Willingness of WHO staff to work in health emergencies in the African Region: opportunity for phased deployment of staff and ensure continuity of health services

A human resource base that ensures appropriate deployment of staff to emergencies, addressing different shock events in emergencies, without disrupting continuity of service is germane to a successful response. Consequently, the WHO Health Emergencies programme in the African Region, in collaboration with Africa Centre for Disease Control (ACDC) launched the African Volunteer Health Corps (AVoHC) and Strengthening and Utilization of Response Group for Emergencies (SURGE), an initiative aimed at ensuring a pool of timely responders. We explored the willingness of WHO staff to work in emergencies. A call for expression of interest to be part of the Elite Emergency Experts (Triple E) was published on 5th July 2022 via email and was open for 5 weeks. The responses were analyzed using simple descriptive statistics and presented with graphic illustrations. A total of 1253 WHO staff, from all the six WHO regions, cutting across all cadre, applied to the call. The applicants had various trainings and experiences in emergency and have responded to mostly disease outbreaks. Two-third of the applicants were males. This paper did not explore reasons for the willingness to work in emergencies. However, contrary to fears expressed in literature that health workers would not want to work in emergencies with potential for infections, the applicants have worked mostly in infectious emergencies. Literature identified some themes on factors that could impact on willingness of health workers to work in emergencies. These include concerns for the safety of the responders and impact of partners, child and elderly care, as well as other family obligations, which emergency planners must consider in planning emergency response.

Pharmaceutical Care in Primary Care: an Experience with Hypertensive Patients in the North of Brazil

Abstract Background: Uncontrolled blood pressure has been associated with poor adherence to drug treatment. Objectives: To assess blood pressure control in hypertensive patients attending primary health centers after implementation of a pharmaceutical follow-up program in a city of the north of Brazil. Methods: Observational, cross sectional, descriptive study with 163 hypertensive patients attending public primary health care centers - one located on the riverside and one in the urban area of the city of Santarem, western Pará, Brazil. Adherence to the anti-hypertensive treatment was assessed using the eight-item Morisky test. Pharmacotherapy follow-up (Dader method) of patients with uncontrolled hypertension and non-adherent to anti-hypertensive treatment was performed. Results of the normality test showed that the data did not follow a normal distribution. Continuous variables were then compared using the Wilcoxon signed-rank test, and categorical variables by the likelihood ratio and the McNemar tests. Statistical significance was set at 5%. Results: Of the total sample, 94.5% were not adherent to anti-hypertensive drug therapy and 77.2% had uncontrolled hypertension. Adherence rate was higher in men than women (p=0.006). Pharmacotherapy follow-up improved blood pressure levels, particularly systolic blood pressure (p<0.001). Conclusion: An individualized pharmacotherapeutic follow-up, considering regional and cultural specificities, can contribute to the treatment of hypertensin in the primary care.

Aparelhos de amplificação sonora individual: quais são as queixas mais recorrentes dos usuários e suas possíveis relações com ajustes finos? / Hearing aids: what are the most recurrent complaints from users and their possible relationship with fine tuning?

RESUMO Objetivo identificar as queixas mais recorrentes dos usuários de aparelhos de amplificação sonora individual (AASI) e estabelecer possíveis relações que auxiliem a busca de soluções de problemas no processo de adaptação desses dispositivos. Métodos estudo transversal, descritivo e quantitativo, realizado mediante questionário on-line, respondido por 176 fonoaudiólogos. Após computação e organização das respostas, realizou-se uma codificação e foram descritos 30 termos mais recorrentes, referentes às queixas dos usuários. Foram estabelecidas quatro categorias para verificar cada termo relatado e sua correspondência com o problema apontado em cada questão. Para o direcionamento das possíveis relações entre as queixas e suas resoluções, os termos foram divididos nos seguintes aspectos principais do processo de adaptação de AASI: adaptação física, ajuste das características eletroacústicas e características intrínsecas do usuário. Resultados foram descritos 30 termos representativos das queixas, com maior número de ocorrências para o termo "Aparelho muito alto/Som muito alto", que apareceu 223 vezes. O termo "Não escuta nada" apareceu com menor número de ocorrências, 25 vezes. No total, foram encontradas seis queixas relacionadas a aspectos físicos, 17 a ajustes de características eletroacústicas, quatro que poderiam estar relacionadas a ambos os aspectos e duas a características intrínsecas do indivíduo. Conclusão foi possível elencar as queixas mais referidas pelos usuários de AASI. Observou-se que é viável, a partir de uma queixa, direcionar um suposto aspecto relacionado à adaptação e auxiliar os fonoaudiólogos a levantar soluções, apesar de ser clara a necessidade de um olhar individualizado para cada paciente e situação.

ABSTRACT Purpose To identify the most frequent complaints from hearing-aid users and establish possible relationships that might help audiologists solve some problems. Methods Cross-sectional, descriptive and quantitative study, carried out through an online questionnaire, answered by 176 audiologists. After analyzing the responses and computing the terms, coding was performed and the 30 most frequent complaints were described. Four categories were established to verify each reported term and its correspondence with the problem pointed out in each question. To address the possible relationships between complaints and their solutions, the terms were divided into the following main aspects of the hearing aid fitting process: physical adaptation, adjustment of electroacoustic characteristics and user's intrinsic characteristics. Results 30 representative terms of complaint were described due to their high number of occurrences : the term "very loud device / very loud sound" appeared 223 times whereas the term "I cannot hear anything" had the fewest number of occurrences, 25 appearances. In total, there were six complaints related to physical aspects, 17 to adjustments of electroacoustic characteristics, four that could be related to both aspects and two to intrinsic characteristics of the individual. Conclusion It was possible to identify the most frequently reported complaints of hearing aid users. . It was observed that it is feasible, based on a complaint, to address a supposedly related aspect of adaptation and help audiologists find solutions. However, each particular patient and situation must be given individualized attention.

Recurrent acute otitis media: a survey of current management in England.

OBJECTIVE: Recurrent acute otitis media is common in children. The preferred treatment measures for recurrent acute otitis media have a mixed evidence base. This study sought to assess baseline practice across ENT departments in England. METHODS: A national telephone survey of healthcare staff was conducted. Every ENT centre in England was contacted. A telephone script was used to ask about antibiotic and grommet use and duration in recurrent acute otitis media cases. RESULTS: Ninety-six centres (74 per cent) provided complete information. Recurrent acute otitis media treatment across England by ENT departments varied. The antibiotic first- and second-line prophylaxis offered varies, with trimethoprim used in 33 centres and 29 centres not offering any antibiotics. The timing or choice about when to use grommets also varies, but 87 centres (91 per cent) offer grommet surgery at one stage. CONCLUSION: The treatments received by children in England for recurrent acute otitis media vary by centre; collaborative research in this area is advised.

Type 1 diabetes in adults: diagnosis and management: Last updated 21 July 2021

This guideline covers care and treatment for adults (aged 18 and over) with type 1 diabetes. It includes advice on diagnosis, education and support, blood glucose management, cardiovascular risk, and identifying and managing long-term complications.

Relationship between satisfaction with mental health services, personal recovery and quality of life among service users with psychosis: a cross-sectional study.

BACKGROUND: Mental health policy internationally emphasizes patient centredness and personal recovery. This study investigated the relationship between satisfaction with mental health services among service users with psychosis in Norway, and personal recovery, perceived support for personal recovery, and quality of life. METHODS: Cross-sectional data were collected from 292 service users diagnosed with psychosis from 39 clinical sites across Norway. Satisfaction with services was assessed using the Client Satisfaction Questionnaire-8. A linear mixed model was estimated to explore the relationship between satisfaction with services and preselected covariates, and to control for confounding factors. RESULTS: A large majority of participants (89%) reported moderate-to-high levels of satisfaction. Satisfaction with services was positively associated with perceived support for personal recovery, but not with personal recovery or quality of life. In addition, service users under a Community Treatment Order (CTO) were significantly less satisfied than those who were not. CONCLUSIONS: Satisfaction levels among service users were higher compared with similar, international studies. Those who feel supported in their personal recovery were more satisfied with the care they receive, which support the need for implementation of recovery-oriented practices for service users with psychosis. However, satisfaction with services was not related to service user-rated quality of life or level of personal recovery; thus, more follow-up studies are needed. The lower satisfaction of service users placed under CTOs shows the importance of targeted interventions to improve satisfaction with services among this group. TRIAL REGISTRATION: NCT03271242 , date of registration: 5 sept. 2017.

El terapeuta ocupacional como acompañante terapéutico en el ámbito de la salud mental comunitaria / No disponible

Lo que se explica en este artículo, corresponde a una visión concreta de lo que significa el acompañamiento a personas con una enfermedad mental severa. Esta visión y orientación está basada en la teoría psicodinámica. Se ha teorizado una manera de trabajar específica del terapeuta ocupacional dentro de la atención comunitaria en el ámbito de la salud mental. La intervención domiciliaria que se hace desde la Terapia Ocupacional como acompañante terapéutico está basada en el uso terapéutico del vínculo entre terapeuta y persona, y entre la persona y su comunidad. Dándole a la persona un lugar de protagonismo en la intervención, fomentando la autonomía, la responsabilidad y la creación de un proyecto de vida saludable. Respecto al terapeuta como profesional, se analiza las dificultades con las que se puede encontrar a nivel emocional con la persona a la cual atiende desde una perspectiva transferencial y contratransferencial. Así como la utilidad del uso terapéutico del encuadre que proporciona a la persona coherencia, seguridad y límites

What is explained in this article corresponds to a precise vision of what it means to accompany people with severe mental illness. This view is base on psychodynamic theory. A specific Occupational Therapy way of working in a mental health community setting has been theorized. Home interventions carried out from Occupational Therapy as a therapeutic companion are based on the therapeutic use of the bond between the professional and the person, and between the professional and the community. Offering the client a leading role in the intervention, promoting autonomy, responsibility and the possibility to create a healthy life project. Regarding the therapist as a professional, the emotional issues that may appear, both at a transferential and countertransference level are analysed. As well as the benefits of using a therapeutic setting which offers the client coherence, security and limits

Management of patients diagnosed or suspected with Covid-19 in cardiorespiratory arrest: a scoping review / Manejo de pacientes diagnósticos o sospechosos de Covid-19 en la parada cardiorrespiratoria: revisión de alcance / Manejo de pacientes diagnosticados ou com suspeita de Covid-19 em parada cardiorrespiratória: scoping review

ABSTRACT Objective: to map the production of knowledge about the recommendations that can be applied in managing patients diagnosed or suspected with COVID-19 in cardiorespiratory arrest. Method: a scoping review, according to the Joanna Briggs Institute (2020) guidelines. Search was performed in ten data sources, and two electronic search engines were used; from 2001 to 2020. Results: of the 547 studies found, 14 met the inclusion and exclusion criteria. Most studies were published in 2020 (35.7%), and most studies were conducted in Canada (21.4%). It is observed the use of a systematized care to identify the possible means of care that should be provided to patients who suffer a cardiorespiratory arrest in hospitals, such as the monitoring of suspected cases by assessing the victim's breathing and pulse and identifying arrhythmias and shockable rhythms quickly. Personal protective equipment must be used to protect against droplets and aerosols and respiratory etiquette. Conclusion: managing patients in cardiorespiratory arrest suspected or diagnosis with COVID-19 requiring cardiopulmonary resuscitation should be performed in isolation areas and with the use of adequate protective equipment. There are gaps in scientific productions so that they address more clearly and instructively management when performing cardiopulmonary resuscitation in patients suspected or diagnosed with COVID-19.

RESUMEN Objetivo: mapear la producción de conocimiento sobre las recomendaciones que se pueden aplicar en el manejo de un paciente diagnosticado o sospechoso de tener COVID-19 en paro cardíaco. Método: se trata de una revisión de alcance, de acuerdo con las directrices del Instituto Joanna Briggs (2020). La búsqueda se realizó en diez fuentes de datos y se utilizaron dos buscadores electrónicos; período de tiempo de 2001 a 2020. Resultados: de las 547 publicaciones encontradas, 14 cumplieron los criterios de inclusión y exclusión. La mayoría de los estudios se publicaron en el año 2020 (35,7%) y la mayoría de los estudios se realizaron en Canadá (21,4%). Se observa el uso de una atención sistemática para identificar las posibles vías de asistencia que se deben brindar a los pacientes que sufren una parada cardiorrespiratoria en el ámbito hospitalario, como monitorear los casos sospechosos de la enfermedad mediante la evaluación de la respiración y el pulso de la víctima e identificar rápidamente arritmias y ritmos desfibrilables. Cabe mencionar el uso de equipo de protección personal para protegerse de gotitas y aerosoles y conductas respiratorias específicas para estos casos. Conclusión: el manejo de pacientes en parada cardiorrespiratoria con COVID-19 sospechado o diagnosticado que requieran reanimación cardiopulmonar debe realizarse en áreas de aislamiento y con el uso de equipo de protección adecuado. Se observó que existen lagunas en las producciones científicas, por lo que se abordan de forma más clara e instructiva sobre el manejo al realizar reanimación cardiopulmonar en pacientes con sospecha o diagnóstico de COVID-19.

RESUMO Objetivo: mapear a produção de conhecimento sobre as recomendações que podem ser aplicadas no manejo de paciente diagnosticado ou com suspeita de COVID-19 em Parada Cardiorrespiratória. Método: trata-se de uma revisão de escopo, de acordo com as orientações do Instituto Joanna Briggs (2020). Realizada busca em dez fontes de dados, e utilizados dois buscadores eletrônicos; recorte temporal de 2001 a 2020. Resultados: das 547 publicações encontradas, 14 atenderam aos critérios de inclusão e exclusão. A maior parte dos estudos foi publicada no ano de 2020 (35,7%), e a maioria dos estudos foi realizada no Canadá (21,4%). Observa-se o uso de um cuidado sistematizado para identificação das possíveis vias de assistência que deverão ser prestadas a pacientes que sofrem uma parada cardiorrespiratória no ambiente hospitalar, como o monitoramento de casos suspeitos da doença através da avaliação da respiração e pulso da vítima e identificação das arritmias e de ritmos chocáveis de forma rápida. Vale salientar o uso de equipamentos de proteção individual para proteção contra gotículas e aerossóis e condutas respiratórias específicas para estes casos. Conclusão: o manejo do paciente em parada cardiorrespiratória com suspeita ou diagnóstico de COVID-19 que necessita de reanimação cardiopulmonar deve ser realizado em áreas de isolamento e com a utilização de equipamentos de proteção adequados. Foi visto que existem lacunas nas produções científicas, para que abordem de maneira mais clara e instrutiva sobre o manejo ao realizar ressuscitação cardiopulmonar em pacientes com suspeita ou diagnóstico de COVID-19.

Neumoperitoneo en un paciente en tratamiento con diálisis peritoneal automática: informe de un caso / Pneumoperitoneum in a patient receiving automatic peritoneal dialysis: a case report

DESCRIPCIÓN DEL CASO: caso de neumoperitoneo en un paciente con tratamiento en diálisis peritoneal automática con día seco. Pese a que el neumoperitoneo no es una complicación grave, puede alterar la calidad de vida del paciente, por lo que es necesario investigar su origen. Tras revisar la bibliografía existente, encontramos un único caso de neumoperitoneo en terapia de diálisis peritoneal automática y se han reportado un mayor número de casos de esta complicación en pacientes con diálisis peritoneal continua ambulatoria, todos ellos debido a errores en la técnica. Tras la valoración de enfermería, el paciente identificó algunos errores en la técnica como los posibles causantes de esta complicación. DESCRIPCIÓN DEL PLAN DE CUIDADOS: El plan de cuidados consistió en descartar otras complicaciones de la diálisis peritoneal como obstrucción de catéter o peritonitis, evaluar los posibles errores del paciente en la técnica procediendo a su reentrenamiento y ofrecer apoyo emocional al paciente y la familia. La evaluación del plan de cuidados a la semana y al mes fue favorable. CONCLUSIONES: Como conclusión, hay que destacar la importancia de realizar un entrenamiento personalizado en cada paciente, dependiendo del tipo de terapia prescrita y las potenciales complicaciones para que el paciente las conozca y así poder prevenir su aparición

CASE DESCRIPTION: Case of pneumoperitoneum in a patient on automatic peritoneal dialysis with a dry day. While pneumoperitoneum is not a serious complication may alter the quality of life of the patient, so it is necessary to determine its origin. After reviewing the existing bibliography, we found a case report of pneumoperitoneum on automatic peritoneal dialysis therapy. In addition, other cases with this complication in patients with continuous ambulatory peritoneal dialysis have been reported, all of them because of errors in the technique. After the nursing assessment, the patient identified some errors in the technique as the possible causes of this complication. DESCRIPTION OF THE CARE PLAN: The care plan focused on ruling out other complications of peritoneal dialysis such as catheter obstruction or peritonitis, evaluating possible errors in the technique made by the patient, proceeding with their retraining, and offering emotional support to the patient and the family. The evaluation of the care plan at one week and one month was favorable. CONCLUSIONS: It should be emphasized the importance of personalized training depending on the type of therapy prescribed and the potential complications, so that the patient knows them and can prevent their appearance

Protocolo de atención a viajeros que entran y salen del país en vuelos especiales: Guía Técnica / Protocol of attention to travelers entering and leaving the country on special flights: Technical Guide

El documento contiene los procedimientos de atención para los viajeros que ingresan y salen del país en vuelos especiales en el contexto de la emergencia sanitaria por COVID-19 a nivel nacional declarada por el Decreto Supremo N° 008-2020. El documento fue derogado de baja con R.M. N°493-2023-MINSA del 26 de mayo de 2023.

Exploring access to government-led support for children with disabilities in Bangladesh.

While access to support for individuals with disabilities has attracted international attention, children with disabilities and their families continue to face a range of barriers that limit their timely access to the needed support, including health service. This is even worse for children with disabilities living in resource poor settings like Bangladesh. The objective of this study was to determine the extent to which families of children with disabilities have knowledge about and access to government support for their children with disabilities in Bangladesh. We employed a cross-sectional study among 393 families of children with disabilities who sought services from the Centre for the Rehabilitation of the Paralysed for their children with disabilities in Bangladesh. We used chi-square test to measure the association between categorical variables and, Mann-Whitney U-test to compare mean across different sub-groups. Overall, family members of children with disabilities have limited knowledge about and access to government support. We found a significant association between knowledge and access to government support (p<0.001). Family members with children with disabilities aged younger than six years had less access to government support (p<0.001). We thus concluded with an urgent call on government agencies and service providers to provide relevant and timely information to families of children with disabilities to enable them to access the needed support.

Performance management: a qualitative study of relational boundaries in personal assistance.

Personal assistance (PA) is a model of support where disabled people take control of recruiting, training and managing the people that support them. Personal assistance differs from other forms of care, such as domiciliary or informal care, because the disabled person is in control of how, when and by whom they are supported. With the advent of personal health budgets, PA is no longer limited to social care but is also central to future NHS services and funding arrangements. The aims of this study were to gain a deeper understanding of PA relationships, and to explore how both parties manage interpersonal challenges. We report on data from 58 qualitative interviews with disabled employers and personal assistants. Applying concepts from Goffman's (1959) scheme of impression management, we present an analysis of the relational dynamics that occur when two people cooperate in shared endeavours. Goffman's concepts of team members and non-persons, in addition to the themes of regions and information control, aid a more fundamental understanding of the relational dynamics that occur between disabled employers and their PAs.

Análise do perfil sociodemográfico, motivos de adesão, rotina de treinamento e acompanhamento profissional de praticantes de corrida de rua / Analysis of sociodemographic profile, adhesion reasons and characteristics of training of street running practitioners

A corrida de rua é considerada um fenômeno sociocultural contemporâneo em ampla expansão no Brasil e no mundo. No entanto, há uma carência de informações a respeito do perfil sociodemográfico dos praticantes de corridas de rua, assim como os seus motivos de adesão e rotina de treinamento. Essas informações são essenciais para a elaboração de estratégias de intervenção profissional voltadas para os praticantes de corrida de rua. O presente estudo teve como objetivo analisar o perfil sociodemográfico, os motivos de adesão, a rotina de treinamento e acompanhamento profissional de corredores de rua. Participaram da pesquisa 214 praticantes de corrida de rua, do sexo masculino e feminino, idade entre 18 e 58 anos (M = 36,4 ± 10,3), devidamente inscritos em provas que fazem parte do calendário oficial de corridas. Os praticantes responderam um questionário composto por 18 questões organizadas em 3 categorias: perfil ciodemográfico, motivos de adesão e rotina de treinamento/acompanhamento profissional. Os resultados evidenciaram que a maioria dos praticantes de corrida de rua são do sexo masculino (62,1%), com faixa etária predominante entre 20 e 40 anos, elevado nível de escolaridade e que buscam essa atividade especialmente por motivos de saúde (91,1%) e prazer (69,1%). Apesar de 43,9% dos praticantes não receberem acompanhamento profissional, 96,6% consideram importante ou muito importante a supervisão profissional durante a prática. Os achados indicam que, em geral, os adeptos da corrida de rua optam pela prática devido a busca pela melhora da qualidade de vida e a socialização, bem como a redução do estresse...(AU)

Running is considered a contemporary sociocultural phenomenon in a wide expansion in Brazil and in the world. However, there is a lack of information regarding the sociodemographic profile of street racing practitioners, as well as their reasons for joining this practice and the characteristics of training. This information is essential for the development of strategies for professional intervention aimed at street racing practitioners. The present study sought to analyze the sociodemographic profile, the reasons of adhesion and the characteristics of training of street racing practitioners. A total of 214 male and female street racing practitioners, aged between 18 and 58 years (M = 36.4 ± 10.3), duly enrolled in races that are part of the official racing calendar, participated in the study. The practitioners answered a questionnaire composed of 18 questions organized in 3 categories: sociodemographic profile, reasons of adhesion and training characteristics. The results showed that most of the street racing practitioners are male (62.1%), with a predominant age group between 20 and 40 years of age, a high level of schooling and who seek this activity especially for health reasons (91, 1%) and pleasure (69.1%). Although 43.9% of the practitioners did not receive professional support, 96.6% considered it important hat, in general, the street racing practitioners choose this practice because of the quest for improving quality of life and socialization as well as for reducing stress...(AU)

A Survey on Health Care and Health Concerning Workers for Considering Appropriate Personal Health Record Service.

To prevent worsening of diabetes mellitus, we conducted a developmental research of personal health record (PHR), whereby affected individuals, medical staff and an insurer cooperate and manage effective treatment. Medical expenses can be suppressed by preventing the onset of lifestyle-related diseases. Companies can benefit from improved employee productivity by promoting healthy and efficient working styles. We conducted a health and medical consciousness survey to examine PHR models that are attractive for both employers and employees.

Abordaje de la obesidad con framingham bajo y findrisk alto / Approach to obesity with low framingham and high findrisk

Se exponen dos casos de mujeres con obesidad mórbida que quieren bajar de peso, atendidas en consulta de Enfermería de Familia, desde un abordaje biopsicosocial en el con-texto de la entrevista motivacional. Ambos casos presentan un riesgo cardiovascular bajo (Framingham) y un riesgo de padecer diabetes mellitus tipo 2 elevado (Findrisk), por lo que la incorporación de hábitos de vida saludables y la disminución del peso se convierten en objetivos fundamentales para evitar su aparición. Tras la valoración por patrones funcionales de salud de Marjory Gordo identificación y priorización de los diagnósticos de enfermería siguiendo el modelo AREA, se elaboraron los planes de cuidados utilizando el lenguaje estandarizado de enfermería NANDA-NOC-NIC. Aunque el abordaje de la obesidad fue similar (entrevista motivacional, aumento de la actividad física, manejo del sueño y emociones, alimentación saludable y disminución de la ingesta energética) se individualizó para cada caso. Se obtiene una evolución diferente en casa ocasión, probablemente debido al diferente grado de motivación y a los diferentes recursos de afronta-miento identificados en cada una de las pacientes

We present two cases of women with morbid obesity who want to lose weight, assisted in the Family Nurse consultation, from a biopsychosocial approach in the context of the motivational interview. Both cases have a low cardiovascular risk (Framingham) and high risk of developing diabetes mellitus type 2 (Findrisk), so the incorporation of healthy lifestyle habits and weight reduction become fundamental objectives to prevent their appearance. After an assessment using Marjory Gordon’s functional health patterns, nursing diagnoses were identified and prioritized based on the AREA model. By last, care plans were elaborated using the standardized nursing language NANDA-NOC-NIC. Although the approach to obesity was similar (motivational interview, increase in physical activity, management of sleep and emotions, healthy eating and decrease in energy intake) was individualized for each case; a different evolution was obtained, probably due to the different degree of motivation and the different coping resources identified in each patient

[Chronicle of a century of public health in Mexico: from public health to social protection in health.] / Crónica de un siglo de salud pública en México: de la salubridad pública a la protección social en salud.

This paper describes the creation of the legal framework and the origin, growth and consolidation of the institutions and interventions (initiatives, programs and policies) that nourished public health in Mexico in the past century. It also discusses the recent efforts to guarantee universal social protection in health. This quest, which lasted a century, developed through three generations of reform that gave birth to a health system that offers protection against sanitary risks, protection of health care quality and financial protection to all the population in the country.

En este artículo se describen la creación de los marcos legales y el origen, crecimiento y consolidación de las instituciones e intervenciones (iniciativas, programas, políticas) que han conformado la salud pública moderna en México. También se discuten los esfuerzos recientes por hacer universal la protección social en salud. Esta gesta, que duró un siglo, se fue abriendo paso a través de tres generaciones de reformas que dieron lugar a un sistema de salud que hoy ofrece protección contra riesgos sanitarios, protección de la calidad de la atención y protección financiera a los habitantes de todo el país.