med Inform ; 30(1): 100-104, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34479383

RESUMEN

OBJECTIVE: To select the best papers that made original and high impact contributions in the area of human factors and organizational issues in biomedical informatics in 2020. METHODS: A rigorous extraction process based on queries from Web of Science® and PubMed/Medline was conducted to identify the scientific contributions published in 2020 that address human factors and organizational issues in biomedical informatics. The screening of papers on titles and abstracts independently by the two section editors led to a total of 1,562 papers. These papers were discussed for a selection of 12 finalist papers, which were then reviewed by the two section editors, two chief editors, and by three external reviewers from internationally renowned research teams. RESULTS: The query process resulted in 12 papers that reveal interesting and rigorous methods and important studies in human factors that move the field forward, particularly in clinical informatics and emerging technologies such as brain-computer interfaces. This year three papers were clearly outstanding and help advance in the field. They provide examples of applying existing frameworks together in novel and highly illuminating ways, showing the value of theory development in human factors. Emerging themes included several which discussed physician burnout, mobile health, and health equity. Those concerning the Corona Virus Disease 2019 (Covid-19) were included as part of that section. CONCLUSION: The selected papers make important contributions to human factors and organizational issues, expanding and deepening our knowledge of how to apply theory and applications of new technologies in health.


Asunto(s)
Registros Electrónicos de Salud , Equidad en Salud , Informática Médica/organización & administración , Interfaz Usuario-Computador , Agotamiento Profesional , Humanos
11.
Nurs Adm Q ; 45(4): 311-323, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34469389

RESUMEN

The promotion of diversity, equity, and inclusion (DEI) in nursing is a topic of renewed importance, given the civil unrest following the death of George Floyd and identified disparities in health and health outcomes during the COVID-19 pandemic. Despite its progress, the nursing profession continues to struggle with recruiting and retaining a workforce that represents the cultural diversity of the patient population. The authors completed a review of the literature on DEI in nursing and found a scarcity of studies, and that a limitation exists due to the strength of the evidence examined. This article aims to provide a review of the literature on DEI in nursing, outcomes and strategies associated with organizational DEI efforts, and knowledge on how the American Nurses Credentialing Center Pathway to Excellence® Designation Program framework supports DEI initiatives. The authors further provided recommendations for nurse leaders and a checklist of proposed questions for assessing commitment, culture, and structural empowerment initiatives toward a more diverse, equitable, and inclusive organization.


Asunto(s)
Diversidad Cultural , Equidad en Salud , Liderazgo , Enfermería/normas , Inclusión Social , COVID-19/epidemiología , Empoderamiento , Humanos , Cultura Organizacional , Pandemias , Racismo/prevención & control , SARS-CoV-2 , Recursos Humanos/organización & administración
12.
BMC Health Serv Res ; 21(1): 975, 2021 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-34530826

RESUMEN

BACKGROUND: Screening in primary care for unmet individual social needs (e.g., housing instability, food insecurity, unemployment, social isolation) is critical to addressing their deleterious effects on patients' health outcomes. To our knowledge, this is the first study to apply an implementation science framework to identify implementation factors and best practices for social needs screening and response. METHODS: Guided by the Health Equity Implementation Framework (HEIF), we collected qualitative data from clinicians and patients to evaluate barriers and facilitators to implementing the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE), a standardized social needs screening and response protocol, in a federally qualified health center. Eligible patients who received the PRAPARE as a standard of care were invited to participate in semi-structured interviews. We also obtained front-line clinician perspectives in a semi-structured focus group. HEIF domains informed a directed content analysis. RESULTS: Patients and clinicians (i.e., case managers) reported implementation barriers and facilitators across multiple domains (e.g., clinical encounters, patient and provider factors, inner context, outer context, and societal influence). Implementation barriers included structural and policy level determinants related to resource availability, discrimination, and administrative burden. Facilitators included evidence-based clinical techniques for shared decision making (e.g., motivational interviewing), team-based staffing models, and beliefs related to alignment of the PRAPARE with patient-centered care. We found high levels of patient acceptability and opportunities for adaptation to increase equitable adoption and reach. CONCLUSION: Our results provide practical insight into the implementation of the PRAPARE or similar social needs screening and response protocols in primary care at the individual encounter, organizational, community, and societal levels. Future research should focus on developing discrete implementation strategies to promote social needs screening and response, and associated multisector care coordination to improve health outcomes and equity for vulnerable and marginalized patient populations.


Asunto(s)
Equidad en Salud , Grupos Focales , Humanos , Ciencia de la Implementación , Atención Primaria de Salud , Investigación Cualitativa
13.
Lancet Oncol ; 22(9): e400-e409, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34478676

RESUMEN

Cancer has not been an explicit priority of Canada's international health and development agenda, but it is key to realising the country's Sustainable Development Goal commitments. Multiple converging political, health, and social forces could now drive support for a more integrated Canadian approach to global cancer control. Success will depend on the extent to which Canadian leaders and institutions can build consensus as a community and agree to work together. Collaboration should include agreement on the framing and prioritisation of the core issues, building a broad coalition base, aligning with priorities of international partners, and on a governance structure that reflects the principles of equity, diversity, and inclusion. This Series paper will discuss global cancer control within Canada's global health agenda, how Canada can address its history of colonisation and present-day disparities in its global work, and the challenges and opportunities of creating a Canadian global cancer control network.


Asunto(s)
Salud Global , Neoplasias/prevención & control , Canadá , Consenso , Equidad en Salud , Humanos , Cooperación Internacional , Oncología Médica/organización & administración
14.
Healthc Policy ; 17(1): 17-24, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34543172

RESUMEN

The unequal social and economic burden of the COVID-19 pandemic is evident in racialized and low-income communities across Canada. Importantly, social inequities have not been adequately addressed and current public policies are not reflective of the needs of diverse populations. Public participation in decision-making is crucial and there is, therefore, a pressing need to increase diversity of representation in patient partnerships in order to prevent the further exclusion of socially marginalized groups from research and policy making. Deliberate effort and affirmative action are needed to meaningfully engage and nurture diverse patient partnerships by broadening the scope of the patient community to include excluded or underrepresented individuals or groups. This will help us co-develop ways to enhance access and equity in healthcare and prevent the systematic reproduction of structural inequalities that have already been heightened by the COVID-19 pandemic.


Asunto(s)
Investigación Biomédica/normas , COVID-19/terapia , Atención a la Salud/normas , Equidad en Salud/normas , Política de Salud , Selección de Paciente , Proyectos de Investigación/normas , Adulto , Anciano , Anciano de 80 o más Años , Canadá , Femenino , Guías como Asunto , Humanos , Masculino , Persona de Mediana Edad , Pandemias , SARS-CoV-2
19.
Int J Equity Health ; 20(1): 208, 2021 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-34526041

RESUMEN

BACKGROUND: Cycling for transport provides many health and social benefits - including physical activity and independent access to jobs, education, social opportunities, health care and other services (accessibility). However, some population groups have less opportunity to reach everyday destinations, and public transport stops, by bicycle - owing in part to their greater aversion to riding amongst motor vehicle traffic. Health equity can therefore be improved by providing separated cycleway networks that give more people the opportunity to access places by bicycle using traffic-free routes. The aim of this study was to assess the health equity benefits of two bicycle infrastructure development scenarios - a single cycleway, and a complete network of cycleways - by examining the distributions of physical activity and accessibility benefits across gender, age and income groups. METHODS: Travel survey data collected from residents in Sydney (Australia) were used to train a predictive transport mode choice model, which was then used to forecast the impact of the two intervention scenarios on transport mode choice, physical activity and accessibility. The latter was measured using a utility-based measure derived from the mode choice model. The distributions of the forecast physical activity and accessibility benefits were then calculated across gender, age and income groups. RESULTS: The modelled physical activity and accessibility measures improve in both intervention scenarios. However, in the single cycleway scenario, the benefits are greatest for the male, high-income and older age groups. In the complete network scenario, the benefits are more equally distributed. Forecast increases in cycling time are largely offset by decreases in walking time - though the latter is typically low-intensity physical activity, which confers a lesser health benefit than moderate-intensity cycling. CONCLUSIONS: Separated cycleway infrastructure can be used to improve health equity by providing greater opportunities for transport cycling in population groups more averse to riding amongst motor vehicle traffic. Disparities in the opportunity to access services and economic/social activities by bicycle - and incorporate more physical activity into everyday travel - could be addressed with connected, traffic-free cycleway networks that cater to people of all genders, ages and incomes.


Asunto(s)
Ciclismo , Planificación Ambiental , Ejercicio Físico , Equidad en Salud , Adolescente , Adulto , Australia , Planificación Ambiental/estadística & datos numéricos , Femenino , Humanos , Renta/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...