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4.
N C Med J ; 81(1): 5-13, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31908325

RESUMEN

BACKGROUND In 2016, the North Carolina Division of Public Health (DPH) launched the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) program to provide 5 local health departments (LHDs) with financial resources and technical assistance to address 3 aims: improve birth outcomes, reduce infant mortality, and improve health for children from birth to 5 years.METHOD: State legislation established an academic-practice partnership between NCDPH and the University of North Carolina at Chapel Hill (UNC) to provide program evaluation and implementation coaching to LHDs. ICO4MCH used a collective impact framework, principles of implementation science, and a health equity approach to implement evidence-based strategies to address the program's aims.RESULTS: A shared measurement system was developed by an evaluation stakeholders group led by the NCDPH and UNC in which LHDs reported data on a quarterly basis and the evaluators returned reports to drive improvements. Structured assessments and technical assistance provided by implementation coaches helped grantees address barriers to implementation including cultivating and sustaining a diverse community action team, addressing staff turnover, and using data to drive improvements.LIMITATIONS: It was challenging for grantees to balance community needs and build partnerships in the first year while integrating data from multiple assessments into action plans to meet the performance measures. It was necessary to streamline assessments and reduce indicators to make data more actionable.CONCLUSION: An academic-practice partnership was integral to successful implementation of the ICO4MCH program and may serve as a model for moving evidence-based maternal child health programs to practice in LHDs.


Asunto(s)
Salud del Niño , Promoción de la Salud/organización & administración , Relaciones Interinstitucionales , Salud Materna , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , North Carolina , Embarazo , Evaluación de Programas y Proyectos de Salud
5.
N C Med J ; 81(1): 51-54, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31908336

RESUMEN

Medicaid is an essential source of health coverage that finances more than half of all births in North Carolina. This paper examines current eligibility for pregnant women and its impacts on health outcomes for mothers and children. The authors provide suggestions to increase access to this vital health insurance program and better promote the health of North Carolina's families.


Asunto(s)
Cobertura del Seguro/estadística & datos numéricos , Medicaid , Niño , Salud del Niño , Determinación de la Elegibilidad , Femenino , Humanos , Salud Materna , North Carolina , Embarazo , Estados Unidos
6.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1047782

RESUMEN

Objetivo: desvelar a produção acerca da assistência de enfermagem prestada às crianças/adolescentes vítimas de violência. Método: trata-se de uma revisão sistematizada realizada com consulta nas bases de dados: LILACS, Scielo e BDENF. Foram selecionados 19 artigos para compor este trabalho. A análise de dados deu-se por meio da proposta de Mendes, Silveira e Galvão. Resultados: os dados foram discutidos através dos tópicos: despreparo dos profissionais frente aos casos de violência infantil; sentimentos dos profissionais envolvidos no cuidado à criança/adolescente vítima de violência; notificação, protocolos e rotinas na assistência à criança/ adolescente vítima de violência; estratégias de assistência à criança/adolescente vítima de violência. Conclusão: os profissionais de enfermagem não se sentem preparados para atuarem frente aos casos de violência infantil. Identificou-se a necessidade de protocolos assistenciais que respaldem a assistência profissional. Ademais, é importante o fortalecimento da rede de atenção intersetorial que garanta a assistência adequada às vítimas e suas famílias


Objective: to explore the literature regarding the nursing care provided to children/adolescents victims of violence. Method: it consists of a systematic review performed on databases such as, LILACS, Scielo and BDENF. 19 articles have been selected to compose this study. The data analysis was developed throughout Mendes, Silveira and Galvão's proposal. Results: the data discussion occurred throughout the following topics: professional unpreparedness to deal with cases of child violence; the feelings of professionals involved on the care provided to a child/adolescent victim of violence; notification, protocols and routines regarding the assistance of children/adolescents victims of violence. Conclusion: nursing professionals do not feel prepared to deal with situations of children violence. It was identified the need of protocols that support the nursing assistance. Furthermore, it is important to enhance the intersectoral attention network in order to ensure the appropriate care to the victims and their families


Objetivo: desvelar la producción acerca de la asistencia de enfermería a los niños/adolescentes víctimas de violencia. Método: se trata de una revisión sistematizada realizada con consulta en las bases de datos: LILACS, Scielo y BDENF. Se seleccionaron 19 artículos para componer este trabajo. El análisis de datos se dio através de la propuesta de Mendes, Silveira y Galvão. Resultados: los datos fueron discutidos através de los tópicos: despreparo de los profesionales frente a los casos de violencia infantil; sentimientos de los profesionales envolvidos en el cuidado al niño/ adolescente víctima de violencia; notificación, protocolos y rutinas en la asistencia al niño/adolescente víctima de violencia; estrategias de asistencia al niño/adolescente víctima de violencia. Conclusión: los profesionales de enfermería no se sienten preparados para actuar frente a los casos de violencia infantil. Se identificó la necesidad de protocolos asistenciales que soporten la asistencia profesional. Además, es importante el fortalecimiento de la red de atención intersectorial que promueva la asistencia adecuada a las víctimas y sus familia


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Maltrato a los Niños/psicología , Violencia Doméstica , Atención de Enfermería , Maltrato a los Niños/terapia , Salud del Niño , Salud del Adolescente , Exposición a la Violencia
7.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1048000

RESUMEN

Objetivo: discutir as vivências dos profissionais no cuidado em rede intersetorial voltado à criança e adolescente e suas articulações/trabalho no território. Método: pesquisa qualitativa, exploratório-descritivo, desenvolvida com 26 trabalhadores da rede intersetorial, em um município do Rio Grande do Sul, entre os meses de maio a junho de 2014. Os instrumentos utilizados para a coleta de dados foram entrevistas semiestruturadas com os depoimentos gravados e, posteriormente, transcritos na íntegra. Resultados: o profissional possui uma vivência de rede intersetorial, entendendo que esta rede deve partir de premissas como a interdisciplinaridade e o trabalho em conjunto. Que a rede de cuidado deve transpor serviços de saúde, ampliando olhares para projetos sociais e de inclusão. Conclusão: o território pode ser incorporado como um espaço de cuidado, de relações sociais e de modos de vida, sendo espaço também de vínculos entre profissionais e usuários


Objective: to discuss the experiences of professionals of the intersectoral care network focused on children and adolescents and their connections / work in the territory. Method: This qualitative study exploratory-descriptive, that included 26 intersectoral network workers in a city of Rio Grande do Sul state, Brazil between the months of May and June 2014. Data collection was conducted through a semistructured interview during which the testimonies were recorded and subsequently transcribed in full. Results: The professional has an experience of intersectoral network, which is based on the premises of interdisciplinarity and working together. The care network must be more than just health services, including social and community spaces, social and inclusion projects. Conclusion: The territory can be understood as a space of care, social relations and ways of life, also offering space for links between professionals and users of services


Objetivo: discutir las experiencias de los profesionales acerca de la red de atención direccionada a los niños y adolescentes y sus articulaciones / trabajo en el territorio. Método: investigación cualitativa, exploratoriodescriptivo, desarrollada con 26 trabajadores de la red intersectorial entre los meses de mayo hasta junio de 2014 en una ciudad en Rio Grande do Sul. La recolección de datos fue realizada por medio de entrevista semiestructurado, con los testimonios grabados y posteriormente transcritos en su totalidad. Resultados: el profesional tiene una experiencia de red intersectorial, la comprensión de que la red de premisas como la interdisciplinariedad y el trabajo en conjunto. La red de cuidado debe pasar a los servicios de salud, la ampliación de las miradas para proyectos sociales e inclusión. Conclusión: El territorio puede ser incorporado como un espacio de atención, las relaciones sociales y formas de vida también el espacio y las relaciones entre los profesionales y los usuarios


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Salud del Niño , Colaboración Intersectorial , Personal de Salud/organización & administración , Salud del Adolescente , Investigación Cualitativa , Atención a la Salud Mental
8.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1048054

RESUMEN

Objetivo: compreender a contribuição da consulta de enfermagem para a educação em saúde dos familiares de crianças em tratamento quimioterápico ambulatorial. Método: pesquisa de campo de abordagem qualitativa, realizada no interior do estado de São Paulo com 15 famílias atendidas na consulta de enfermagem, por meio de entrevista semiestruturada. Os dados foram analisados com a técnica de análise de conteúdo. Resultados: identificou-se uma categoria temática central "A consulta de enfermagem como ferramenta para o empoderamento dos pais", subsidiada pelos seguintes núcleos de sentido: fundamental, apoio, acolhimento, relação de confiança e vínculo, aprendizado e segurança. Conclusão: a consulta de enfermagem foi revelada como um espaço que proporciona o empoderamento da família por meio da aquisição do conhecimento sobre o diagnóstico, o tratamento e a forma de lidar com a criança oncológica, o que possibilita aos pais maior segurança para cuidarem do filho


Objective: to understand the contribution of the nursing consultation to the health education of the relatives of children undergoing outpatient chemotherapy. Method: a qualitative field survey was carried out at in a town in the State of Sao Paulo with 15 families seen at the nursing consultation. Data collection was performed through a semi-structured interview and analyzed through content analysis technique. Results: a central thematic category was identified: "The nursing consultation as a tool for empowering the parents", supported by the nuclei of meaning: fundamental, support, reception, trust and bonding, learning and confidence. Conclusion: the nursing consultation was revealed as a moment for providing empowerment for the child's family through knowledge acquisition regarding the diagnosis, treatment and way of coping with the oncological child, which provides the parents with greater confidence to care for their child


Objetivo: comprender la contribución de la consulta de enfermería para la educación en salud de familiares de niños en tratamiento ambulatorio de quimioterapia. Método: estudio de campo de enfoque cualitativo, realizado en el interior de São Paulo, con 15 familias atendidas en consulta de enfermería, por medio de entrevista semiestructurada. Los datos fueron analizados con la técnica de análisis de contenido. Resultados: se identificó una categoría temática central "La consulta de enfermería como herramienta para empoderamiento de los padres", auxiliada por los siguientes núcleos de sentido: fundamental, apoyo, acogida, relación de confianza y vínculo, aprendizaje y seguridad. Conclusión: la consulta de enfermería fue revelada como un espacio que proporciona el empoderamiento de la familia por medio de adquisición de conocimiento sobre el diagnóstico, el tratamiento y la forma de tratar con el niño oncológico, lo que les propicia a los padres mayor seguridad para cuidar del hijo


Asunto(s)
Humanos , Masculino , Niño , Adulto , Padres/educación , Enfermería de Consulta , Oncología Médica/educación , Relaciones Profesional-Familia , Familia , Salud del Niño , Investigación Cualitativa , Atención Ambulatoria
9.
J Glob Health ; 9(2): 0204249, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31788233

RESUMEN

Background: mHealth technology holds promise for improving the effectiveness of frontline health workers (FLWs), who provide most health-related primary care services, especially reproductive, maternal, newborn, child health and nutrition services (RMNCHN), in low-resource - especially hard-to-reach - settings. Data are lacking, however, from rigorous evaluations of mHealth interventions on delivery of health services or on health-related behaviors and outcomes. Methods: The Information Communication Technology-Continuum of Care Service (ICT-CCS) tool was designed for use by community-based FLWs to increase the coverage, quality and coordination of services they provide in Bihar, India. It consisted of numerous mobile phone-based job aids aimed to improve key RMNCHN-related behaviors and outcomes. ICT-CCS was implemented in Saharsa district, with cluster randomization at the health sub-center level. In total, evaluation surveys were conducted with approximately 1100 FLWs and 3000 beneficiaries who had delivered an infant in the previous year in the catchment areas of intervention and control health sub-centers, about half before implementation (mid-2012) and half two years afterward (mid-2014). Analyses included bivariate and difference-in-difference analyses across study groups. Results: The ICT-CCS intervention was associated with more frequent coordination of AWWs with ASHAs on home visits and greater job confidence among ASHAs. The intervention resulted in an 11 percentage point increase in FLW antenatal home visits during the third trimester (P = 0.04). In the post-implementation period, postnatal home visits during the first week were increased in the intervention (72%) vs the control (60%) group (P < 0.01). The intervention also resulted in 13, 12, and 21 percentage point increases in skin-to-skin care (P < 0.01), breastfeeding immediately after delivery (P < 0.01), and age-appropriate complementary feeding (P < 0.01). FLW supervision and other RMNCHN behaviors were not significantly impacted. Conclusions: Important improvements in FLW home visits and RMNCHN behaviors were achieved. The ICT-CCS tool shows promise for facilitating FLW effectiveness in improving RMNCHN behaviors.


Asunto(s)
Agentes Comunitarios de Salud , Promoción de la Salud/métodos , Telemedicina , Niño , Salud del Niño , Femenino , Humanos , India , Salud del Lactante , Recién Nacido , Salud Materna , Servicios de Salud Materno-Infantil/organización & administración , Estado Nutricional , Embarazo , Evaluación de Programas y Proyectos de Salud , Salud Reproductiva , Servicios de Salud Reproductiva/organización & administración
10.
Rev. latinoam. cienc. soc. niñez juv ; 17(2): 127-147, jul.-dic. 2019. tab, graf
Artículo en Español | LILACS | ID: biblio-1043046

RESUMEN

Resumen (analítico) La investigación tiene como objetivo identificar los principales problemas de acceso a los servicios de salud de niños y niñas con diversidad funcional en América Latina. Se trata de una revisión sistemática. Se desarrollaron estrategias detalladas para la búsqueda individual en Health, Redalyc, Medline y SciELO entre mayo y junio de 2018. Se incluyeron artículos originales publicados entre enero 2013- julio 2018 en portugués, inglés o español. Se realizaron análisis descriptivos para la categorización de los estudios. Se identificaron 9 artículos, todos transversales de diseño descriptivo. A partir de los resultados obtenidos, quedó evidente que las dificultades de acceso a los servicios de salud están asociadas a la mayor vulnerabilidad a factores demográficos, socioeconómicos, siendo necesario traspasar las barreras existentes a través de la creación y efectividad de políticas públicas que garanticen acceso a la salud.


Abstract (analytical) The research aims to identify the main problems in terms of access to health services for children with disabilities in Latin America. This is a systematic review that involved detailed individual search strategies for Bireme, Redalyc, Medline and SciELO between May and June 2018. Original articles that were published between January 2013 and July 2018 in Portuguese, English and Spanish were reviewed. Descriptive analysis was categorized out to categorize the studies that were reviewed. A total of 9 articles were identified, all with a cross-cutting descriptive design. From the results obtained, it was evident that the difficulties involved in access to health services for this population are associated with greater vulnerability in terms of demographic and socioeconomic factors. It is necessary to overcome existing barriers through the creation and implementation of public policies that guarantee access to health.


Resumo (analítico) A investigação tem como objetivo identificar os principais problemas de acesso aos serviços de saúde de crianças com diversidade funcional na América Latina. Se trata de uma revisão sistemática, onde foram desenvolvidas estratégias detalhadas de busca individual para Bireme, Redalyc, Medline e SciELO entre maio e junho de 2018. Foram incluídos artigos originais publicados entre janeiro de 2013 a julho de 2018 nos idiomas português, inglês ou espanhol. Foram feitas análises descritivas para a categorização dos estudos. Foram identificados 9 artigos, todos transversais de desenho descritivo. A partir dos resultados obtidos, ficou evidente que as dificuldades de acesso aos serviços de saúde estão associadas a maior vulnerabilidade aos fatores demográficos e socioeconômicos sendo necessário traspassar as barreiras existentes através da criação e efetivação de políticas públicas que garantam acesso à saúde.


Asunto(s)
Salud del Niño , Niños con Discapacidad
11.
Rev. Esc. Enferm. USP ; 53: e03484, Jan.-Dez. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1020386

RESUMEN

RESUMO Objetivo Relatar a experiência de estudantes e docentes de um projeto de extensão universitária no planejamento e realização de oficinas educativas sobre desenvolvimento infantil com educadoras de creche. Método Relato de experiência alicerçado nos referenciais das Necessidades Essenciais das Crianças e na Teoria Bioecológica do Desenvolvimento Humano. Resultados Participaram das oficinas oito graduandas, duas docentes de Enfermagem de uma universidade pública e 24 educadoras de uma creche localizada no município de São Paulo, em região de alta vulnerabilidade social. As oficinas educativas abordaram os temas: fundamentos do desenvolvimento infantil, marcos do desenvolvimento nas áreas pessoal e social, linguagem, motor fino e grosseiro e promoveram o desenvolvimento infantil na creche. Como estratégias pedagógicas, foram utilizadas dinâmicas interativas, jogos didáticos e recursos midiáticos. As oficinas educativas favoreceram a translação do conhecimento sobre o desenvolvimento infantil e as necessidades essenciais das crianças. Conclusão As ações de extensão proporcionaram articulação entre a universidade e a comunidade por meio do compartilhamento de saberes entre profissionais da saúde e da educação visando à promoção do desenvolvimento infantil.


RESUMEN Objetivo Relatar la experiencia de estudiantes y docentes de un proyecto de extensión universitaria en la planificación y realización de talleres educativos acerca del desarrollo infantil con educadoras de guarderías. Método Relato de experiencia cimentado en los marcos de referencia de las Necesidades Esenciales de los Niños y la Teoría Bioecológica del Desarrollo Humano. Resultados Participaron en los talleres ocho estudiantes de graduación, dos docentes de Enfermería de una universidad pública y 24 educadoras de una guardería ubicada en el municipio de São Paulo, en zona de alta vulnerabilidad social. Los talleres educativos abordaron los temas: fundamentos del desarrollo infantil, hitos del desarrollo en las áreas personal y social, lenguaje, motricidad fina y gruesa, y promovieron el desarrollo infantil en la guardería. Como estrategias pedagógicas, fueron utilizadas dinámicas interactivas, juegos didácticos y recursos mediáticos. Los talleres favorecieron la traslación del conocimiento acerca del desarrollo infantil y las necesidades esenciales de los niños. Conclusión Las acciones de extensión proporcionaron articulación entre la universidad y la comunidad mediante el intercambio de saberes entre los profesionales sanitarios y de la educación a fin de promover el desarrollo infantil.


ABSTRACT Objective To report the experience of students and teachers of a university extension project in the planning and performance of educational workshops on child development with educators of a day care center. Method Report of experience based on frameworks of The Irreducible Needs of Children and the Bioecological Theory of Human Development. Results The workshops included eight undergraduate students, two nursing professors from a public university and 24 educators from a day care center located in a region of high social vulnerability in São Paulo. The educational workshops promoted child development in the day care center and the following themes were addressed: child development fundamentals, developmental milestones in the personal and social areas, language, fine and gross motor coordination. Interactive dynamics, didactic games and media resources were used as pedagogical strategies. The educational workshops favored the transfer of knowledge on child development and irreducible needs of children Conclusion Extension activities provided a link between the university and the community through the sharing of knowledge among health and education professionals aimed at promoting child development.


Asunto(s)
Humanos , Femenino , Desarrollo Infantil , Educación en Salud , Enfermería Pediátrica , Jardines Infantiles , Salud del Niño
12.
RECIIS (Online) ; 13(4): 843-853, out.-dez. 2019. ilus
Artículo en Portugués | LILACS | ID: biblio-1047584

RESUMEN

Os indicadores de morbidade e de mortalidade materno-infantis são essenciais no contexto da organização da Rede Cegonha, no âmbito do Sistema Único de Saúde (SUS). Esta rede organiza-se para assegurar o acesso, o acolhimento e a resolutividade, por meio de um modelo de atenção voltado para o pré-natal, parto e nascimento, puerpério e sistema logístico. Este artigo apresenta um estudo ecológico desta rede em uma Regional de Saúde, realizado com uso de dados dos Sistemas de Informação de Saúde do Departamento de Informática do SUS. Verificou-se um percentual crescente de gestantes que realizaram sete ou mais consultas pré-natais. No entanto, poucas concluíram a assistência pré-natal, porque não realizaram a consulta de puerpério. Observou-se uma taxa de mortalidade infantil próxima à da meta estipulada pela ONU. Identificou-se um aumento das cesáreas e uma redução de partos normais, além de uma alta mortalidade materna. Esses indicadores apontam para a necessidade de melhoria da qualidade da atenção pré-natal e da assistência ao parto.


Indicators of maternal-child morbidity and mortality are essential in the context of the organization of the Rede Cegonha (Stork Network), within the scope of the Unified Health System (SUS ­ Sistema Único de Saúde). This network is organized to ensure access, protection and successful resolution, through a model of attention focused on prenatal, delivery and childbirth, puerperium (or postpartum period) and logistic system. This article presents an ecological study of this network in a Regional de Saúde (Regional Health Department) that was carried out using data from the SUS Department of Informatics of the Health Information Systems. An increasing percentage of pregnant women who had seven or more prenatal visitscould be observed. However, few pregnant women completed prenatal care because they have not sought for the puerperium consultation. A child mortality rate close to the target set out in the United Nations Sustainable Development Goals was observed. An increase in caesarean sections and a reduction in normal deliveries and at the same time a high maternal mortality were identified. These indicators point to the need to improve the quality of prenatal and delivery care.


Los indicadores de morbilidad y de mortalidad materno-infantil son esenciales en el contexto de la organización de la Rede Cegonha (Red Cigüeña), en el ámbito del Sistema Único de Salud (SUS ­ Sistema Único de Saúde). Esa red se organiza para asegurar el acceso, el acogimiento y la capacidad resolutiva, por medio de un modelo de atención dirigido al prenatal, parto, nacimiento, puerperio y sistema logístico. Este artículo presenta un estudio ecológico de la red en una Regional de Saúde (Dirección Regional de Salud) realizado utilizando datos de los Sistemas de Información de Salud del Departamento de Informática del SUS. Se ha verificado un porcentaje creciente de gestantes que realizaron siete o más consultas de prenatal. Sin embargo, pocas gestantes concluyeron la asistencia prenatal, porque no realizaron la consulta de puerperio. Se observó una tasa de mortalidad infantil próxima a la meta estipulada por la ONU. Se identificó un aumento de las cesáreas y una reducción de partos normales, además de una alta mortalidad materna. Esos indicadores apuntan la necesidad de mejorar la calidad de la atención prenatal y de la asistencia al parto.


Asunto(s)
Humanos , Mortalidad Infantil , Mortalidad Materna , Indicadores de Salud , Salud de la Mujer , Prestación de Atención de Salud , Atención Prenatal , Sistema Único de Salud , Salud del Niño , Parto Humanizado , Servicios de Salud Materno-Infantil , Estudios Ecológicos , Acogimiento , Accesibilidad a los Servicios de Salud
13.
; IBFAN.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-46900

RESUMEN

Durante o XV Encontro Nacional de Aleitamento Materno (ENAM), especialistas alertam da importância de combater a obesidade infantil e adulta através da amamentação exclusiva até os seis meses. Um estudo realizado pela Organização Mundial da Saúde revelou que crianças alimentadas exclusivamente com leite materno no primeiro semestre de vida tinham risco 25% menor de obesidade. Além disso, o estudo cita uma pesquisa que revela que cada mês adicional de amamentação estava associado a uma redução de 4% na prevalência de sobrepeso.


Asunto(s)
Lactancia Materna , Sobrepeso , Obesidad Pediátrica , Obesidad/prevención & control , Salud del Niño , Promoción de la Salud
14.
Niger J Clin Pract ; 22(11): 1516-1529, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31719273

RESUMEN

Background: A Free Maternal and Child Health program (FMCHP) was implemented in 12 states in Nigeria by the National Health Insurance Scheme (NHIS), between 2009 and 2015, using funds from the debt relief gains. It was called the Millennium Development Goals (MDGs) NHIS-MDG FMCHP. The program ended with the termination of the MDG in 2015. With the creation of the Basic Health Care Provision Fund (BHCPF) in Nigeria, this study sought to examine the past implementation experiences of the NHIS-MCH project with a view to identifying the enabling and constraining factors to program implementation, and the opportunities for adaptation and program scale-up in Nigeria using the BHCPF. Methods: The study was undertaken in the Federal Capital Territory, Abuja, and involved review of relevant documents and in-depth interviews with 21 key informants. The program was assessed in themes from the conceptual framework. Interviews were transcribed and analyzed using thematic analysis. Results: The program enrolled about 1.5 million pregnant women and children during the period of implementation in the country. The respondents perceived the program as pro-poor, efficient, and effective, and led to marked improvement in the functionality of the facilities, availability of services and reduced out-of-pocket expenditure, which led to increased demand and utilization of MCH services. There was inadequate stakeholder consultation, alleged corrupt practices, challenges with registration, issues with counterpart funding and public financing management issues identified. Most respondents supported the idea of using the new fund (BHCPF) to revitalize/scale-up the Free MCH program. Conclusion: This study highlights the key lessons and implementation challenges identified by the respondents. The NHIS-MDG FMCHP had positive impact on the target population though it was not sustained following the conclusion of the MDG program. The findings will inform policy decisions about the appropriateness of sustaining the program and the feasibility of extending healthcare coverage using the proposed BHCPF. The new fund (BHCPF) can be used to reactivate and scale-up the Free MCH program, but the current level of funding will not assure universal health coverage for the target beneficiaries as realized from the costing aspect of this study.


Asunto(s)
Financiación Gubernamental , Gastos en Salud , Servicios de Salud Materno-Infantil/economía , Programas Nacionales de Salud/economía , Cobertura Universal del Seguro de Salud/economía , Niño , Salud del Niño , Prestación de Atención de Salud/economía , Femenino , Promoción de la Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Seguro de Salud , Servicios de Salud Materno-Infantil/organización & administración , Nigeria , Embarazo
15.
Lancet ; 394(10211): 1836-1878, 2019 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-31733928
16.
Clin Ter ; 170(5): e321-e327, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31612186

RESUMEN

INTRODUCTION: Temporomandibular disorders (TMD) are an heterogeneous group of disorders affecting temporomandibular joints (TMJ), masticatory muscles, or both. The aim of this study is to evaluate the relationship between general health and psychological distress variables and the clinical diagnosis of TMD in children between 8 - 13 years old. Moreover, it will be underlined the different perception of psychological distress existing between patients and their parents. MATERIALS AND METHODS: Patients were divided in two groups: the "case group", which includes patients with TMD, and the "control group", which included patients asymptomatic for TMD. The "case group" is composed by 29 patients, while the "control group" is composed by 22 patients. The patients were asked to fill in a questionnaire called Child Health Questionnaire (CHQ), to evaluate general health and psychological condition and, eventually, the presence of symptoms of stress, anxiety and/or depression. The CHQ is 87 - item questionnaire developed in USA specifically for children. RESULT: As widely reported during the present work, the link between TMD and psychological distress is existing and quite strong, because of lack of number of patients many aspects worth of attentions have not been analyzed as they deserved. CONCLUSION: That's way the conclusion must lead to the proposal of going on with the present study following, possibly, some aspects of research as an increase of the number of patients involved in the study; Individuate possible elements, internal and external, that could strongly influence differences between patient's results and parent's results, etc.


Asunto(s)
Salud del Niño , Estrés Psicológico/psicología , Trastornos de la Articulación Temporomandibular/psicología , Adolescente , Adulto , Estudios de Casos y Controles , Niño , Depresión/psicología , Femenino , Humanos , Masculino , Estrés Psicológico/etiología , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/complicaciones
17.
Rev Saude Publica ; 53: 92, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31644723

RESUMEN

OBJECTIVE: To estimate the use of the first dose of antibiotics in the health care unit in children from the 2015 Pelotas Birth Cohort at 24 months. METHODS: A total of 4,014 children were monitored. We used descriptive statistics and Poisson regression to analyze the association between socioeconomic and demographic variables, participation in daycare units, in the activities of the Pastoral da Criança and in the Primeira Infância Melhor program, low birth weight, hospitalization between 12 and 24 months, place of medical appointment, prevalence of medical appointment in the last 30 days, prescription of antibiotics, and administration of the first dose in the health care unit. RESULTS: A total of 1,044 children had medical appointments in the last 30 days, of which 45% were prescribed antibiotics and only 10.5% were administered the first dose of this medication in the health care unit. Children with brown, yellow or indigenous skin color were administered 2.5 times more antibiotics than white children. Children whose mothers had 12 years or more of education were administered 83.0% fewer antibiotics than those whose mothers had up to 4 years of education. Among those who were hospitalized for 12 to 24 months, the use of antibiotics was almost four times higher than among those who were not. Among the children served by the Brazilian Unified Health System (SUS), only 15.3% were administered the first dose of antibiotic in the health care unit. When compared with children served by private health care or health plan, administration of the first dose in the SUS was 76.0% higher. CONCLUSIONS: Despite the efforts related to the Pastoral da Criança campaign "Antibiotic: first dose immediately," adherence to the provision of antibiotics in the health care unit is still low. Strategies are necessary and urgent so children have access to the first dose of antibiotics in the health care unit.


Asunto(s)
Antibacterianos/administración & dosificación , Encuestas de Atención de la Salud/estadística & datos numéricos , Adulto , Citas y Horarios , Brasil/epidemiología , Salud del Niño/estadística & datos numéricos , Preescolar , Estudios de Cohortes , Prescripciones de Medicamentos/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Masculino , Madres , Programas Nacionales de Salud , Prevalencia , Factores Socioeconómicos , Factores de Tiempo , Adulto Joven
19.
Res Nurs Health ; 42(6): 446-457, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31599010

RESUMEN

The purpose of this paper is to describe the approaches and recruitment strategies of a study focused on the impact of coal fly ash on neurobehavioral performance among children living in proximity to coal-burning power plants. Challenges encountered with each recruitment approach are highlighted as well as solutions used to overcome those challenges and ultimately enroll children and one of their parents or guardians. To ensure participants were distributed throughout the study area, geographical information systems were used to guide recruitment and achieve the target sample size (N = 300). Several approaches were employed to recruit the number of needed participants, including "shoe leather" or door-to-door recruitment, placement of flyers and brochures in public spaces, mailings to targeted addresses, media announcements, and local government outreach. Since September 2015, 265 participants have been enrolled in the study using a combination of the described recruitment approaches. Even with a well-designed plan, it is important to re-examine strategies at every step to maximize recruitment efforts. Researcher flexibility in adapting to new strategies is vital in facilitating recruitment efforts, and the recruitment of participants in the study remains a dynamic and evolving process.


Asunto(s)
Salud del Niño , Ceniza del Carbón/efectos adversos , Selección de Paciente , Proyectos de Investigación , Niño , Carbón Mineral , Sistemas de Información Geográfica , Recursos en Salud/economía , Humanos , Centrales Eléctricas
20.
Epidemiol Health ; 41: e2019045, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31623420

RESUMEN

OBJECTIVES: Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran-despite achieving some of the MDGs-need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries. METHODS: This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated. RESULTS: Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children. CONCLUSIONS: Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.


Asunto(s)
Salud del Niño , Indicadores de Salud , Salud Materna , Desarrollo Sostenible , Niño , Femenino , Humanos , Irán/epidemiología , Embarazo
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