Impacto de la pandemia COVID-19 en la atención de la diabetes mellitus según cobertura de salud en el Partido de General Pueyrredón, Argentina / Impact of the COVID-19 pandemic on diabetes mellitus care according to health coverage in the General Pueyrredón District, Argentina

INTRODUCCIÓN las personas con DM conforman un grupo de alto riesgo de enfermedad y muerte por COVID-19. Objetivos valorar el impacto de la pandemia COVID-19 en la atención de las personas con DM, focalizando en el control metabólico, internación y sus percepciones respecto del proceso de atención, en población con y sin cobertura de salud del PGP, Bs As, Argentina. MÉTODOS se apeló a la triangulación metodológica. El enfoque cuantitativo utilizó un diseño cuasi-experimental que comparó dos períodos de 12 meses de duración cada uno, delimitados por el 3 de marzo de 2020; el cualitativo recurrió a entrevistas en profundidad en base a ejes temáticos, se utilizó análisis temático. Se incluyeron personas de 18 años y más del PGP con diagnóstico de DM; se conformaron dos grupos según su situación de cobertura de salud. Los criterios de valoración principal fueron la HbA1c y el control metabólico; las diferencias con valor de p < 0,05 se consideraron estadísticamente significativas. Se ajustaron modelos multivariados. RESULTADOS se incluyeron 327 participantes [158 con cobertura de salud (48,3%), 169 sin cobertura (51,7%)]. La mediana de HbA1c aumentó de 8,1% (RIC 2,7) a 8,8% (RIC 2,8); los participantes sin cobertura de salud partieron de valores más altos en la prepandemia [Me 9.0 % (RIC 2,4) vs. Me 7,2 % (RIC 1,48)]. La pandemia, la falta de cobertura de salud y el tratamiento incompleto de la DM fueron predictores independientes del aumento de la HbA1c; el tratamiento con insulina fue predictor del deterioro del control glucémico. El trabajo doméstico y de enseñanza recayó en las mujeres. Angustia, estrés y tristeza fueron los sentimientos que caracterizaron la salud mental de las personas con DM en pandemia; el proceso de atención fue percibido con miedo e incertidumbre, acentuado en el grupo sin cobertura de salud. DISCUSIÓN la pandemia COVID-19 impactó en múltiples dimensiones de la vida de las personas con DM, resaltando diferenciales de género y clase.

National policy and plan of action on healthy ageing 2017- 2027

The twin island state of Antigua and Barbuda lies in the eastern arc of the Leeward Islands of the Lesser Antilles, separating the Atlantic Ocean from the Caribbean Sea. Antigua is 650 km southeast of Puerto Rico and Barbuda lies 48 km due north of Antigua. Low-lying and volcanic in origin, they are part of the Leeward Islands group in the northeast Caribbean. Antigua has an area of 108 sq miles and Barbuda 62 sq miles. The terrain is mostly low-lying limestone and coral islands, with some higher volcanic areas. The sandy soil on much of the islands has only scrub vegetation. Some parts of Antigua are more fertile­most notably the central plain­due to the volcanic ash in the soil. These areas support some tropical vegetation and agricultural uses The climate is characterized as tropical maritime with little seasonal temperature variation. Rainfall averages 990 mm (39 in) per year, with the amount varying widely from season to season. The islands generally experience low humidity and recurrent droughts.

National strategic plan for health 2016-2020

Government has accepted the fact that HEALTH is much more than the prevention or reduction of disease, but is a resource for national productivity and development. As such investments in ensuring, a healthy population is an asset for national development. It is for this reason that Government re-affirms its strong commitment to providing better health care to all Grenadians. The National Strategic Plan for Health 2016-2025 provides the framework that will guide the efforts of the Ministry of Health and Social Security (MOHSSSSSS) and its partners over the next ten years. It reflects the Ministry's fundamental belief that health is a basic human right and as a result no one should be denied access to health care. Consequently, one of the overarching goals of this strategic plan is ensure that health services are made available, accessible and affordable to all people without discrimination. Like many other developing countries, Grenada continues to be challenged by meeting the demands for health care services to its citizens. Chronic non-communicable diseases are the leading cause of morbidity and mortality. Life style and food choices are the main contributing factors of the disease profile and pose a significant challenge to the delivery of secondary care due to the escalating cost associated with the management of these diseases. This requires the Ministry of Health to place greater emphasis on prevention and health promotion. Notwithstanding the fact, every citizen must however accept responsibility for his/her individual health outcomes. Recently, Grenada has also been experiencing the outbreaks of new and re-emerging communicable diseases, which have been linked to climate change factors. It behooves us therefore to take necessary steps to protect and maintain our environment for our future generations. The Plan further reflects the belief that health fundamentally affects individual productivity and is therefore a critical input for long-term development of the country. To this end, we have set out our major priorities and therefore in concert with the private sector, we will heighten our focus and continue to promote health and wellness among our citizens.

Pensamiento estratégico y lógica de programación: el caso de salud / Thinking strategically and logically about programming: the health case

En el ensayo se habla del pensamiento estratégico, pero no como un cambio terminológico con relación a la planificación estratégica, sino como una expresión del cambio de significado -político y científico- contenido en esa modificación. Este trabajo es una continuación de otros del mismo autor, en particular de "Pensar en Salud"

Imperatives for community participation in health development: processes, strategies and issues

Limitations faced by governments to provide the resources required for health development has emphasized the critical role of community participation. This document reaffirms the need for individuals, families and community groups to be involved in an organized fashion in a range of decision making processes leading to self-care and self-responsibility. As a strategy, community participation is not being promoted as a separate program. Rather, it is to be integrated as part of all health development programs. Forces that contributed to the adoption of community participation as a strategy for achieving the social goal of Health For All and the factors which affect its promotion are discussed. Brief description is included of measures that had been taken for its promotion, nature of the Caribbean communities, types of participation and recent trends. Reasons for failure of integration and effects on community health development are reviewed. To facilitate the planning and implementation described at community level, certain requirements for organization and management of community health education and participation at national level are discussed. These pertain to: policy guidelines, development,. of human resources; provisions of needed logistic support; broad programming and mechanism to achieve intrasectoral collaboration. The maintaining phase is concerned with sustaining people's involvement. Monitoring and evaluation of program implementation ensures that required skills and behaviroal changes leading to self care and self reliance are in place by the time program inputs are completed. Indicators are needed that are community related and health system related. Implications for areas of research and related issues of technical, adminstrative and political nature are included. (Summary)

East Caribbean countries hurricane shelters survey : Antigua - Barbuda

Survey of proposed shelters in various villages in Antigua. The proposed shelters consisted of schools, which after the survey were found in need of strong storm shutters, and of general maintenance programs. the locations of the proposed shelters are shown on the map of Antigua in appen dix a, showing a relatively even distribution of shelters. Appendix B contains summary sheets for each surveyed shelter. Each form describes the building and site in summary form, in addition to listing the repairs and modifications recommended. The detailed cost of repairs and modifications are listed in appendix C. The selection of the schools to be surveyed and the approximate estimates of costs were prepared by the public works department

Disaster preparedness in Antigua and Dominica : A survey of public awareness and practices

This is a revised version of the third and final report on a two part survey of public knowledge, attitudes and practices related to disaster preparedness in the Islands of Antigua and Dominica. The campaign sought to, among other things, (I) heighten the awareness of the general public to the potential dangers of hurricanes, (II) provide basic information on hurricanes and other tropical weather disturbances, (III) enumerate disaster preparedness measures that households, community organizations, businesses and others should take, (IV) suggest procedures to follow prior to, during and after a hurricane or other disaster, (V) provide government officials with approaches and techniques to plan for and manage national disasters, and (VI) make available to community organizations basic materials to facilitate their community awareness programmes this final report represents the findings of a survey of government officials, ngo's and national disaster preparedness committee members. It also provides a comparative assessment of the household and student survey results (AU)

Report of workshop on " Management of Health Services in Disaster " for health personnel

Report on a four-day workshop on "Health Services Management in Disaster" for health personnel. The purpose of the workshop was twofold: 1) To strengthen the knowledge and skills of health personnel in the management of health services in the event of a disaster, 2) To test the "Study Guide on Health Services Organization in the Event of a Disaster" developed for PAHO by the University of Wisconsin". The course was divided in to seven lessons, each with its own learning objectives. The topics discussed include: 1) Health care disaster plans as part of an overall national disaster preparedness plan; 2) Organization of the health system 3) Organization of first level care at the disaster site; 4) Organization of rural health services for disaster situations; 5) Organization of health care facilities for disaster situations; 6) Implementation of the disaster plan in a health care facility and; 7) Update and evaluation of hospital disaster management plans

Report

Report detailing the sixth meeting of the management committee of the Pan-Caribbean Disaster Preparedness and Prevention Project. Specifics are given on the following activities: 1) Opening ceremony; 2) Election of chairman; 3) Adoption of agenda; 4) Procedural matters; 5) Report of activities: Nov 1983-Apr 1984; 6) Status of project funding; 7) Discussion on permanent regional disaster preparedness mechanism; 8) Staff matters; 9) Review and approval of work programme april-Nov 1984; 9) Importance of forthcoming meetings to project; 10) Date and venue of the next meeting of the management committee. A list of the participants at tending the meeting is attached as annex I to this report. Annex II con tains the address by the Hon. DR. Ronald Irvine; Annex IIi lists the agenda of the meeting, and Annex IV contains the PAHO budget and OFDA/ usaid funds

East caribbean countries hurricane shelters survey : Antigua - Barbuda : Field survey notes

This document contains the detailed notes on surveyed proposed shelters in Antigua. Each summary contains the following information: Name of building, site, dimensions, and descriptions of building, condition of physical structure and needed repairs in terms of: Floors, roof, walls windows, sanitation, kitchen facilities and doors. The underlying objectives of this survey are: to evaluate the adequacy of the shelters in providing safe refuge for evacuees, To assess the ability to service basic needs during the period of evaluation, to determine the level of vulnerability of the buildings, to establish qualitatively which shelters are satisfactory and which are not, to recommend measures for upgrading unsatisfactory facilities, and to estimate the costs associated with implementing such recommendations

Country report on status of disaster preparedness / prevention

Report addressing the current status of disaster preparedness/prevention activities in the caribbean area. Country reports are available for the following countries: 1) Anguilla; 2) Antigua and Barbuda; 3) Barbados; 4) British virgin island; 5) Guyana; 6) St. Kitts/Nevis; 7) St. Lucia; 8) Turks and Caicos Islands. topics of discussion include roles and activities of the respective national disaster preparedness committees and sub-committees, recent training programs in which countries have participated, recommendations for future national and regional programs and activities and the need for increased exchange of information between countries (AU)