Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.071
Filtrar
1.
Sex Reprod Health Matters ; 28(2): 1778153, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32757830

RESUMEN

Through quantitative and qualitative methods, in this article the authors describe the perspectives of indigenous women who received antenatal and childbirth medical care within a care model that incorporates a non-governmental organisation (NGO), Partners in Health. They discuss whether the NGO model better resolves the care-seeking process, including access to health care, compared with a standard model of care in government-subsidised health care units (setting of health services networks). Universal health coverage advocates access for the most disadvantaged and vulnerable populations as a priority. However, the issue of access includes problems related to the effect of certain structural social determinants that limit different aspects of the obstetric care process. The findings of this study show the need to modify the structure of organisational values in order to place users at the centre of medical care and ensure respect for their rights. The participation of agents outside the public system, such as NGOs, can be of great value for moving in this direction. Women's participation is also necessary for learning how they are being cared for and the extent to which they are satisfied with obstetric services. This research experience can be used for other countries with similar conditions.

2.
Cancer ; 2020 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-32745271

RESUMEN

BACKGROUND: The role of socioeconomic factors as determinants of oncology consultations for advanced cancers in public payer health care systems is unknown. This study examined the association between material deprivation and receipt of cancer care among patients with advanced gastrointestinal (GI) cancer. METHODS: This was a population-based, retrospective cohort study of noncuratively treated patients with GI cancer diagnosed from 2007 to 2017. Material deprivation, representing income, quality of housing, education, and family structure, was defined as quintiles on the basis of 2016 census data. The first consultation with a radiation oncologist or medical oncologist and the receipt of 1 or more instances of radiation and/or chemotherapy were measured in the year after diagnosis. Adjusted, cause-specific Cox proportional hazards competing risk analyses were used (competing event = death). RESULTS: This study included 34,022 noncuratively treated patients with GI cancer. Consultation rates ranged from 67.8% for those in the most materially deprived communities to 73.5% for those in the least materially deprived communities. Among those with a consult, rates of cancer-directed therapy ranged from 58.5% for patients in the most materially deprived communities to 62.3% for patients in the least materially deprived communities. Patients living in the most materially deprived communities were significantly less likely to see a radiation and/or medical oncologist after a diagnosis (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.85-0.92) and significantly less likely to receive radiation and/or chemotherapy (HR, 0.80; 95% CI, 0.76-0.85) than those living in the least materially deprived communities. CONCLUSIONS: This study identified socioeconomic disparities in accessing cancer care. Continued efforts at examining and developing evidence-based policies for interventions that begin before or at the time of oncologist consultation are required to address root causes of inequities.

3.
Int J Cardiol ; 2020 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-32634487

RESUMEN

BACKGROUND: This review assessed global health technology assessment (HTA) reports and recommendations of non-vitamin K oral anticoagulants (NOACs) in non-valvular atrial fibrillation (NVAF). METHODS: NHTA agency websites were searched for HTA reports evaluating NOACs versus NOACs or vitamin K antagonists. HTA methods and information on patient involvement/access were collected and empirically analyzed. RESULTS: The review identified 38 unique HTA reports published between 2012 and 2017 in 16 countries including 11 in Europe. NOACs that were cost-effective per local willingness-to-pay (WTP) thresholds were positively recommended for the treatment of NVAF. WTP thresholds ranged from €20,000 to 69,000. Apixaban was recommended in 10/12 (83%) countries, dabigatran in 9/13 (69%) countries, and rivaroxaban in 10/13 (76%) over warfarin. Edoxaban was recommended in 5/7 (71%) countries. Economic evaluations and recommendations comparing NOACs were sparse (two or three countries per NOAC) and generally favored apixaban and edoxaban, followed by dabigatran. Eleven HTA reports from four countries considered the patient voice (Canada [n = 3], Scotland [n = 3], England [n = 4], Brazil [n = 1]); however, only 2/11 (18%) developed recommendations based on this. Among the reports with a positive recommendation, 26/30 (87%) featured a decision that aligned with the approved regulatory label. CONCLUSIONS: Most agencies recommended NOACs over warfarin for patients with NVAF. Few countries made statements recommending one NOAC over another. Given different WTP thresholds, a drug that is cost-effective in one market may not be in another. Therefore, the various NOAC recommendations from HTA agencies cannot be generalized across different countries.

4.
BMC Med Educ ; 20(1): 224, 2020 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-32664903

RESUMEN

BACKGROUND: Medical students, practitioners and other health professionals are commonly unprepared to address the many complex issues that emerge while conducting research in the Global South. As a response to identified deficiencies in global health education, a hybrid online/face-to-face multi-institutional credit course was developed based on the equity-centered principles advanced by the Canadian Coalition for Global Health Research (CCGHR), namely Authentic partnering, Inclusion, Shared benefits, Commitment to the future, Responsiveness to causes of inequities, and Humility. This study aimed to analyze the extent to which the course was effective in fortifying attitudes consistent with the CCGHR principles; identify successes and challenges; and assess how a course such as this can fill an identified gap. METHODS: This interprofessional course was offered to 25 graduate and postgraduate students in various health professions and public health. Faculty were drawn from medicine, public health, nursing and social sciences from four universities in Western Canada. A pre-post retrospective survey, key informant interviews and participant observation were used to gather data for this study. RESULTS: Findings showed that student attitudes regarding global health research and practice significantly evolved towards views consistent with the principles articulated. The multiple instructors and hybrid course format created both opportunities and challenges; the interprofessional nature of the cohort was considered a strong asset, as was the fact that many students came from the Global South. Some students suggested that the course could be further strengthened by concretely partnering with institutions in the Global South rather than offered solely to learners registered in universities in the Global North. CONCLUSIONS: While weaknesses were identified, results support the conclusion that a course focused on the CCGHR principles could be useful in preparing the next generation of global health researchers and practitioners to mitigate historical limitations in this field. Longitudinal follow-up is warranted to provide more definitive conclusions.

5.
Health Inf Manag ; : 1833358320936801, 2020 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-32700567

RESUMEN

BACKGROUND: Evidence-based interventions are necessary for planning and investing in health information systems (HIS) and for strengthening those systems to collect, manage, sort and analyse health data to support informed decision-making. However, evidence and guidance on HIS strengthening in low- and middle-income countries have been historically lacking. OBJECTIVE: This article describes the approach, methods, lessons learned and recommendations from 5 years of applying our learning agenda to strengthen the evidence base for effective HIS interventions. METHODS: The first step was to define key questions about characteristics, stages of progression, and factors and conditions of HIS performance progress. We established a team and larger advisory group to guide the implementation of activities to build the evidence base to answer questions. We strengthened learning networks to share information. RESULTS: The process of applying the learning agenda provided a unique opportunity to learn by doing, strategically collecting information about monitoring and evaluating HIS strengthening interventions and building a body of evidence. There are now models and tools to strengthen HIS, improved indicators and measures, country HIS profiles, documentation of interventions, a searchable database of HIS assessment tools and evidence generated through syntheses and evaluation results. CONCLUSION: The systematic application of learning agenda processes and activities resulted in increased evidence, information, guidance and tools for HIS strengthening and a resource centre, making that information accessible and available globally. IMPLICATIONS: We describe the inputs, processes and lessons learned, so that others interested in designing a successful learning agenda have access to evidence of how to do so.

6.
Int J Equity Health ; 19(1): 106, 2020 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-32664954

RESUMEN

BACKGROUND: With the turn of the century, most countries in Latin America witnessed an increased concern with universalism and redistribution. In the health sector, this translated into a wide range of reforms to advance Universal Health Coverage (UHC) that, however, have had to cope with health systems that stratified the population since their foundation and the further segmentation inherited by market-oriented policies in the 1980s and 1990s. Studies on social welfare stress the relevance of cross-class alliances between the middle and working classes to reach universal and sustainable social benefits. Consequently, the endurance of separate health schemes across groups of the population in most countries in Latin America may seriously hamper the efforts towards UHC. AIM: This article addresses the potential of current policy architectures of health care to tackle segmentation between social classes in access to health services in two of the best performers of health coverage in the region, namely Chile and Uruguay. METHODS: The article is a comparative case study based on a literature review and applies an analytical framework that links universal outputs to the policy architectures of health care. The study assesses universal outputs in terms of coverage, generosity and financial protection, identifying equity gaps in each of these dimensions across groups of the population. FINDINGS: Latest processes of reform for UHC in Chile and Uruguay perform highly regarding population coverage. Nevertheless, equity gaps in access to quality services and financial protection remain. In both countries, such gaps relate to the eligibility criteria. In Chile, segmentation is reinforced by the persistence of separated pools of resources that hinder solidarity. Besides, the significant role of private actors and differences in quality between public and private service providers continue to push middle and upper-middle classes to private options. Uruguay's health reform reinforced the public system and promoted financial solidarity by pooling and progressively allocating resources. Despite this, fragmentation in service provision continues the segmentation of access to health care. CONCLUSIONS: The study shows differences in the options of reforms for UHC in Chile and Uruguay and the relevance of policy architectures to reverse, or conversely deepen, segmentation across groups of the population.

7.
Mil Med ; 2020 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-32633325

RESUMEN

Bottom Line Up Front: Prison, for most incarcerated persons, can be a harsh and oftentimes dehumanizing environment. The U.S. criminal justice system has become more punitive than rehabilitative since the 1970s. In a reversal of this trend, newly passed legislation has charged prisons with preparing incarcerated persons for reentry into society, reducing recidivism, and providing rehabilitation programs targeting individual needs and risk. At the same time, prison staff delivering these services are faced with the challenge of burn-out, fatigue, depression, PTSD, suicide, and substance abuse at higher rates than individuals in other professions. To sustainably deliver the newly mandated prison-based services with an emphasis on the health and wellbeing of both the staff and the incarcerated population, prisons and the criminal justice system must change dramatically. The key to accomplishing this change is a foundational shift in mindset, from a self-focused "inward mindset" to an in impact-focused "outward mindset." The purpose of this article is to hypothesize the potential for increased safety, security, and human wellbeing when a prison culture adopts an outward mindset.

8.
Int J Equity Health ; 19(1): 116, 2020 07 06.
Artículo en Inglés | MEDLINE | ID: mdl-32631376

RESUMEN

BACKGROUND: The People's Health Movement (PHM) was formed in 2000 and drew inspiration from the Alma Ata Declaration on Primary Health Care's 'Health for All' (1978). Since then PHM has been an active part of a global counter-hegemonic social movement. This study aimed to gain insights on social movement building, drawing on the successes and failures reported by activists over their experiences of working in the Health for All social movement to improve health, justice and equity. METHODS: Qualitative research methods were employed in this study to capture complex and historical narratives of individual activists, through semi-structured interviews and subsequent thematic analysis of transcripts. The research design and analysis were informed by social movement theory and literature on health activism as a pathway for social change. In this study we examine the semi-structured interviews of 15 health activists who are part of the PHM, with the aim of deriving lessons for strengthening movements for Health for All. RESULTS: This study locates the activists' narratives within a socio-political analysis of the global trends of late modern individualism and capitalist neoliberalism. This highlights the challenges faced by civil society groups mobilising collective action and building social movements for Health for All. The study found that within the constraints of the neoliberal socio-political and economic conditions which have caused the rise in social and health inequities, this group of long-term health activists have been nurturing alternative approaches to structuring society and building collective agency to improve health. CONCLUSION: The practical long-term experiences of the PHM activists examined in this study contribute to a better understanding of the processes and motivations that lead to and sustain health activism, and the dilemmas, strategies, impacts and achievements of such activism.

9.
Artículo en Inglés | MEDLINE | ID: mdl-32610734

RESUMEN

How can we keep people - wherever they live - healthy and safe? Among all global health initiatives, universal health coverage (UHC) has garnered most political attention. But can UHC (as important as it is) actually achieve the two fundamental aspirations of the right to health: keeping people healthy and safe, while leaving no one behind? There is a universal longing for health and security, but also a deep-seated belief in fairness and equity. Can UHC achieve both health and equity, or what I have called, "global health with justice?" What makes a population healthy and safe? Certainly, universal and affordable access to healthcare is essential, including clinical prevention, treatment, and essential medicines. But beyond medical care are public health services, including surveillance, clean air, potable water, sanitation, vector control, and tobacco control. The final and most important factor in good health are social determinants, including housing, employment, education, and equity. If we can provide everyone with these three essential conditions for good health (healthcare, public health and social determinants), it would vastly improve global health. But we also need to take measures to leave no one behind. To achieve equity, we need to plan for it, and here I propose national health equity programs of action. Society's highest obligation is to achieve global health, with justice.

10.
Sex Reprod Health Matters ; 28(2): 1785377, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32729386

RESUMEN

In 2014, Indonesia reinvigorated its commitment to the provision of a universal health care system by introducing the National Health Insurance Program (Jaminan Kesehatan Nasional, JKN), with the aim of increasing access to health care for all sectors of society. A key question that emerges in the current climate is: how can Indonesia ensure people can access HIV health care? This question is critically important given Indonesia is on the verge of passing a law criminalising all sex outside of marriage. If passed, anyone presenting with HIV will be suspected ipso facto of involvement in criminal activity (e.g. them or their partner having sex outside of marriage and/or using intravenous drugs). In this environment, preventing transmission of HIV from mother to child becomes more difficult. In exploring these issues, we argue that, in a time of populist morality, Indonesia must give significant attention to how universal health coverage can prevent HIV transmission, particularly from mother to child. We offer three key strategies for Indonesia to implement in this regard: removing health care provision from a moral framework; de-idealising the category of woman; and repositioning shame and stigma around HIV.

11.
Pediatr Rheumatol Online J ; 18(1): 60, 2020 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-32664961

RESUMEN

There is increasing concern about the emerging global non-communicable diseases (NCDs) burden. The focus has mainly been on NCDs in adults but it is important that MSK morbidity in both children and adults is included in strategic planning. There have been considerable advances in the understanding and treatment options for children and young people (CYP) and clinical outcomes are improving for those who can access such high quality care. However vast inequity exists and there are many CYP who live in areas of the world with high burden of health care challenges, compounded by paucity of specialist care and limited access to treatments. The Paediatric Global Musculoskeletal Task Force aims to raise awareness about unmet needs for CYP with MSK conditions, promotion of MSK health through lifestyle and the avoidance of injury. We aim to leverage change through 'working together better'.

12.
Health Hum Rights ; 22(1): 221-235, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32669803

RESUMEN

Over the past three decades, Brazil has developed a decentralized universal health system and achieved significant advances in key health indicators. At the same time, Brazil's health system has struggled to ensure equitable and quality health services. One response to the broad promises and notable shortcomings has been a sharp rise in right-to-health litigation, most often seeking access to medicines. While much has been written about the characteristics of patient-plaintiffs and the requested medicines in right-to-health litigation in Brazil, little research has examined potential community-level and institutional drivers of judicialization and their role as mechanisms of accountability. To explore these dimensions, we used a mixed-effects analytical model to examine a representative sample of lawsuits for access to medicines filed against the state of Rio Grande do Sul in 2008. We found that the presence of a Public Defender's Office was associated with a sevenfold increase in the likelihood of a municipality having a medicine-requesting lawsuit. This effect was maintained after controlling for a series of municipality characteristics. As low- and middle-income countries seek to achieve universal health coverage within the framework of the Sustainable Development Goals, Brazil's experience may be illustrative of the challenges that health systems will face and the institutional mechanisms that will emerge, advancing accountability and individual patients' interests in response.

13.
BMJ Open ; 10(7): e039458, 2020 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-32641342

RESUMEN

INTRODUCTION: Universal health coverage (UHC) includes the dimensions of equity in access, quality services that improve health and protection against financial hardship. Cataract continues to be the leading cause of blindness globally, despite cataract surgery being an efficacious intervention. The aim of this scoping review is to map the nature, extent and global distribution of data on cataract services for UHC in terms of equity, access, quality and financial protection. METHODS AND ANALYSIS: The search will be constructed by an Information Specialist and undertaken in MEDLINE, Embase and Global Health databases. We will include all published non-interventional primary research studies and systematic reviews that report a quantitative assessment of access, equity, quality or financial protection of cataract surgical services for adults at the subnational, national, regional or global level from population-based surveys or routinely collected health service data since 1 January 2000 and published through to February 2020.Screening and data charting will be undertaken using Covidence systematic review software. Titles and abstracts of identified studies will be screened by two authors independently. Full-text articles of potentially relevant studies will be obtained and reviewed independently by two authors against the inclusion criteria. Any discrepancies between the authors will be resolved by discussion, and with a third author as necessary. A data charting form will be developed and piloted on three studies by three authors and amendments made as necessary. Data will be extracted by two reviewers independently and summarised narratively and using maps. ETHICS AND DISSEMINATION: Ethical approval was not sought as the scoping review will only use published and publicly accessible data. The review will be published in an open access peer-reviewed journal. A summary of the results will be developed for website posting, stakeholder meetings and inclusion in the ongoing Lancet Global Health Commission on Global Eye Health.

15.
PLoS One ; 15(6): e0235445, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32603349

RESUMEN

BACKGROUND: Hepatitis C elimination will require widespread access to treatment and responses at the health-service level to increase testing among populations at risk. We explored changes in hepatitis C testing and the cascade of care before and after the introduction of direct-acting antiviral treatments in Victoria, Australia. METHODS: De-identified clinical data were retrospectively extracted from eighteen primary care clinics providing services targeted towards people who inject drugs. We explored hepatitis C testing within three-year periods immediately prior to (pre-DAA period) and following (post-DAA period) universal access to DAA treatments on 1st March 2016. Among ever RNA-positive individuals, we constructed two care cascades at the end of the pre-DAA and post-DAA periods. RESULTS: The number of individuals HCV-tested was 13,784 (12.2% of those with a consultation) in the pre-DAA period and 14,507 (10.4% of those with a consultation) in the post-DAA period. The pre-DAA care cascade included 2,515 RNA-positive individuals; 1,977 (78.6%) were HCV viral load/genotype tested; 19 (0.8%) were prescribed treatment; and 12 had evidence of cure (0.5% of those RNA-positive and 63.6% of those eligible for cure). The post-DAA care cascade included 3,713 RNA-positive individuals; 3,276 (88.2%) were HCV viral load/genotype tested; 1,674 (45.1%) were prescribed treatment; and 863 had evidence of cure (23.2% of those RNA-positive and 94.9% of those eligible for cure). CONCLUSION: Marked improvements in the cascade of hepatitis C care among patients attending primary care clinics were observed following the universal access of DAA treatments in Australia, although improvements in testing were less pronounced.

16.
Sex Reprod Health Matters ; 28(2): 1779631, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32515666

RESUMEN

Achieving universal health coverage (UHC) for sexual and reproductive health (SRH) requires informed budgeting that is aligned with UHC objectives. We draw data from Adding It Up 2019 (AIU-2019) to provide critical new country-level and regional, intervention-specific costs for the provision of SRH services. AIU-2019 is a cost-outcomes analysis, undertaken from the health system perspective, which estimates the costs and impacts of offering SRH care in low- and middle-income countries. We present direct cost estimates for 109 SRH interventions and find that human resources comprise the largest category of direct SRH service costs and that the most expensive services in the model are largely preventable. We use scenario analysis to explore the synergistic costs and impacts of providing SRH interventions in clusters, focussing on chlamydia and gonorrhoea treatment, provision of safe abortion and post-abortion care services, and safe childbirth services. When costs are considered for the preventive and impacted services in these three clusters, there are cost savings for some of the impacted services in the packages and for the abortion-related package overall. The direct cost estimates from our analysis can be used to guide UHC budgeting and planning efforts. Having these cost estimates and understanding the potential for cost savings when providing comprehensive SRH services are critical for efforts to fulfil the rights and needs of all individuals, including the most marginalised, to access this essential care.

17.
Health Res Policy Syst ; 18(1): 73, 2020 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-32586326

RESUMEN

BACKGROUND: Demographic changes in the pattern of disease burden, escalating health expenditures and inequitable access to healthcare are global challenges. Irrespective of their level of development, all countries need to reform their health systems to prepare for the future emerging health needs, in order to meet their commitments of health systems strengthening, universal health coverage (UHC) and explicit targets in the Sustainable Development Goals (SDGs). We propose three core principles for the future health system as described herein. A health system is not simply a 'cure delivery machine' but part of a 'social security system' that engages all stakeholders through a shared vision and value of health and well-being, not merely an absence of diseases. The future health system shall provide people-centred, affordable care, tailored to the individual's needs, accessible at any time and any place, and reflect the notion of leaving no one behind through a life course approach - underpinned by the SDGs. Information and communications technology (ICT) offers the potential to facilitate the realisation of these principles by improving the information flow between different parts of the health system through electronic means. We introduce Japan's new data platform - Person-centred Open PLatform for wellbeing (PeOPLe) - planned to be introduced in 2020 as one example of an ICT-based intervention to realise the three proposed principles. PeOPLe integrates data collected throughout the life course to enable all people to receive affordable, personalised health and social care at any time and any place throughout their lifetime. Furthermore, we discuss the applicability of these principles and PeOPLe to the health systems context of Thailand and the Philippines, including elaborations on ICT transformation challenges. CONCLUSION: Current rising momentum and scale for ICTs in the UHC era offers a great opportunity to make a difference for countries. The PeOPLe concept is not only relevant to resource-rich countries; its applicability to other Asian countries could be feasible though it will need to be adapted to the various country contexts. We hope that this paper contributes to wider discussion around policy choices of ICT application for future health systems strengthening and UHC in order to achieve the SDGs.

19.
Int J Public Health ; 65(5): 617-625, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32474715

RESUMEN

OBJECTIVES: We investigate the reliability of a survey question on forgone healthcare services for financial reasons, based on analysis of actual healthcare use over the 3-year period preceding response to the question. We compare the actual use of different health services by patients who report having forgone health care to those who do not. METHODS: Based on a prospective cohort study (CONSTANCES), we link survey data from enrolled participants to the Universal Health Insurance (UHI) claims database and compare use of health services of those who report having forgone health care to controls. We present multivariable logistic regression models and assess the odds of using different health services. RESULTS: Compared to controls, forgoing care participants had lower odds of consulting GPs (OR = 0.83; 95% CI 0.73, 0.93), especially specialists outside hospitals (gynecologists: 0.74 (0.69, 0.78); dermatologists: 0.81 (0.78-0.85); pneumologists 0.82 (0.71-0.94); dentists 0.71 (0.68, 0.75)); higher odds of ED visits (OR = 1.25; 95% CI 1.19, 1.31); and no difference in hospital admissions (OR = 1.02; 95% CI 0.97, 1.09). Participants with lower occupational status and income had higher odds of forgoing health care. CONCLUSIONS: The perception of those who report having forgone health care for financial reasons is consistent with their lower actual use of community-based ambulatory care (CBAC). While UHI may be necessary to improve healthcare access, it does not address the social factors associated with the population forgoing health care for financial reasons.

20.
Sex Reprod Health Matters ; 28(2): 1778610, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32530386

RESUMEN

WHO's normative guidance on self-care interventions for sexual and reproductive health and rights (SRHR) promotes comprehensive, integrated and people-centred approaches to health service delivery. Implementation of self-care interventions within the context of human rights, gender equality, and a life course approach, offers an underused opportunity to improve universal health coverage (UHC) for all. Results from an online global values and preferences survey provided lay persons' and healthcare providers' perspectives on access, acceptability, and implementation considerations. This analysis examines 326 qualitative responses to open-ended questions from healthcare providers (n = 242) and lay persons (n = 70) from 77 countries. Participants were mostly women (66.9%) and were from the Africa (34.5%), America (32.5%), South-East Asia (5.6%), European (19.8%), Eastern Mediterranean (4.8%), and Western Pacific regions (2.8%). Participants perceived multiple benefits of self-care interventions for SRHR, including: reduced exposure to stigma, discrimination and access barriers, increased confidentiality, empowerment, self-confidence, and informed decision-making. Concerns include insufficient knowledge, affordability, and possible side-effects. Implementation considerations highlighted the innovative approaches to linkages with health services. Introduction of self-care interventions is a paradigm shift in health care delivery bridging people and communities through primary health care to reach UHC. Self-care interventions can be leveraged by countries as gateways for reaching more people with quality, accessible and equitable services that is critical for achieving UHC. The survey results underscored the urgent need to reduce stigma and discrimination, increase access to and improve knowledge of self-care interventions for SRHR for laypersons and healthcare providers to advance SRHR.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA