Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 720.722
Filtrar
1.
Recurso na Internet em Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-48581

RESUMO

El tema se centra en terminar con el estigma, la discriminación y el prejuicio en contra las personas afectadas por esta enfermedad. La campaña pretende crear conciencia sobre el impacto que la discriminación y el estigma social tienen en las personas afectadas por la Lepra, y sobre cómo estas actitudes obstaculizan los esfuerzos para detener la propagación de la enfermedad.


Assuntos
Hanseníase , Estratégias de eSaúde
4.
Multimedia | Recursos Multimídia | ID: multimedia-9561

RESUMO

Durante esta sesión, el equipo directivo de la RECAINSA, compartió las principales actividades realizadas durante el 2021 así como los resultados obtenidos, las lecciones aprendidas y las proyecciones de trabajo del 2022 de la Red.


Assuntos
Informática Médica , Estratégias de eSaúde , Telemedicina
5.
Artigo em Espanhol | PAHO-IRIS | ID: phr-55571

RESUMO

[RESUMEN]. Objetivo. Estimar el impacto presupuestal de la vacunación contra COVID-19 en seis países de América Latina: Argentina, Brasil, Chile, Colombia, México y Perú, durante el periodo 2021-2022. Métodos. Se evaluaron las vacunas de Sinopharm (BBIBP-CorV), Janssen (JNJ-78436735), Instituto de Gamaleya (Gam-COVID-Vac), Sinovac (CoronaVac), CanSino (Convidecia), AstraZeneca (Vaxzevria), Moderna (mRNA-1273) y Pfizer (BNT162b2), según disponibilidad para cada país. Se adoptó la perspectiva del sistema de salud, de manera que solo se incluyeron costos médicos directos. El horizonte temporal se adoptó teniendo en cuenta los tiempos de implementación de cada plan de vacunación, excluyendo menores de 16 años y gestantes. Se incluyeron los siguientes costos: costo de la vacunación y aplicación, costos de la hospitalización general aislamiento, cuidado intermedio e intensivo. Se compararon dos escenarios de vacunación: 1) Población que desea vacunarse (según las encuestas nacionales) y 2) Población que debería vacunarse (total susceptible de vacunación). Los costos agregados para cada escenario de vacunación se compararon con el escenario de no vacunación. Adicionalmente, se realizaron análisis de sensibilidad determinísticos y probabilísticos. Resultados. Los diferentes esquemas de vacunación contra COVID-19 disponibles en América Latina generan ahorros potenciales que oscilan entre USD 100 y USD 1 500 millones de dólares por país para el período 2021-2022, asumiendo que se logra implementar en su totalidad el plan de vacunación previsto en cada país. Conclusiones. La vacunación contra COVID-19 es una estrategia que además de reducir la morbilidad y mortalidad para Latinoamérica, genera ahorros potenciales para los sistemas de salud en la región.


[ABSTRACT]. Objective. To estimate the budgetary impact of COVID-19 vaccination in six Latin American countries: Argentina, Brazil, Chile, Colombia, Mexico, and Peru, during the 2021-2022 biennium. Methods. Vaccines from Sinopharm (BBIBP-CorV), Janssen (JNJ-78436735), Gamaleya Institute (Gam-COVID-Vac), Sinovac (CoronaVac), CanSino (Convidecia), AstraZeneca (Vaxzevria), Moderna (mRNA-1273), and Pfizer (BNT162b2) were evaluated, according to their availability in each country. The health system perspective was adopted, so that only direct health care costs were included. The time horizon adopted took into account the implementation times of each vaccination plan, excluding children under 16 years of age and pregnant persons. The following costs were included: cost of vaccination/vaccine administration and costs of hospitalization (general isolation, stepdown care, and intensive care). Two vaccination scenarios were compared: 1) population wanting to be vaccinated (according to national surveys); and 2) population that should be vaccinated (total population susceptible to vaccination). The aggregate costs for each vaccination scenario were compared with the no-vaccination scenario. Deterministic and probabilistic sensitivity analyses were also performed. Results. The different COVID-19 vaccination regimens available in Latin America generate potential savings ranging from USD 100 million to USD 1.5 billion per country for the 2021-2022 biennium, assuming that the vaccination plan proposed for each country is fully implemented. Conclusions. COVID-19 vaccination is a strategy that not only reduces morbidity and mortality in Latin America, but also generates potential savings for health systems in the region.


[RESUMO]. Objetivo. Estimar o impacto orçamentário da vacinação contra a COVID-19 em seis países da América Latina: Argentina, Brasil, Chile, Colômbia, México e Peru, no período 2021-2022. Métodos. Foram avaliadas as vacinas da Sinopharm (BBIBP-CorV), Janssen (JNJ-78436735), Instituto Gamaleya (Gam-COVID-Vac), Sinovac (CoronaVac), CanSino (Convidecia), AstraZeneca (Vaxzevria), Moderna (mRNA-1273) e Pfizer (BNT162b2), conforme a disponibilidade para cada país. Adotou-se a perspectiva do sistema de saúde, de forma que só foram incluídos custos médicos diretos. O horizonte temporal foi adotado levando em consideração os tempos de implementação de cada plano de vacinação, excluindo crianças menores de 16 anos e gestantes. Foram incluídos os seguintes custos: custos de vacinação e aplicação, custos gerais de hospitalização, isolamento, e cuidados intermediários e intensivos. Compararam-se dois cenários de vacinação: 1) população disposta a se vacinar (com base em pesquisas nacionais) e 2) população que deveria ser vacinada (total elegível de vacinação). Os custos agregados para cada cenário de vacinação foram comparados com o cenário de não vacinação. Além disso, foram realizadas análises de sensibilidade determinísticas e probabilísticas. Resultados. Os diferentes esquemas de vacinação contra a COVID-19 disponíveis na América Latina geram economias potenciais entre 100 milhões e 1,5 bilhão de dólares por país para o período 2021-2022, considerando a implementação completa do plano de vacinação previsto em cada país. Conclusões. A vacinação contra a COVID-19 é uma estratégia que, além de reduzir a morbidade e a mortalidade na América Latina, gera economias potenciais para os sistemas de saúde da região.


Assuntos
Vacinação , Coronavirus , COVID-19 , SARS-CoV-2 , Custos de Cuidados de Saúde , Vacinas contra COVID-19 , América Latina , Vacinação , Vacinas contra COVID-19 , Custos de Cuidados de Saúde , América Latina , Vacinação , Vacinas contra COVID-19 , Custos de Cuidados de Saúde
6.
Washington, D.C.; PAHO; 2022-01-11. (PAHO/HSS/HS/21-0014).
Não convencional em Inglês | PAHO-IRIS | ID: phr-55564

RESUMO

The measurement of health spending and the monitoring of resources through the SHA 2011 health accounts system represent invaluable tools for decision-making and the adoption of health policies. Knowing how much is being spent and how it is being spent allows, for example, to verify whether spending is linked to a country's policy priorities; if the resources of the system are translated into greater and better health benefits; and if the resources are allocated according to the specific health needs and therefore achieve the maximum potential for the population. This strategic information facilitates the monitoring of progress towards the objectives of access and universal coverage of the system from financing, with efficiency, equity and sustainability. This publication describes the data from a survey of health accountants in the Region of the Americas, with the objective of analyzing the key elements to improve the institutionalization strategies of health accounts in the countries. Thus, it was found that the frequency of staff turnover and insufficient resources represent obstacles to full institutionalization. The background to the establishment and expansion of the accounts in Latin America, and the disclosure practices of the most frequent results, are also described. It concludes with final thoughts and recommendations.


Assuntos
Sistemas de Saúde , Serviços de Saúde , Prioridades em Saúde , Tomada de Decisões , Recursos Financeiros em Saúde , Financiamento dos Sistemas de Saúde , América
7.
Washington, D.C.; OPS; 2022-01-06. (OPS/EGC/COVID-19/21-0006).
Não convencional em Espanhol | PAHO-IRIS | ID: phr-55557

RESUMO

La COVID-19 ha generado efectos catastróficos en los sistemas de salud y en la salud de las personas en la Región de las Américas, en especial en el caso de las mujeres y las niñas, cuyas condiciones han empeorado en todos los ámbitos. Las mayores preocupaciones al respecto se centran en las consecuencias directas (morbilidad y mortalidad) de la acción del virus sobre poblaciones definidas, en los resultados de las medidas orientadas a mitigar la propagación del virus y en el efecto indirecto sobre las condiciones socioeconómicas. En este complejo escenario, el enfoque de género, con sus consecuencias en el contexto actual, no ha recibido la debida atención durante la pandemia. El género es uno de los determinantes estructurales asociados a la salud, pero no aparece en los análisis de los efectos directos e indirectos de la pandemia. Además, es fundamental para reconocer y analizar los efectos diferenciales de la pandemia sobre hombres y mujeres y su interacción con los diferentes determinantes de la salud. El presente informe es una iniciativa de la Organización Panamericana de la Salud y apunta a generar un conjunto de conocimientos que permitan, por un lado, reconocer, entender e instalar la temática de género y salud en el contexto de la pandemia, y, por otro, comprender el comportamiento de la enfermedad y sus posibles efectos. El informe se cierra con una serie de conclusiones y recomendaciones sobre datos y evidencia, y sobre respuestas en planes y políticas.


Assuntos
COVID-19 , Coronavirus , Infecções por Coronavirus , Gênero e Saúde , Mulheres , Determinantes Sociais da Saúde , Mortalidade , Morbidade , Fatores Socioeconômicos , Pandemias , Sistemas de Saúde , Política de Saúde
8.
Washington, D.C.; OPS; 2022-01-04. (OPAS/HSS/HS/21-0014).
Não convencional em Português | PAHO-IRIS | ID: phr-55551

RESUMO

A mensuração dos gastos com saúde e o monitoramento dos recursos por meio do sistema de contas de saúde SHA 2011 representam ferramentas valiosas para a tomada de decisões e a adoção de políticas de saúde. Saber quanto está sendo gasto e como está sendo gasto permite, por exemplo, verificar se o gasto está vinculado às prioridades políticas de um país; se os recursos do sistema se traduzem em maiores e melhores benefícios à saúde; e se os recursos são alocados de acordo com as necessidades específicas de saúde e, portanto, atingem o máximo potencial de benefícios para a população. Essas informações estratégicas facilitam o monitoramento do andamento dos objetivos de acesso e cobertura universal do sistema a partir do financiamento, com eficiência, equidade e sustentabilidade. Esta publicação descreve os dados de uma pesquisa com contadores de saúde na Região das Américas com o objetivo de analisar os elementos-chave para melhorar as estratégias de institucionalização das contas de saúde nos países. Assim, constatou-se que a frequência de rotatividade de pessoal e a insuficiência de recursos representam entraves à plena institucionalização. Descreve também os antecedentes do estabelecimento e expansão das contas na América Latina e as práticas de divulgação dos resultados mais frequentes. Conclui com considerações finais e recomendações.


Assuntos
Sistemas de Saúde , Prestação de Contas Financeiras em Saúde , Políticas, Planejamento e Administração em Saúde , Política de Saúde , Gastos em Saúde , Política Pública , Saúde Pública , Cobertura Universal de Saúde , Estratégias para Cobertura Universal de Saúde , Recursos em Saúde , América , América Latina
9.
Washington, D.C.; OPS; 2022-01-04. (OPS/HSS/HS/21-0014).
Não convencional em Espanhol | PAHO-IRIS | ID: phr-55550

RESUMO

La medición del gasto en salud y el seguimiento de recursos a través del sistema de cuentas de salud SHA2011 representan herramientas invaluables para la toma de decisiones y la adopción de políticas de salud. Conocer cuánto se gasta y cómo se gasta permite, por ejemplo, verificar si el gasto se vincula con las prioridades de política de un país; si los recursos del sistema se traducen en mayores y mejores prestaciones de salud; y si los recursos son asignados de acuerdo con las necesidades de salud específicas y alcanzan, por tanto, el máximo potencial de beneficios para la población. Esta información estratégica facilita el monitoreo del avance hacia los objetivos de acceso y cobertura universal del sistema desde el financiamiento, con eficiencia, equidad y sostenibilidad. Esta publicación describe los datos de una encuesta realizada a contadores de salud de la Región de las Américas con el objetivo de analizar los elementos clave para mejorar las estrategias de institucionalización de las cuentas de salud en los países. Así, se constató que la frecuencia en la rotación de personal y la insuficiencia de recursos representan obstáculos para la plena institucionalización. También se describen los antecedentes del establecimiento y la ampliación de las cuentas en América Latina y las prácticas de divulgación de los resultados más frecuentes. Concluye con reflexiones finales y recomendaciones.


Assuntos
Sistemas de Saúde , Prestação de Contas Financeiras em Saúde , Políticas, Planejamento e Administração em Saúde , Política de Saúde , Gastos em Saúde , Política Pública , Saúde Pública , Cobertura Universal de Saúde , Estratégias para Cobertura Universal de Saúde , Recursos em Saúde , América Latina , América
10.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-22268663

RESUMO

The governance of COVID 19 in Lower and Middle-Income Countries (LMICs) is very critical for curbing its effects. However, it is unknown what governance strategies are adopted by Health Facility Governing Committees (HFGCs) s as a response to the pandemic. We employed an exploratory qualitative design to study the governance strategies adopted by HFGCs during the COVID19. Since COVID 19 is new, an inductive approach was used as it involves analyzing collected data with little or no predetermined theory for the study. A purposive sampling technique was employed in which multistage clustered sampling was used to select regions, councils, health facilities and respondents. In-depth interviews with HFGCs chairpersons and Focus Group Discussions with members of HFGCs were used to collect data. The data were analyzed based on the themes which emerged during data collection. We found five governance strategies that were found to be commonly adopted by many HFGCs which are financial allocation, re-planing, mobilization of resources, community sensitization and mobilization of stakeholders. however, these governance structures were not all adopted by all HFGCs. The HFGCs slowly adopted governance strategies in the times of COVID 19 pandemics because were unprepared. Despite being empowered by the Direct Health Facility Financing, still, the newest of the COVID 19 has been a challenge to many HFGCs. This calls for urgent capacity building for governance institutions on how to deal will pandemics in primary health facilities. Key Questions Box O_TEXTBOXKey Questions What is Already Known?[tpltrtarr] Governance of pandemics is very critical for minimizing its effects [tpltrtarr]Government in Lower and Middle-Income Countries (LMICs) reacted differently to bring the COVID 19 pandemic under control [tpltrtarr]Little is known on the governance strategies adopted by Health Facility Governing Committees (HFGCs) to control COVID 19 at the primary health care facilities in LMICs What are the new findings?[tpltrtarr] HFGCs response to the COVID 19 is mixed as some HFGCs were so active and others were so slowly in instituting governance strategies to combat the pandemic [tpltrtarr]The common governance strategies adopted were financial allocation, re-planning, embolization of resources, community sensitization and stakeholders mobilization [tpltrtarr]HFGCs in LMICs were not well prepared for the pandemic at the community level What do new findings imply?[tpltrtarr] Capacitated HFGCs in both soft and hard aspects cornerstone for effective governance of the pandemics in primary health care [tpltrtarr]Preparedness of pandemics in LMICs needs to go beyond upper-level governance structures C_TEXTBOX

11.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-22268709

RESUMO

IntroductionEasy and equitable access to testing is a cornerstone of the public health response to COVID-19. Currently in Australia, testing using Polymerase Chain Reaction (PCR) tests for COVID-19 is free-to-the-user, but the public purchase their own Rapid Antigen Tests (RATs). We conduct an economic analysis of government-funded RATs in Australia. MethodsAn interactive decision tree model was developed to compare one policy in which government-funded RATs are free-to-the-user, and one in which individuals purchase their own RATs. The decision tree represents RAT and PCR testing pathways for a cohort of individuals without COVID-19-like symptoms, to estimate the likelihood of COVID-19 positive individuals isolating prior to developing symptoms and the associated costs of testing, from a government perspective. Key input parameter values are uncertain, so a range of scenario analyses are presented. ResultsAssuming 10% prevalence of COVID-19 in a cohort of 10,000 individuals who would use government-funded RATs, and assuming 20% of the cohort would purchase RATs if not government-funded, the model estimates an additional 696 individuals would isolate early at a cost to the government of around $52,000. From these values, for every additional $112 associated with government funding of RATs, an additional individual with COVID-19 and no symptoms is expected to isolate. Scenario analyses indicate that the incremental cost to the government per additional COVID-19 positive individual isolating with no symptoms would, at most, be a few hundred dollars. ConclusionsBased on the presented decision tree model, even only minor reductions in COVID-19 transmission rates due to early isolation would justify the additional costs associated with a policy of government-funded RATs.

12.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-22268760

RESUMO

BACKGROUNDHigher COVID-19 incidence and morbidity have been amply documented for US Black and Hispanic populations but not as clearly for other racial and ethnic groups. Efforts to elucidate the mechanisms underlying racial health disparities can be confounded by the relationship between race/ethnicity and socioeconomic status. OBJECTIVEExamine race/ethnicity and social vulnerability effects on COVID-19 outcomes in the San Francisco Bay Area, an ethnically and socioeconomically diverse region. DESIGNRetrospective cohort study. SETTINGGeocoded patient records from the University of California, San Francisco Health system between January 1, 2020 to December 31, 2020. PATIENTSPatients who underwent polymerase chain reaction testing for COVID-19. EXPOSURESRace/ethnicity and Social Vulnerability Index (SVI). MAIN MEASURESCOVID-19 test frequency, positivity, hospitalization rates, and mortality. KEY RESULTSHigher social vulnerability, but not race/ethnicity, was associated with less frequent testing yet a higher likelihood of testing positive. Asian hospitalization rates (11.5%) were double that of White patients (5.4%) and exceeded the rates for Black (9.3%) and Hispanic (6.9%) groups. A modest relationship between higher hospitalization rates and increasing social vulnerability was evident only for White individuals. The Hispanic group had the lowest mean age at death and thus highest years of expected life lost due to COVID-19. CONCLUSIONSCOVID-19 outcomes were not consistently explained by greater socioeconomic vulnerability. Asian individuals showed disproportionately high rates of hospitalization regardless of socioeconomic status. Study of the San Francisco Bay Area population not only provides valuable insights into the differential contributions of race/ethnicity and social determinants of health to COVID-19 outcomes but also emphasizes that all racial groups have experienced the toll of the pandemic, albeit in different ways and to varying degrees.

13.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-22268794

RESUMO

IntroductionEthiopia registered its first case of COVID-19 on March 13, 2020. We aimed to assess maternal, newborn, and child health care (MNCH) utilization during the first six months of the COVID-19 pandemic, as well as potential barriers and enablers of service utilization from health care providers and clients. MethodsMixed study design was conducted as part of the Birhan Health and Demographic Surveillance System in Ethiopia. The trend of service utilization during the first six months of COVID-19 was compared to corresponding time and data points of the preceding year. ResultService utilization of new family planning visits (43.2 to 28.5/month, p = 0.014) and sick under five child visits (225.0 to 139.8/month, P = 007) declined during the initial six months of the pandemic compared to the same period in the preceding year. Antenatal and postnatal care visits, facility delivery rates, and child routine immunization visits also decreased although this did not reach statistical significance. Interviews with health care providers and clients highlighted several barriers to service utilization during COVID-19, including fear of disease transmission, economic hardship, and transport service disruptions and restrictions. Enablers of service utilization included communities decreased fear of COVID-19, and awareness-raising activities. ConclusionProvision of essential MNCH services is crucial to ascertain favorable maternal and child health outcomes. In low- and middle-income country settings like Ethiopia, health systems might be fragile to withstand the caseloads and priority setting due to the pandemic. Our study presents early findings on the utilization of MNCH services that were maintained except sick child and new family planning visits. Government leaders, policy makers, and clinicians who wish to improve the resilience of their health system will need to continuously monitor service utilization and clients evolving concerns during the pandemic to prevent increases in maternal and child morbidity and mortality. What is already known?Facility-based essential MNCH services utilization decreased during the initial phase of the pandemic and similarly facility-based healthcare utilizations were reduced in the 2014-2015 Ebola outbreak in west Africa. What are the new findings?Facility based essential MNCH services such as antenatal care, postnatal care, family planning, facility deliveries, routine immunization and repeat family planning utilization were maintained in the initial six month of the pandemic unlike other similar studies elsewhere. What do the new findings imply?In light of a pandemic, essential MNCH services such as antenatal and postnatal care, family planning, facility deliveries, repeat family planning and routine immunizations can be sustained in a health system. More attention may be given to better understand the reduction of sick under five visits. Further research can be conducted on the utilization of essential MNCH services on maternal and child health outcomes. Our results emphasize the importance of health systems and clinicians to sustain the resilience of their health system. Among those the Ministry of Health (MoH) directive to avail MNCH services in all facilities during the pandemic and the maturity level of some programs (Even though new family planning utilizers are limited, they know the benefit and would want to continue the repeat family planning utilization, benefits of facility delivery, routine immunization, antenatal care and postnatal care). Strengths and limitations of this studyO_ST_ABSStrengths of the studyC_ST_ABS{checkmark} We present primary data on service utilization during the early months of the pandemic in an area of Ethiopia, one of the agrarian regions, which is generalizable to 80% of the countrys population. {checkmark}The mixed methods approach integrated both quantitative service utilization coverage data with sociocultural, contextual, and exploratory qualitative to better understand our findings and reasons for changes in service utilization. {checkmark}The study highlights success stories in community-based care and government leadership for key services like routine immunization that may benefit other settings. Limitation of the study{checkmark} Our study focused on service utilization and may not have been powered to detect significant differences. Furthermore, we focused on coverage of service utilization as the primary outcome rather than mortality or morbidity. {checkmark}We do not have detailed data on service provision (e.g., which services were restricted and for how long, in what manner). {checkmark}There is the potential of recall bias were possible limitation since qualitative data was collected three months later than the initial six months of the pandemic (March to August 2020).

14.
Artigo em Inglês | MEDLINE | ID: mdl-34982327

RESUMO

PURPOSE: The purpose of this report from the field is to describe the process by which an multidisciplinary workgroup, selected by the CDC Foundation in partnership with maternal health experts, developed a definition of racism that would be specifically appropriate for inclusion on the Maternal Mortality Review Information Application (MMRIA) form. DESCRIPTION: In the United States Black women are nearly 4 times more likely to experience a pregnancy-related death. Recent evidence points to racism as a fundamental cause of this inequity. Furthermore, the CDC reports that 3 of 5 pregnancy related deaths are preventable. With these startling facts in mind, the CDC created the Maternal Mortality Review Information Application (MMRIA) for use by Maternal Mortality Review Committees (MMRC) to support standardized data abstraction, case narrative development, documentation of committee decisions, and analysis on maternal mortality to inform practices and policies for preventing maternal mortality. ASSESSMENT: Charged with the task of defining racism and discrimination as contributors to pregnancy related mortality, the work group established four goals to define their efforts: (1) the desire to create a product that was inclusive of all forms of racism and discrimination experienced by birthing people; (2) an acknowledgement of the legacy of racism in the U.S. and the norms in health care delivery that perpetuate racist ideology; (3) an acknowledgement of the racist narratives surrounding the issue of maternal mortality and morbidity that often leads to victim blaming; and (4) that the product would be user friendly for MMRCs. CONCLUSION: The working group developed three definitions and a list of recommendations for action to help MMRC members provide suggested interventions to adopt when discrimination or racism were contributing factors to a maternal death. The specification of these definitions will allow the systematic tracking of the contribution of racism to maternal mortality through the MMRIA and allow a greater standardization of its identification across participating jurisdictions with MMRCs that use the form.

15.
Artigo em Inglês | MEDLINE | ID: mdl-34982333

RESUMO

OBJECTIVES: Mother's health and wellbeing significantly affects child health. Women's autonomy can improve healthcare-seeking behaviour, utilisation of healthcare services, and planned pregnancy, thereby improving child health. The global under-five mortality rate (U5MR) has seen the fastest decline in the past two decades, but the influence of gender equality on child mortality remains unaddressed. A strategic approach addressing gender equality is needed to reduce the U5MR further. The study aimed to identify and investigate the association between indicators of gender equality and U5MR using a human rights-based approach. METHODS: We analysed open-source secondary data from international agencies comprising 521 gender-sensitive variables for 193 countries. Nine variables were included for the final Structural Equation Model based on the theoretical model. Model 1 consisted of 193 countries, and Model 2 comprised a subgroup analysis of 11 variables for 158 countries. Gender equality was a latent variable, and the U5MR was the outcome variable. RESULTS: Gender equality was significantly associated with U5MR (Z = - 7.47, 95% CI = - 754.67 to - 440.98, p < 0‧001, n = 193 for Model 1, and Z = - 7.71, 95% CI = - 808.26 to - 480.72, p < 0‧001, n = 158 for Model 2). Female education, women's waged and salaried employment, women as employers, and women's representation in leadership and parliament enhanced gender equality, whereas the prevalence of child marriage and intimate partner violence (IPV) negatively affected gender equality. Improvement in gender equality significantly reduced U5MR. CONCLUSIONS FOR PRACTICE: Improving women's economic, educational, and social position and increasing female representation in higher leadership and policymaking positions is the key to reducing child mortality. Notably, eliminating child marriage and IPV is the key to achieving gender equality and is needed at the forefront of national policies. Gender equality can significantly improve women's reproductive autonomy, a critical factor in improving healthcare utilisation for women and their children.

16.
Artigo em Inglês | MEDLINE | ID: mdl-34982344

RESUMO

INTRODUCTION: Community-academic partnerships (CAPs) aim to improve neighborhood population health. Though measuring the impact of partnership activities at a population level can be difficult, evaluating indicators of wellbeing may increase understanding of how communities benefit from CAPs. This study examined child health indicators over time in two low-income, predominantly Black/African American and Hispanic communities where partnerships between an academic child development center and community coalitions were formed with the intention of improving child well-being. METHODS: Trends in three child wellbeing indicators (graduation rates, kindergarten readiness, and proportion of youth in school and/or employed) were compared between two CAP communities and several neighboring comparison communities. Data between 2011 and 2017 were analyzed to calculate percent change from baseline and mapped using ArcGIS to visualize trends by zip code. Proportions of youth meeting benchmarks were also determined. RESULTS: Kindergarten readiness and high-school graduation rates improved in CAP communities but not in geographically proximal and socioeconomically similar comparison communities. No improvements were found in the proportion of youth in school or employed. DISCUSSION: This study revealed population-level indicators improved over time in CAP communities. Because community-level child health and wellbeing are influenced by many factors, this correlation is not proof of a causal relationship. Assessing population level indicators can nonetheless provide insight into the benefit of CAPs, and the commitment to monitoring such outcomes can itself advance how academic and community partners plan activities and set long-term goals.

17.
Health Serv Res ; 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34982473

RESUMO

OBJECTIVE: To investigate how the health services research (HSR) workforce supply in the United States has evolved over the last five years. DATA SOURCES: Membership data of AcademyHealth participants, professional networking websites, PubMed, grant databases, and the Integrated Postsecondary Education Data System. STUDY DESIGN: Descriptive study comparing size and characteristics of the HSR workforce and graduates identified across multiple data sources. Lists of authors and principal investigators (PIs) were merged and de-duplicated to identify unique counts. Pearson's Chi Squared test was used to compare characteristics between members and non-members of AcademyHealth. DATA COLLECTION: Downloaded files from websites and received survey data extracted by AcademyHealth between 2016 and 2020. PRINCIPAL FINDINGS: The workforce size ranged from 9,610 to 28,136, depending on data source. Common employers included universities, government settings, and health systems. Little overlap in employers existed for individuals with potentially competing skillsets. The HSR workforce appeared more diverse than the US adult population, with two to three times greater representation among Asian individuals yet lower representation among Black/African American (30%) and Hispanic (75%) individuals compared to the US population. 87,721 master's and 3,105 doctoral degree graduates from core HSR fields were added over five years from public and not-for-profit institutions. Including for-profit institution graduates increased the count by 15% for master's and 30% for doctoral graduates. Hispanic (any race), Black/African American, and multi-racial individuals gained representation among core HSR graduates, with for-profit institutions substantially contributing to the number of Black/African American graduates. CONCLUSIONS: The HSR workforce is growing with increasing diversity among its graduates compared to previous studies. Additional work is needed to understand how employers value the contributions of those trained in HSR. Continued efforts are needed to ensure HSR workforce diversity to frame critical research questions and develop programs and policies that reflect the needs of the community. This article is protected by copyright. All rights reserved.

18.
J Genet Psychol ; : 1-10, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34984962

RESUMO

In Malaysia, sexual health risks such as unprotected sex, teenage pregnancies, abandoned babies, abortion, and sexually transmitted diseases are on the rise because adolescents are increasingly engaging in such sexual behaviors. The present study aimed to investigate the relationship between perceived peer sexual behaviors and sexual behaviors among adolescents as well as to examine the interacting role of gender in such a relationship. This cross-sectional study recruited a sample of 338 school-going adolescents (Mage = 16.7; SDage = 1.53) using the purposive sampling method. Participants were required to complete questionnaires consisting of the modified Human Sexuality Questionnaire-Orgasmic Experience Scale and the Peer Norms Scale. Results indicated that adolescents who perceived their peers to be actively engaging in sexual behaviors were more prone to being sexually active themselves. The results also showed gender as a significant moderator in the relationship between adolescents' perceived peers' sexual behaviors and sexual behaviors. Besides, the impact of perceived peer sexual behaviors on sexual behaviors was found to be stronger in male than female adolescents. Overall, the findings from this study hinted at the importance of peers and gender differences during the planning and implementation of sexual and health education.

19.
Med Care ; 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34984989

RESUMO

BACKGROUND: Health care systems in the United States are increasingly interested in measuring and addressing social determinants of health (SDoH). Advances in electronic health record systems and Natural Language Processing (NLP) create a unique opportunity to systematically document patient SDoH from digitized free-text provider notes. METHODS: Patient SDoH status [recorded by Your Current Life Situation (YCLS) Survey] and associated provider notes recorded between March 2017 and June 2020 were extracted (32,261 beneficiaries; 50,722 YCLS surveys; 485,425 provider notes).NLP patterns were generated using a machine learning test statistic (Term Frequency-Inverse Document Frequency). Patterns were developed and assessed in a training, training validation, and final validation dataset (64%, 16%, and 20% of total data, respectively).NLP models analyzed SDoH-specific categories (housing, medical care, and transportation needs) and a combined SDoH metric. Model performance was assessed using sensitivity, specificity, and Cohen κ statistic, assuming the YCLS Survey to be the gold standard. RESULTS: Within the training validation dataset, NLP models showed strong sensitivity and specificity, with moderate agreement with the YCLS Survey (Housing: sensitivity=0.67, specificity=0.89, κ=0.51; Medical care: sensitivity=0.55, specificity=0.73, κ=0.20; Transportation: sensitivity=0.79, specificity=0.87, κ=0.58). Model performance in the training and training validation datasets were comparable.In the final validation dataset, a combined SDoH prediction metric showed sensitivity=0.77, specificity=0.69, κ=0.45. CONCLUSION: This NLP algorithm demonstrated moderate performance in identification of unmet patient social needs. This novel approach may enable improved targeting of interventions, allocation of limited resources and monitoring a health care system's addressing its patients' SDoH needs.

20.
Med Care ; 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34984991

RESUMO

BACKGROUND: While overall Medicare Part C (Medicare Advantage) enrollment has grown more rapidly than fee-for-service Medicare enrollment, changes in the growth and characteristics of different enrollee populations have not been examined. OBJECTIVES: For 2011-2019, to compare changes in the growth and characteristics of younger (age younger than 65) and older (age 65 and older) Medicare beneficiaries enrolled in Medicare Part A only, Medicare Parts A & B, and Medicare Part C. RESEARCH DESIGN: This was a retrospective, observational study. SUBJECTS: Medicare beneficiaries who were alive and enrolled in Medicare Part A only, Medicare Parts A & B, or Medicare Part C on June 30 of each year and in no other plan that year. MEASURES: For each plan type and age group the numbers and mean ages of enrollees and the proportion of enrollees who were: black, female, concurrently enrolled in Medicaid, and (for older enrollees), whose initial reason for eligibility was old age and survivors' benefits. RESULTS: Between 2011 and 2019, Medicare Part C experienced rapid expansions of 85.0% among older and 109.5% among younger enrollees. Part C enrollees were increasingly likely to be dually enrolled in Medicaid, Black and, among younger enrollees, female. CONCLUSIONS: Trends in demographic characteristics and changes in policy and growth in employer group plan offerings will likely continue to impact health care service utilization and costs in the Medicare population. Particularly as Medicare expansion to younger age groups is considered, future research should explore disparities in risk scores and care equity, quality, and costs across different Medicare enrollment options.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...