Salud mental, género y trabajo: dispositivo para la erradicación de las violencias en el ámbito de la salud / Mental health, gender and work: a facility for the eradication of violence in the field of health

Este escrito recupera la experiencia de institucionalización de la red de abordaje de las violencias en el recorte específico de la violencia laboral por razones de género1 (VG), con la intención de situar la discusión en la intersección género, salud mental y trabajo, y sus implicancias en las instituciones de salud y la vida de las trabajadoras/es. Desarrollamos coordenadas conceptuales y marcos normativos en clave de derechos humanos que instan a modos particulares de abordar la violencia en el mundo del trabajo. Posteriormente, se presenta el recorte de la experiencia de asesoramiento para la conformación de comités y la red de equipos por región sanitaria que acompañan a trabajadoras que atraviesan situaciones de VG. A modo de cierre presentamos los desafíos que emergen de nuestro trabajo.

Manager's leadership is the main skill for ambulatory health care plan success.

To demonstrate effectiveness of ambulatory health care plan implementation among institutions and variables associated with the differences observed. Randomized selection of primary health care (PHC) centers was done. Leadership ability of the plan manager was explored. Univariate/bivariate analyses were performed to observe correlation between variables. Two groups of PHC centers were established according to the efficacy of plan implementation: high and low performance. Differences between groups were observed (592%-1023% more efficacy in controls and practices; P < .001). Leadership was responsible for the main differences observed. Leadership of manager for implementation of the health care plan was the major important variable to reach the best efficacy standards.

Healthcare model based on personalised attention: impact on maternal mortality and health system quality.

BACKGROUND: Latin America's public healthcare model has traditionally offered health services on demand including provision for the most deprived inhabitants. However, this care model has not provided the expected improvement in health conditions or equity for the indigent population. AIM: To compare maternal health indicators between previous services and a new healthcare model based on personalised care and a named healthcare worker. METHODS: Pregnant women in La Plata, Argentina were observed during two periods: a control period using a historical model and an intervention period where a new healthcare model was provided, each period lasting 12 months. Indicators of the quality of antenatal care services were measured, including mortality rate, number of pregnancy related consultations, vaccination coverage, gestational age at delivery, newborn weight, laboratory and scan monitoring, early pregnancy detection and type of delivery. RESULTS: The number of patients undergoing antenatal surveillance increased almost five-fold during the period of the new healthcare model. Also the rate of early detection of pregnancy, average number of health consultations and vaccination coverage were significantly higher with the new model compared with previous care. Maternal gestation at delivery increased from 37.4±3.8% to 39.3±2.5% weeks (P<0.001) and neonatal weight increased from 3048 AE 612 g to 3301 AE 580 g (P=0.003). There were no maternal deaths in the intervention group compared with seven deaths in the control group. Child mortality rate was 13.7 and 11.8 per 1000 for control and intervention groups respectively (P=0.039). CONCLUSIONS: A named responsible health worker and personalised care helped contribute to improvements in quality of antenatal care in the health system.