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Rev Saude Publica ; 54: 130, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33331524


OBJECTIVE: To analyze whether lawsuits for medicines filed against the state of Rio Grande do Norte agree with medical-sanitary and pharmaceutical assistance management criteria established by the public policies of access to medicines in force in Brazil. METHODS: This is a descriptive and retrospective study of the individual lawsuits that claimed medicines in the state of Rio Grande do Norte between 2013 and 2017. Information was collected from the procedural documents on the requested medicines, the diagnoses referred and the origin of the medical prescription, in order to analyze medical-sanitary and pharmaceutical assistance management characteristics. RESULTS: We analyzed 987 lawsuits, which requested 1,517 medications. Of these, 60.7% were not part of the National List of Essential Medicines, and, in 75% of the cases, there was a therapeutic alternative in the Brazilian Unified Health System. In 13.6% of the actions, at least one drug was prescribed for off-label use. Prescribers of philanthropic and private services often request medicines not covered by the pharmaceutical care policy. Even judicialized drugs that are part of the national list are constantly requested for non-standard indications. CONCLUSIONS: Court decisions for the supply of medicines violate health rules and make it difficult to manage pharmaceutical assistance, which may weaken the implementation of these policies.

Medicamentos Essenciais , Acesso aos Serviços de Saúde , Legislação como Assunto , Assistência Farmacêutica , Política Pública , Brasil , Política de Saúde , Humanos , Estudos Retrospectivos , Direito à Saúde
RECIIS (Online) ; 14(4): 960-969, out.-dez. 2020. ilus
Artigo em Português | LILACS | ID: biblio-1145572


Uma trajetória individual que reverbera em suas práticas e pesquisas, interfaces da comunicação e da saúde ao longo do processo de construção do Sistema Único de Saúde no Brasil. Em entrevista à Reciis, a cientista social Janine Cardoso aborda as campanhas sobre aids, a cobertura jornalística das epidemias de dengue e o contexto da pandemia de Covid-19. Os direitos à saúde e à comunicação, a articulação com os princípios do SUS e práticas dialógicas são pensados em diferentes conjunturas, das lutas pela redemocratização do país ao momento atual, em que os discursos de negação da ciência e da democracia encontram força. Janine Cardoso é professora do Programa de PósGraduação em Informação e Comunicação em Saúde (PPGICS), do Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Icict), Fundação Oswaldo Cruz (Fiocruz).

Humanos , Política Pública , Sistema Único de Saúde , Comunicação em Saúde , Direito à Saúde , Promoção da Saúde , Notícias , Infecções por Coronavirus , Jornalismo , Dengue , Pandemias , Mídias Sociais
Wiad Lek ; 73(9 cz. 2): 2044-2048, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33148857


OBJECTIVE: The aim: Of the study is to characterize the internal acts of the United Nations on the regulation of the right to health of its staff. PATIENTS AND METHODS: Materials and methods: Achieving the purpose of the study is ensured due to the analysis of internal acts of the United Nations, doctrinal sources on the issue selected. The methodological basis is a number of special and general methods. CONCLUSION: Conclusions: The right to health guaranteed by the International Bill of Human Rights is comprehensive and closely linked to labour human rights. International civil servants of the UN system are not exempt. Thus, within the United Nations, a number of acts have been developed, the provisions of which set out recommendations aimed at reducing possible cases of infection of workers, maintaining their mental health while on quarantine, informing staff about their actions in case of illness, testing workers, etc. However, these acts need to be improved.

Direito à Saúde , Nações Unidas , Direitos Humanos , Humanos
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054263


For Africa, the backdrop1 against which COVID-19 emerged is a stark one. Although sub-Saharan Africa accounts for 11% of the world's population, it bears 24% of the global disease burden. The continent is home to 60% of the people with human immunodeficiency virus (HIV), and over 90% of malarial patients. In this region, infectious diseases such as malaria and HIV cause 69% of deaths. As states respond to COVID-19, we need to keep our eyes open to what effective responses are notifying us about our healthcare systems, so that we can craft sustainable interventions as a result and uphold the right to health. This is especially true in the light of the ongoing nature of pandemics on the continent, making urgent the need to maximise the value of our health system and its resources, as we seek lasting transformation.

Infecções por Coronavirus , Acesso aos Serviços de Saúde , Pandemias , Pneumonia Viral , Pobreza , Privatização , Direito à Saúde , África ao Sul do Saara/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Assistência à Saúde/métodos , Infecções por HIV/epidemiologia , Humanos , Malária/epidemiologia , Defesa do Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Pneumonia Viral/virologia
Georgian Med News ; (304-305): 177-182, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965271


The article explores the issue of the human right to health as a fundamental one in a democratic society, international norms and standards, international obligations of Ukraine, as well as the financial activities of public authorities in the context of radical reform of the health care system in Ukraine. It is being focused onto the WHO's "Health for All" policy, as well as "Health 2020", which became the basis for a new European Health Strategy, the nationwide Health 2020: Ukrainian Dimension. It is emphasized that the financing function of the WHO and other international organizations is considered to be the key function of the health system. The purpose of this article is of this article is to identify the peculiarities of the financial activities of public authorities in the context of a thorough reform of the healthcare system in Ukraine and to evaluate the compliance of national legislation with international norms and standards. The methodological basis of the conducted research is the general methods of scientific cognitivism as well as concerning those used in legal science: methods of analysis and synthesis, formal logic, comparative law etc.; The norms of international documents of universal and regional status, adopted by the new legislation of Ukraine in the light of radical reform of the health care system, are analyzed. The object of the study is the public relations that arise during implementation of financial activities by public authorities.; The research revealed measures taken by the state to fulfill its obligations under international treaties in the field of healthcare: amending the current legislation and practice of its implementation; making changes to administrative practice; providing legal expertise of bills; provision of training in the study of international treaties and the practice of international judicial institutions to categories of the employees whose professional activity is related to law enforcement, as well as to the detention of people (imprisoned); measures taken to ensure the elimination of systemic deficiencies and the cessation of breaches within international treaties caused by these deficiencies. Attention is drawn to the relation between the concepts of "public finances" and "public financial activities". The peculiarities of the legal organization of financial activity of the state and bodies of local self-government, the content of financial activity in the sphere of healthcare are revealed. The role of the state and local self-government bodies in financial activity as subjects of financial function is revealed. The principles, methods, forms of financial activity are described. It is emphasized that the new model of financing healthcare in Ukraine is based on the following principles: financial protection; universality of coverage and equity of access to care; transparency and accountability; efficiency; free choice; competition among suppliers; predictability of the volume of funds for medical services in the state budget; subsidiarity.

Administração Financeira , Direito à Saúde , Assistência à Saúde , Direitos Humanos , Humanos , Ucrânia
BMJ Glob Health ; 5(9)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32938607


To mitigate the spread of COVID-19, governments throughout the world have introduced emergency measures that constrain individual freedoms, social and economic rights and global solidarity. These regulatory measures have closed schools, workplaces and transit systems, cancelled public gatherings, introduced mandatory home confinement and deployed large-scale electronic surveillance. In doing so, human rights obligations are rarely addressed, despite how significantly they are impacted by the pandemic response. The norms and principles of human rights should guide government responses to COVID-19, with these rights strengthening the public health response to COVID-19.

Infecções por Coronavirus , Direitos Humanos , Pandemias , Pneumonia Viral , Direito à Saúde , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Privacidade , Vigilância em Saúde Pública
RECIIS (Online) ; 14(3): 681-691, jul.-set. 2020.
Artigo em Português | LILACS | ID: biblio-1121856


A doença falciforme é a afecção genética mais prevalente no Brasil; de acordo com o Programa Nacional de Triagem Neonatal (PNTN), nascem cerca de 3.500 (três mil e quinhentas) crianças por ano com hemoglobina S, uma das responsáveis pela doença, ou seja, 1/1.000 nascidos vivos no Brasil. Considerando o grau de sua incidência, é necessário observar o acesso à saúde possibilitado aos portadores dessa enfermidade, devendose analisar as dificuldades que afligem esse segmento populacional e a efetividade das políticas públicas existentes para enfrentamento dessa hemoglobinopatia. Por meio de metodologia descritiva e explicativa, constatou-se que o segmento social acometido por essa doença se encontra historicamente associado aos afrodescendentes, dada sua origem mutante no continente africano em resposta à disseminação da malária, fato que conjuga a enfermidade com os fatores raciais de discriminação histórica da população negra. A falciforme foi utilizada, em certos casos, como fundamento para exclusão dos negros da sociedade, como argumento para segregação racial nos Estados Unidos e como fundamento para ideia de embranquecimento da população brasileira.

Sickle cell disease is the most prevalent genetic disorder in Brazil; according to the PNTN ­ Programa Nacional de Triagem Neonatal (National Neonatal Screening Program), approximately 3,500 (three thousand, five hundred) babies with haemoglobin disorders are born each year that is to say 1/1,000 live-born in Brazil. Since the high degree of its incidence, it is necessary to observe how the access to the health is given to patients with this disease, and the difficulties that afflict this population segment and the effectiveness of existing public policies to confront this kind of genetic hemoglobinopath should be analyzed. Through descriptive and explanatory methodology, it was found that the social segment affected by this disease is historically associated with people of African descent, due to its mutant origin in the African continent in response to the spread of malaria, fact that combines the disease with the factors of historical discrimination against the Black population. Sickle cell disease, in certain cases, was used as a basis for exclusion of Black people from society, as an argument for racial segregation in the United States and as a basis for the idea of whitening the Brazilian population.

La anemia de células falciformes es el trastorno genético que prevalece en Brasil; según el PNTN ­ Programa Nacional de Triagem Neonatal (Programa Nacional de Detección Neonatal), aproximadamente 3 500 (tres mil quinientos) niños nacen por año con una alteración de la sangre que causa esa enfermedad, o sea 1/1.000 nacidos vivos en Brasil. Teniendo en cuenta el grado de su incidencia, es necesario observar el acceso a la salud posibilitado a los portadores de la enfermedad, y se deben analizar las dificultades que afligen ese segmento de la población y la efectividad de las políticas públicas existentes para enfrentar esa hemoglobinoptía genética. A través de una metodología descriptiva y explicativa, se descubrió que el segmento social afectado por la enfermedad está históricamente asociado con los afrodescendientes, debido a su origen cambiante en el continente africano en respuesta a la propagación de la malaria, un hecho que combina la enfermedad con los factores de discriminación histórica de la población negra. La célula falciforme, en ciertos casos, ha sido utilizada como base para la exclusión de los negros de la sociedad, como argumento para la segregación racial en los Estados Unidos y como base para la idea de blanquear la población brasileña.

Humanos , Hemoglobina Falciforme , Grupo com Ancestrais do Continente Africano , Nascimento Vivo , Fatores Raciais , Anemia Falciforme , Política Pública , Brasil , Direito à Saúde , Programas Nacionais de Saúde
RECIIS (Online) ; 14(3): 692-708, jul.-set. 2020. ilus
Artigo em Português | LILACS | ID: biblio-1121860


A Lei Geral de Proteção de Dados (LGPD) promulgada no Brasil em 2018 é reflexo do movimento internacional de busca pela preservação de direitos fundamentais como privacidade, intimidade, honra, direito de imagem e dignidade humana. O objetivo do estudo foi o de apontar em que medida a estrutura do sistema público de saúde brasileiro será impactada pela publicação da Lei e indicar eventuais caminhos a serem trilhados nesse sentido. Trata-se de pesquisa de abordagem qualitativa, descritiva e exploratória, com utilização do método dedutivo a partir de pesquisa bibliográfica/artigos e documental/ordenamento jurídico. Os resultados alcançados apontam para a estreita relação entre o SUS e a necessidade de proteção de dados sensíveis e de boas práticas em segurança da informação, com impacto direto na privacidade de pacientes. A partir dos resultados, concluiu-se que o SUS será eminentemente impactado pela LGPD e, dada a imponência de sua estrutura de tecnologia da informação, deverá adotar medidas diligentes e céleres para seu amoldamento à Lei.

The General Data Protection Law enacted in Brazil in 2018 reflects the international movement for the preservation of fundamental rights such as privacy, intimacy, honor, image rights and human dignity. The objective of the study was to point out to what extent the structure of the Brazilian public health system will be impacted by the publication of the Law and to indicate possible paths to be taken in this direction. This is a qualitative, descriptive and exploratory research using the deductive method from the analysis of articles and legal order. The results achieved point to the relationship between SUS and the need to protect sensitive data and good practices in information security, with direct impact on patient privacy. From the results, it was concluded that the SUS will be eminently impacted by GDPL and, given the importance of its information technology structure, it should take diligent and fast measures to comply with the Law.

La Ley General de Protección de Datos, promulgada en Brasil en 2018, reflexionó sobre el movimiento internacional para la preservación de principios fundamentales como la privacidad, la intimidad, el honor, la dirección de la imagen y la dignidad humana. El propósito de este estudio es determinar en qué medida el sistema público del sistema público brasileño se verá afectado por la publicación de la Ley e indicar eventuales caminos a seguir en esta dirección. Esta es una investigación cualitativa, descriptiva y exploratoria que utiliza el método deductivo con análisis de artículos y orden legal. Los resultados obtenidos apuntan a la estrecha relación entre el SUS y la necesidad de proteger los datos confidenciales y las buenas prácticas en seguridad de la información, con impacto directo en la privacidad del paciente. Con base en los resultados, se concluye que el SUS se verá afectado de manera eminente por la LGPD y, dada la imposición de su estructura de tecnología de la información, será necesario adoptar medidas diligentes y rápidas para su enmienda a la Ley.

Humanos , Sistema Único de Saúde , Brasil , Segurança Computacional , Confidencialidade , Tecnologia da Informação , Telemedicina , Disseminação de Informação , Direito à Saúde , Jurisprudência
Rev Lat Am Enfermagem ; 28: e3354, 2020.
Artigo em Espanhol, Português, Inglês | MEDLINE | ID: mdl-32785564


Objective to identify the reasons that led to the judicialization of health care in the context of the COVID-19 pandemic; describe the outcomes of lawsuits concerning health care involving the COVID-19; and analyze the cases of health care judicialization intended to ensure the population's right to health. Method qualitative, explanatory case study. Data were collected from the websites of the Federal Prosecution Service, Regional Labor Court (1st Region), and the Court of Justice of Rio de Janeiro. The inclusion criterion was public civil actions that concerned health care and situations involving the COVID-19 pandemic. Two categories emerged from data analysis. Results four cases were identified. Conclusion the judicialization of health care consists of obtaining assets and rights in the courts. These assets and rights are essential to ensure the health of citizens but have been denied in various instances, often due to the omission of the executive and legislative powers. Analyzing the judicialization of health care amidst the pandemic brings focus and highlights the importance of giving voice and visibility to the enormous contingent of the Brazilian society unassisted by public authorities.

Infecções por Coronavirus/epidemiologia , Assistência à Saúde/legislação & jurisprudência , Pandemias/legislação & jurisprudência , Pneumonia Viral/epidemiologia , Betacoronavirus , Brasil/epidemiologia , Humanos , Direito à Saúde
Am J Public Health ; 110(10): 1512-1518, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32816540


The humanitarian crisis revealed as a result of Hurricane Maria in Puerto Rico demonstrates a long history of US colonial neglect and human rights violations. This reality has made it especially difficult for the people of Puerto Rico to achieve their right to the highest attainable standard of health.The impacts are pervasive, resulting in disparities in Puerto Rican health, including water access and quality; wealth, including economic loss and disinvestment; and sustainability of the island's resources. As a result of failed governmental protection and support, public health issues related to access to care, a failing infrastructure, and discrimination all contributed to crisis on the island. A human rights framework is necessary to assess the ongoing human rights violations of the quality of life to support millions of American citizens on the island.This essay utilizes a rights-based approach to reveal historical disenfranchisement of Puerto Rico before the storms, identifies the specific human rights violations that resulted from the US government's lack of emergency preparedness and responsiveness, and demands rebuilding the island to reconcile all that has been lost.

Altruísmo , Colonialismo , Saúde Pública , Direito à Saúde , Tempestades Ciclônicas , Disparidades nos Níveis de Saúde , Humanos , Porto Rico , Qualidade de Vida
Rev Panam Salud Publica ; 44, aug. 2020
Artigo em Espanhol | PAHO-IRIS | ID: phr-52525


[RESUMEN]. En este estudio se identifican y describen los cambios introducidos en el entramado constitucional y legal, y la política económica y social de Cuba entre los años 2015 y 2020 que inciden en el acceso a la salud y se actualiza el mapa conceptual sobre salud pública y propiedad intelectual en Cuba (MC SPPIC). Se realizó la búsqueda de documentos, ajustada al período de tiempo analizado, en la Gaceta Oficial de la República de Cuba y los sitios en Internet de la Oficina Cubana de la Propiedad Industrial, los organismos de la Administración Central del Estado y del Grupo de las Industrias Biotecnológica y Farmacéutica BioCubaFarma. El MC SPPIC actualizado refleja los cambios en la nueva Constitución de la República de Cuba adoptada en 2019, la actualización de los Lineamientos de la Política Económica y Social para el quinquenio 2016-2021 y las leyes, decretos leyes y otras disposiciones legales relacionados con la propiedad intelectual en el período 2015-2020. La Política sobre el Sistema de Propiedad Industrial aprobada se fortaleció con legislaciones específicas para la protección de la propiedad industrial, en especial las que inciden en la protección de los resultados obtenidos por la industria biotecnológica y farmacéutica cubana. Los cambios reflejados en el MC SPPIC actualizado favorecen la interacción y la sinergia entre los diversos actores que inciden en el acceso a la salud —en su sentido más amplio— de la población cubana.

[ABSTRACT]. This study identifies and describes the changes introduced in Cuba’s constitutional and legal framework, and the country’s economic and social policy between 2015 and 2020, in terms of the effects on access to health. The conceptual map of public health and intellectual property in Cuba was also updated. A document search for the time period of the study was conducted in the Official Gazette of the Republic of Cuba and on the webpages of the Cuban Office of Industrial Property, Cuban government agencies, and the Cuban Biotechnology and Pharmaceutical Industries group (BioCubaFarma). The updated conceptual map reflects amendments to the new Constitution of the Republic of Cuba adopted in 2019, updated guidelines on economic and social policy for the quinquennium 2016-2021, and laws, decrees, and legal provisions adopted in the period 2015-2020 in relation to intellectual property. The approved policy on the industrial property system was strengthened with specific legislation to protect industrial property, especially for the protection of the results obtained by the Cuban biotechnology and pharmaceutical industry. The changes reflected in the updated conceptual map favor interactions and synergy among the various actors that affect the Cuban population’s access to health in the broadest sense.

[RESUMO]. Neste estudo, procuramos identificar e descrever as mudanças introduzidas no quadro constitucional e legal e na política econômica e social de Cuba entre 2015 e 2020 que afetam o acesso à saúde, bem como atualizar o mapa conceitual sobre saúde pública e propriedade intelectual em Cuba (MC SPPIC). Realizamos uma busca em documentos, ajustada ao período analisado, no Diário Oficial da República de Cuba e nos sites do Escritório Cubano de Propriedade Industrial, dos órgãos da Administração Central do Estado e do grupo da indústria biotecnológica e farmacêutica BioCubaFarma. O MC SPPIC atualizado reflete as mudanças na nova Constituição da República de Cuba adotada em 2019, a atualização das Diretrizes de Política Econômica e Social para o quinquênio 2016-2021 e as leis, decretos-lei e outras disposições legais relacionadas à propriedade intelectual no período 2015-2020. A Política sobre o Sistema de Propriedade Industrial, adotada previamente, foi fortalecida com legislação específica para a proteção da propriedade industrial, especialmente no que diz respeito à proteção dos resultados obtidos pela indústria biotecnológica e farmacêutica cubana. As mudanças refletidas no MC SPPIC atualizado favorecem a interação e sinergia entre os diversos atores que influenciam o acesso à saúde — em seu sentido mais amplo — por parte da população cubana.

Propriedade Intelectual , Legislação como Assunto , Indústria Farmacêutica , Direito à Saúde , Cuba , Propriedade Intelectual , Legislação como Assunto , Indústria Farmacêutica , Direito à Saúde , Propriedade Intelectual , Legislação como Assunto , Indústria Farmacêutica , Direito à Saúde
Revista Digital de Postgrado ; 9(2): 211, ago. 2020.
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1103439


En años recientes los venezolanos hemos enfrentado problemas de diversa índole con relación a la situación de salud. Entre ellos, problemas en la prescripción y la obtención de medicamentos. En esta publicación se tratarán aspectos importantes para la correcta prescripción y obtención de medicamentos, lo cual, a su vez, debería ser el colofón de la atención médica de primera que siempre ha caracterizado a nuestro país y que hoy, lamentablemente, ha devenido en una situación muy dolorosa. La prescripción y obtención de medicamentos puede verse dificultada por diversos inconvenientes, entre los cuales podemos considerar aquellos que tienen relación con el medicamento propiamente dicho, con el prescriptor y el cliente, con las regulaciones vigentes en nuestro país y con la disponibilidad en los centros autorizados para su venta. Como consecuencia de una prescripción inadecuada y un consumo inapropiado de medicamentos pueden surgir problemas muy serios, entre los cuales habría que destacar, en el campo de los antiinfecciosos, la resistencia bacteriana. Y en el campo de fármacos destinados al tratamiento del dolor, la ansiedad y el insomnio, la posibilidad de adicciones diversas. La prescripción adecuada de medicamentos conlleva la necesidad de conocer, a la par de los efectos beneficiosos y terapéuticos de los mismos, la posibilidad de efectos adversos e interacciones. Todos los prescriptores sanitarios deben conocer los fundamentos de la Farmacovigilancia, la cual permitirá conocer el verdadero balance riesgo-beneficio de los fármacos, por lo cual hacemos una breve mención de la misma al final de esta presentación(AU)

In recent years, Venezuelans have faced various kinds of problems related to the health situation. Among them, problems in prescription and acquisition of medicines. This publication will discuss important aspects for the correct prescription and obtention of medicines, which, in turn, should be the culmination of the excellent medical care that has always characterized our country but that today, unfortunately, has become a very disgraced and sad situation. Prescription and acquisition of medicines can be hindered by various inconveniences, among which we can consider those that are related to the product itself, to the prescriber and the client, to the regulations in force in our country and to the availability in authorized centers for sale. As a result of an inadequate prescription and consumption of medications, very serious problems can arise, among which, in the field of anti-infectives, bacterial resistance should be highlighted. In the field of drugs for the treatment of pain, anxiety and insomnia, the possibility of diverse addictions. Proper prescription of medicaments entails the need to know, along with their beneficial and therapeutic effects, the possibility of adverse effects and interactions. All health prescribers must know the basics of Pharmacovigilance, which allow to know the true risk-benefit balance of drugs, so we make a brief mention of it at the end of this presentation.(AU)

Humanos , Prescrições de Medicamentos/normas , Resistência Microbiana a Medicamentos , Direito à Saúde , Farmacologia Clínica , Especificações Sanitárias , Farmacovigilância
J Urban Health ; 97(4): 448-456, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32720298


Effective responses to a global pandemic require local action. In the face of a pandemic or similar emergencies, communities of people who use drugs face risks that result from their ongoing drug use, reduced ability to secure treatment for drug use and correlated maladies, lack of access to preventive hygiene, and the realities of homelessness, street-level policing, and criminal justice involvement. Herein, we document the efforts of a coalition of people who use drugs, advocates, service providers, and academics to implement solutions to reduce these risks at a municipal and state level focusing on New Haven and the State of Connecticut. This coalition identified the communities at risk: active users needing access to harm reduction services, persons in treatment needing access to their medications, the homeless and marginally housed needing improved hygiene, people engaged in sex work, and the incarcerated needing release from custody. The section describing each of the risks demonstrates how the coalition acted preemptively at early stages of the pandemic, ahead of official initiatives, to develop ameliorative risk reduction solutions. Outcomes discussed include instances in which obstacles were overcome or still remain.

Betacoronavirus , Infecções por Coronavirus/epidemiologia , Direitos Humanos , Pneumonia Viral/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Pessoas em Situação de Rua , Humanos , Pandemias , Direito à Saúde , Trabalho Sexual
BMC Public Health ; 20(1): 1084, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32650772


BACKGROUND: Legal empowerment and social accountability are two strategies that are increasingly used to address gaps in healthcare in low- and middle-income countries, including failure to provide services that should be available and poor clinical and interpersonal quality of care. This paper is an explanatory case study of a legal empowerment effort that employs community paralegals and trains Village Health Committees (VHCs) in Mozambique. The research objective was to explore how community paralegals solved cases, the impact paralegals had on health services, and how their work affected the relationship between the community and the health sector at the local level. METHODS: The case study had two components: (1) a retrospective review of 24 cases of patient/community grievances about the health system, and (2) qualitative investigation of the program and program context. The case reviews were accomplished by conducting structured in-depth interviews (IDIs) with those directly involved in the case. The qualitative investigation entailed semi-structured Key Informant Interviews (KIIs) with district, provincial, and national health managers and Namati staff. In addition, focus group discussions (FGDs) were held with Health Advocates and VHC members. RESULTS: Case resolution conferred a sense of empowerment to clients, brought immediate, concrete improvements in health service quality at the health facilities concerned, and seemingly instigated a virtuous circle of rights-claiming. The program also engendered incipient improvements in relations between clients and the health system. We identified three key mechanisms underlying case resolution, including: bolstered administrative capacity within the health sector, reduced transaction and political costs for health providers, and provider fear of administrative sanction. CONCLUSIONS: This study contributes to the limited literature regarding the mechanisms of legal empowerment case resolution in health systems and the impact of hybrid legal empowerment and social accountability approaches. Future research might assess the sustainability of case resolution; how governance at central, provincial, and district level is affected by similar programs; and to what extent the mix of different cases addressed by legal empowerment influences the success of the program.

Empoderamento , Serviços de Saúde/legislação & jurisprudência , Disparidades em Assistência à Saúde/legislação & jurisprudência , Direito à Saúde/legislação & jurisprudência , Responsabilidade Social , Feminino , Grupos Focais , Programas Governamentais , Humanos , Masculino , Moçambique , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Estudos Retrospectivos , Direito à Saúde/psicologia
PLoS One ; 15(7): e0236316, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687519


BACKGROUND: The need to address sexual and reproductive health and rights (SRHR) in humanitarian settings is more urgent than ever, especially among young refugees. We conducted a scoping review to identify and synthesise the literature on perceived barriers and facilitators to SRHR among young refugees and interventions created to address their needs. METHODS: We searched three databases (PubMed, Global Health and POPLINE) for peer-reviewed and grey literature published in English between January 2008 and June 2018 that reported on SRHR barriers, facilitators and interventions for young refugees aged 10 to 24 years. We extracted data using standardised templates and assessed the quality of studies according to study design. Data were charted using qualitative content analysis and organised in line with a socio-ecological framework (individual, social and community, institutional and health system, and structural). FINDINGS: We screened 1,169 records and included 30 publications (qualitative, quantitative, and mixed methods) across 22 countries; 15 were peer-reviewed articles and 15 were from the grey literature. Twenty-two publications reported on young people in refugee camps or alternatives to camps (e.g. sustainable settlements), and eight referred to young refugees who had been resettled to a third country. We identified 19 sub-categories for barriers and 14 for facilitators at the individual, social and community, institutional and health system, and structural levels. No publications discussed the SRHR challenges faced by young homosexual, bisexual, transgender or queer refugees, or those living with HIV. Nine publications described interventions, which tended to focus on the provision of SRHR services and information, and the training of peers, parents, religious leaders and/or service providers. CONCLUSIONS: Findings highlight that while young refugees experience similar barriers to SRHR as other young people, many of these barriers are exacerbated by the refugee context. The limited number of publications and evidence on interventions underlines the immediate need to invest in and evaluate SRHR interventions in refugee contexts.

Saúde Global , Refugiados/estatística & dados numéricos , Saúde Reprodutiva/estatística & dados numéricos , Direito à Saúde/estatística & dados numéricos , Saúde Sexual/estatística & dados numéricos , Adolescente , Fatores Etários , Altruísmo , Criança , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Serviços de Saúde Reprodutiva/organização & administração , Discriminação Social/prevenção & controle , Adulto Jovem