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2.
Cent Eur J Public Health ; 27(3): 198-203, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580554

RESUMO

OBJECTIVES: Evidence that health interventions work is not enough to ensure implementation into policy and practice. The complexity of public health systems requires more diverse actions. This paper proposes a conceptual model to enhance understanding of interlinking factors that influence the evidence implementation process. METHODS: A literature review was conducted to explore factors that influence the process of evidence implementation in complex public health systems, including research findings and observations from 32 case studies of injury prevention interventions underway in 24 countries and results from evidence research networks. Concepts and themes identified through a critical review were organised, ordered and interlinked to build the model. RESULTS: An Evidence Implementation Model for Public Health Systems and four concepts or themes: Evidence implementation target; Actors involved in implementation; Knowledge transfer; and Barriers and facilitators to evidence implementation were developed to provide a simplified, yet broad framework that highlights multiple factors and back and forth inter-linkages within and between the concepts that influence the uptake of evidence into public health systems policy and practice. CONCLUSIONS: Understanding the factors discussed within and amongst the four concepts of this model should ultimately help to positively influence the uptake of evidence into real world public health systems. This model has relevance for decision makers, researchers, knowledge brokers, and implementers.


Assuntos
Política de Saúde , Saúde Pública , Tomada de Decisões , Medicina Baseada em Evidências
4.
BMJ Glob Health ; 4(5): [7], 6 September 2019.
Artigo em Inglês | LILACS, BDS | ID: biblio-1022085

RESUMO

In the recent decades, Brazil has outperformed comparable countries in its progress toward meeting the Millennium Development Goals. Many of these improvements have been driven by investments in health and social policies. In this article, we aim to identify potential impacts of austerity policies in Brazil on the chances of achieving the sustainable development goals (SDGs) and its consequences for population health. Austerity's anticipated impacts are assessed by analysing the change in federal spending on different budget programmes from 2014 to 2017. We collected budget data made publicly available by the Senate. Among the selected 19 programmes, only 4 had their committed budgets increased, in real terms, between 2014 and 2017. The total amount of extra money committed to these four programmes in 2017, above that committed in 2014, was small (BR$9.7 billion). Of the 15 programmes that had budget cuts in the period from 2014 to 2017, the total decrease amounted to BR$60.2 billion (US$15.3 billion). In addition to the overall large budget reduction, it is noteworthy that the largest proportional reductions were in programmes targeted at more vulnerable populations. In conclusion, it seems clear that the current austerity policies in Brazil will probably damage the population's health and increase inequities, and that the possibility of meeting SDG targets is lower in 2018 than it was in 2015.


Assuntos
Humanos , Brasil , Disparidades nos Níveis de Saúde , Política de Saúde , Populações Vulneráveis
5.
RECIIS (Online) ; 13(3): 482-495, jul.-set. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1016540

RESUMO

Uma das importantes conquistas para consolidação da democracia no Brasil foi a criação e a efetivação da Lei de Acesso à Informação (LAI). Neste artigo, interessa relacionar a LAI, a institucionalização da Política Nacional de Informação e Informática em Saúde e o Programa de Pesquisa para o SUS (PPSUS), privilegiando as Fundações de Amparo à Pesquisa (FAP), um dos atores deste Programa do Ministério da Saúde (MS). O método utilizado para o estudo foi a realização de um levantamento de editais publicados e de projetos de pesquisa contemplados no PPSUS, voltados para a instituição da Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais, Travestis e Transexuais (PNSILGBT). Ao observar, nos sites das instituições mencionadas, os registros de projetos de pesquisa relacionados à saúde da população LGBT, valorizou-se a dimensão da usabilidade, apreendendo desorganização nas apresentações dos editais e dos resultados, o que proporciona ineficiência na sua operacionalização e na funcionalidade das formulações de políticas no campo da saúde.


One of the important achievements for consolidation of the democracy in Brazil was the LAI ­ Lei de Acesso à Informação (access to information law) passed by Brazilian government and its implementation. In this article, we intend to examine how the LAI, the institutionalization of the Política Nacional de Informação e Informática em Saúde (a national policy on health information) and the PPSUS ­ Programa de Pesquisa para o SUS (research program for the SUS) are related, favouring the FAP ­ Fundações de Amparo à Pesquisa (foundations for research support), one of the actors of this program developed by Ministry of Health of Brazil. A survey of published call for proposals and research projects selected by the PPSUS aiming the institution of the PNSILGBT ­ Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais, Travestis e Transexuais (national integral health policy for lesbians, gays, bisexuals, transvestites and transsexuals) was carried out. Observing the research registers about the health of the LGBT population on sites of mentioned institutions, from the perspective of the usability dimension, we identified a disorganization in the presentations of the call for proposals and their result, providing inefficiency in their viability and in the performance of the policy formulation in health field aiming the LGBT population.


Una de las importantes conquistas para la consolidación de la democracia brasileña fue la creación y la realización de la LAI - Lei de Acesso à Informação (ley de acceso a la información). En este artículo buscamos relacionar la LAI, la institucionalización de la Política Nacional de Informação e Informática em Saúde (política nacional de información en salud) y el PPSUS - Programa de Pesquisa para o SUS (programa de investigación para el SUS), privilegiando las FAP - Fundações de Amparo à Pesquisa (fundaciones de auxilio a la investigación), uno de los actores de este programa del Ministerio de Salud de Brasil. El método utilizado para el estudio apresentado aquí ha sido un levantamiento de llamadas públicas y de proyectos de investigación seleccionados en el PPSUS, destinados a la institución de la PNSILGBT ­ Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais, Travestis e Transexuais (política nacional de salud integral de lesbianas, gays, bisexuales, travestis y transexuales. Al observar, en lo portal de las instituciones mencionadas, registros de proyectos de investigación relacionados con la salud de la población LGBT, del punto de vista de la dimensión de la usabilidad, concluimos que hay desorganización en las presentaciones de las llamadas públicas y de los resultados, lo que proporciona ineficiencia en su realización y en la funcionalidad de las formulaciones de políticas del gobierno en el campo de la salud.


Assuntos
Humanos , Sistema Único de Saúde , Brasil , Acesso à Informação , Comunicação em Saúde , Minorias Sexuais e de Gênero , Participação da Comunidade , Internet , Política de Pesquisa em Saúde , Política de Saúde
6.
N C Med J ; 80(5): 306-311, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31471516

RESUMO

Given the known impacts of social, behavioral, and economic factors on health and longevity, health policy reforms are being developed and deployed at both the state and federal levels that support the integration and alignment of health care and social services.


Assuntos
Acesso aos Serviços de Saúde/organização & administração , Determinantes Sociais da Saúde , Assistência à Saúde/organização & administração , Política de Saúde , Humanos , Programas de Rastreamento , North Carolina , Encaminhamento e Consulta , Serviço Social/organização & administração , Estados Unidos
7.
J Glob Health ; 9(2): 020416, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31555441

RESUMO

Background: Kenyan paediatric treatment protocols recommend the use of zinc supplement for all children with diarrhoea. However, there is limited evidence of benefit for young children aged 1-5 months and those who are well-nourished. We examine effectiveness of zinc supplementation for children admitted with diarrhoea to Kenya's public hospitals with different nutritional and age categories. This is to determine whether the current policy where zinc is prescribed for all children with diarrhoea is appropriate. Methods: We explore the effect of zinc treatment on time to discharge for children aged 1-5 and 6-59 months and amongst those classified as either severely - moderately under-nourished or well-nourished. To overcome the challenges associated with non-random allocation of treatments and missing data in these observational data, we use propensity score methods and multiple imputation to minimize bias. Results: The analysis included 1645 (1-5 months) and 11 546 (6-59 months) children respectively. The estimated sub-distribution hazard ratios for being discharged in the zinc group vs the non-zinc group were 1.25 (95% confidence interval (CI) = 1.07, 1.46) and 1.17 (95% CI = 1.10, 1.24) in these respective age categories. Zinc treatment was associated with shorter time to discharge in both well and under-nourished children. Conclusion: Zinc treatment, in general, was associated with shorter time to discharge. In the absence of significant adverse effects, these data support the continued use of zinc for admissions with diarrhoea including those aged 1-5 months and in those who are well-nourished.


Assuntos
Diarreia/tratamento farmacológico , Hospitalização/estatística & dados numéricos , Hospitais Públicos , Zinco/uso terapêutico , Fatores Etários , Pré-Escolar , Feminino , Política de Saúde , Humanos , Lactente , Quênia , Masculino , Estado Nutricional , Alta do Paciente/estatística & dados numéricos , Fatores de Tempo , Resultado do Tratamento
11.
Isr Med Assoc J ; 21(9): 589-594, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31542902

RESUMO

BACKGROUND: Cryptosporidium is a major threat to water supplies worldwide. Various biases and obstacles in case identification are recognized. In Israel, Cryptosporidiosis was included among notifiable diseases in 2001 in order to determine the burden of parasite-inflicted morbidity and to justify budgeting a central drinking water filtration plant. OBJECTIVES: To summarize the epidemiologic features of 14 years of Cryptosporidium surveillance and to assess the effects of advanced water purification treatment on the burden of disease. METHODS: From 2001 to 2014, a passive surveillance system was used. Cases were identified based on microscopic detection in stool samples. Confirmed cases were reported electronically to the Israeli Ministry of Health. Overall rates as well as age, gender, ethnicity and specific annual incidence were calculated per 100,000 population in five age groups: 0-4, 5-14, 15-44, 45-64, > 65 years. RESULTS: A total of 522 Cryptosporidium cases were reported in all six public health districts. More cases were detected among Jews and among males, and mainly in young children, with a seasonal peak during summer. The Haifa sub-district reported 69% of the cases. Most were linked to an outbreak from the summer of 2008, which was attributed to recreational swimming pool activity. Cases decreased after installation of a central filtration plant in 2007. CONCLUSIONS: As drinking water in Israel is treated to maximal international standards, the rationale for further inclusion of Cryptosporidium among mandatory notifiable diseases should be reconsidered. Future surveillance efforts should focus on timely detection of outbreaks using molecular high-throughput testing.


Assuntos
Criptosporidiose/epidemiologia , Cryptosporidium/isolamento & purificação , Monitoramento Epidemiológico , Política de Saúde , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Incidência , Lactente , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Estações do Ano , Fatores Sexuais , Purificação da Água/estatística & dados numéricos , Abastecimento de Água/estatística & dados numéricos , Adulto Jovem
12.
Pan Afr Med J ; 33: 152, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558949

RESUMO

Introduction: Access to free diagnoses and treatments has been shown to be a major determinant in malaria control. The Cameroon government launched in 2011 and 2014 the exemption of the under-fives' simple and severe malaria treatment policy to increase access to health care and reduce inequality, so as to reduce the mortality related to malaria among the under-fives. This study assessed the effect of providing free malaria treatment in the Buea health district. Methods: This retrospective and cross sectional study was carried out in the Buea health district. Aggregated monthly data from (2008-2010) before and (2012-2014) after the implementation of free malaria treatment was compared, to assess the attributable outcomes of free treatment. A semi-structure questionnaire was also used to assess barriers faced in providing free malaria treatment services by health care workers. Data was collected using a semi-structure questionnaire and a data review summary sheet. The data was analysed using Epi-Info 7, Excel and SPSS (Statistical Package for the Social Sciences) version 20.0 for Windows. All statistical tests were performed at 95% confidence interval (significance level of 0.05). Results: Increase utilisation of health care; as general and malaria related consultations (by 5.7% (p=0.001) witnessed an increase after the implementation of free malaria treatment services. Severe malaria hospitalisation also increased, indicating that most caregivers used the health facility when complications had already set in, which could have led to no significant reduction in mortality due to malaria among under-five children (4.4%, p=0.533). Conclusion: Utilisation of health care increased; as consultation and morbidity rate increased after the implementation of free malaria treatment services. Communication strategy should therefore be strengthened so as to better disseminate information, so as to enhance the effectiveness of the program. There is the need to make a large-scale study to assess the impact of subsidized malaria treatment.


Assuntos
Antimaláricos/administração & dosagem , Política de Saúde , Acesso aos Serviços de Saúde/economia , Malária/tratamento farmacológico , Antimaláricos/economia , Camarões , Cuidadores/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Financiamento Governamental/economia , Hospitalização/estatística & dados numéricos , Humanos , Malária/economia , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários
13.
Scand J Public Health ; 47(6): 598-605, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31512561

RESUMO

All political parties in Norway agree that social inequalities in health comprise a public health problem and should be reduced. Against this background, the Council on Social Inequalities in Health has taken action to provide specific advice to reduce social health differences. Our recommendations focus on the entire social gradient rather than just poverty and the socially disadvantaged. By proposing action on the social determinants of health such as affordable child-care, education, living environments and income structures, we aim to facilitate a possible re-orientation of policy away from redistribution to universalism. The striking challenges of the causes of health differences are complex, and the 29 recommendations to combat social inequality of health demand cross sectorial actions. The recommendations are listed thematically and have not been prioritized. Some are fundamental and require pronounced changes across sectors, whereas others are minor and sector-specific.


Assuntos
Política de Saúde , Disparidades nos Níveis de Saúde , Determinantes Sociais da Saúde , Humanos , Noruega , Fatores Socioeconômicos
14.
Scand J Public Health ; 47(6): 608-610, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31512564

RESUMO

Globally, numerous national strategies have taken aim at reducing health inequities. An ever-present tension characterizing these strategies, however, is their lack of attention to the global political economy. This commentary argues that national policies which target only domestic factors (without engaging with the global political economy) will be limited, both, in their ability to address national levels of health equity and the larger global health inequity problem. Meaningful proposals to reduce health inequities have been made that take into account a global political economy perspective. National health equity strategies could provide the lacking momentum to advance such proposals, but will require united and sustained advocacy by global health and health equity scholars. Ultimately, relieving the tension between national health equity commitments and global health equity concerns could be one of the new approaches needed to improve health equity worldwide.


Assuntos
Saúde Global , Equidade em Saúde , Política de Saúde , Determinantes Sociais da Saúde , Humanos , Noruega
15.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46794

RESUMO

No ano em que exerce a presidência pró-tempore do Brics (arranjo de países emergentes composto também por China, Rússia, Índia e África do Sul), o Brasil coordenará diversos encontros com o intuito de propor temas prioritários para ações entre os países membros. Prestes a completar 120 anos, a Fiocruz assumiu o papel estratégico de fortalecer, no âmbito do Brics, uma de suas experiências mais exitosas de cooperação horizontal: a Rede Global de Bancos de Leite Humano.


Assuntos
Bancos de Leite , Leite Humano , Sistema Único de Saúde , Política de Saúde , Atenção à Saúde , Cooperação Horizontal , Brasil
16.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46724

RESUMO

Folheto da campanha da Semana Mundial do Aleitamento Materno - SMAM 2019, que tem como tema: Empoderar mães e pais, favorecer a amamentação. Hoje e para o futuro!.


Assuntos
Folhetos , Promoção da Saúde , Serviços de Saúde Materno-Infantil , Política de Saúde , Equidade de Gênero , Aleitamento Materno , Leite Humano
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