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1.
J. Health NPEPS ; 6(2): 1-23, dez. 2021.
Artículo en Inglés | LILACS, BDENF - Enfermería, Coleciona SUS | ID: biblio-1291053

RESUMEN

Objective: to analyze epidemic curves based on mathematical models for the state of Mato Grosso do Sul and the impacts of population density on COVID-19 transmission. Method: the linear, polynomial and exponential regression model was used to make the numerical adjustment of the respective curves empirical. Result: it was found that the models used describe very well the empirical curves in which they were tested. In particular, the polynomial model is able to identify with reasonable reliability the appearance of the inflection point in the accumulated curves, which corresponds to the maximum point of the respective daily curves. The analysis indicates a weak positive correlation between infection, mortality, lethality and deaths from COVID-19 with population density, as revealed by the correlation and analysis of R2 . Conclusion: the models are very effective in describing the COVID-19 and epidemic curves in the estimation of important epidemiological parameters, such as peak case curves and daily deaths, allowing practical and efficient monitoring of the evolution of the epidemic.


Objetivo: analizar curvas epidémicas basadas en modelos matemáticos para el estado de Mato Grosso do Sul y los impactos de la densidad de población en la transmisión de COVID-19. Método: se utilizó el modelo de regresión lineal, polinomial y exponencial para hacer el ajuste numérico valor de las respectivas curvas empíricas. Resultados: se encontró que los modelos utilizados describen muy bien las curvas empíricas en las que fueron probados. En particular, el modelo polinomial es capaz de identificar con razonable fiabilidad la aparición del punto de inflexión en las curvas acumuladas, que corresponde al punto máximo de las respectivas curvas diarias. El análisis indica una correlación positiva débil entre la infección, la mortalidad, la letalidad y las muertes por COVID-19 con la densidad de población, según lo revelado por la correlación y el análisis de R2 .Conclusión: los modelos son muy efectivos para describir el COVID-19 y curvas epidémicas en la estimación de parámetros epidemiológicos importantes, como las curvas de casos máximos y las muertes diarias, lo que permite un seguimiento práctico y eficaz de la evolución de la epidemia.


Objetivo: analisar as curvas epidêmicas com base em modelos matemáticos para o estado de Mato Grosso do Sul e os impactos da densidade populacional na transmissão da COVID-19. Método: o modelo de regressão linear, polinomial e exponencial foi utilizado para fazer o ajuste numérico das respectivas curvas empíricas. Resultados: verificou-se que os modelos utilizados descrevem muito bem as curvas empíricas nas quais foram testados. Em particular, o modelo polinomial é capaz de identificar com razoável confiabilidade o aparecimento do ponto de inflexão nas curvas acumuladas, que corresponde ao ponto máximo das respectivas curvas diárias. A análise indica uma correlação positiva fraca entre infecção, mortalidade, letalidade e mortes por COVID-19 com a densidade populacional, conforme revelado pela correlação e análise de R 2. Conclusão: os modelos são muito eficazes na descrição das curvas epidêmicas de COVID19 e na estimativa de parâmetros epidemiológicos importantes, como curvas de casos de pico e óbitos diários, permitindo um monitoramento prático e eficiente da evolução da epidemia


Asunto(s)
Modelos Epidemiológicos , COVID-19 , Política de Salud
2.
Hacia promoc. salud ; 26(2): 175-191, jul.-dic. 2021. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1339955

RESUMEN

Resumen Este artículo se refiere a experiencias sobre el cuidado de sí y los obstáculos que en su práctica enfrentan las agentes educativas que laboran en un programa gubernamental colombiano de modalidad familiar. La investigación se llevó a cabo en la ciudad de Cali en el año 2015. Objetivo: Identificar a los actores sociales que a su vez se consideraban a sí mismos como cuidadores con el fin de provocar en ellos la comprensión de sus características biográficas y el lugar que ocupaban en el trabajo de cuidar que realizaban con niños y niñas. Metodología: Se optó por una epistemología constructivista y una metodología cualitativa, con el fin de articular el interés del equipo investigador por la producción de conocimiento con las necesidades de intervención manifestadas por el equipo de trabajo. Resultados: Se encontraron dificultades en el cuidado de sí por parte de las mujeres madres, relacionadas con las dobles jornadas de trabajo y las lógicas del deber ser, con lo cual se legitima el cuidado del otro por encima del propio. Conclusión: Esta situación implica un déficit de cuidado de sí y posiblemente un déficit en el cuidado de sus propios hijos, lo cual evidencia la necesidad de que en la política de primera infancia en Colombia se generen estrategias de autocuidado para quienes trabajan con niños y niñas en primera infancia.


Abstract This article refers to the experiences of self-care and the obstacles that educational agents working in a Colombian government program with families have to face in their practice. The research was carried out in 2015 in the city of Cali. Objetive: To identify the social actors who considered themselves as caregivers in order to encourage them to understand their biographical characteristics and the place they have in the care work they carried out with children. Method: A constructivist epistemology and a qualitative methodology were chosen in order to articulate the interest of the research team in the production of knowledge with the intervention needs expressed by the work team. Results: Difficulties were found in the self-care of women mothers associated with double working hours and the logic of duty in which the care of the other is legitimized over self-care. Conclusions: This situation implies a lack of self-care and possibly a deficit in the care of their own children which shows the need for early childhood policy in Colombia to generate self-care strategies for those working with early childhood children.


Resumo Este artigo se refere a experiências sobre o cuidado de si e os obstáculos que em sua prática enfrentam as empregadas educativas que trabalham em um programa governamental colombiano de modalidade familiar. A pesquisa foi feita na cidade de Cali no ano 2015. Objetivo: Identificar aos atores sociais que a sua vez se consideravam a si mesmos como cuidadores com o fim de provocar neles a compreensão de suas características biográficas e o lugar que ocupavam no trabalho de cuidar que realizavam com meninos e meninas. Metodologia: Se optou por uma epistemologia construtivista e uma metodologia qualitativa, com o fim de articular o interesse da equipe pesquisador pela produção de conhecimento com as necessidades de intervenção manifestadas pela equipe de trabalho. Resultados: Encontraram-se dificuldades no cuidado de si por parte das mulheres mães, relacionadas com as dobres jornadas de trabalho e as lógicas do dever ser, com o qual se legitima o cuidado do outro por encima do próprio. Conclusão: Esta situação implica um déficit de cuidado de si e possivelmente um déficit no cuidado de seus próprios filhos, o qual evidencia a necessidade de que na política de primeira infância na Colômbia se gerem estratégias de autocuidado para quem trabalha com meninos e meninas em primeira infância.

3.
Front Public Health ; 9: 647548, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34595147

RESUMEN

Since the global onset of COVID-19 in early 2020, the disease has significantly impacted mental health. This impact is likely to be further exacerbated for groups who were already marginalized. This paper shares results from a broader study of men who have sex with men (MSM) and transgender people in Bali, Indonesia and includes a focus on psychological distress and happiness during the COVID-19 pandemic; applying sociodemographic and epidemiological characteristics as potential mediators. Psychological distress and the level of happiness were measured by The Kessler Psychological Distress (K10) and the Subjective Happiness Scale (SHS). A cross-sectional survey was conducted from July to September 2020. Of the 416 participants, complete data were available for 363 participants. The majority of participants were aged 26-40 years, currently single, were born outside Bali, were currently living in an urban area, and over one-third were living with HIV. While all were MSM, the majority identified as homosexual/tend to be homosexual (71.3%), however 54 (14.9%) identified themselves as heterosexual. The majority (251, 69.1%) reported moderate to very high psychological distress during the COVID-19 pandemic. The binary logistic regression analysis identified five factors to be significantly associated with higher psychological distress: being a student, reporting higher levels of stigma, had ever experienced discrimination, felt better prior to the COVID-19 pandemic, and less happy than the average person. When homosexual were compared with heterosexual participants, those who identified themselves as being homosexual reported significantly lower psychological distress compared to those identified themselves as heterosexual, which may be associated with these participants not disclosing their status as MSM and the stigma around MSM. Those who considered themselves to be less happy than the average person (316, 87.1%) were more likely to live with a partner and to report moderate to very high psychological distress. Based on the findings, interventions should focus on strategies to reduce stigma, provide non-discriminatory services, and improve access to essential health services.


Asunto(s)
COVID-19 , Distrés Psicológico , Minorías Sexuales y de Género , Personas Transgénero , Estudios Transversales , Felicidad , Política de Salud , Homosexualidad Masculina , Humanos , Masculino , Pandemias , SARS-CoV-2
4.
J Psychosoc Nurs Ment Health Serv ; 59(10): 7-11, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34605677

RESUMEN

The goal of the Aging Matters column is to address important issues related to geropsychiatry and the well-being of older adults. This article offers reflections on columns from the past 15 years and how the aging process has changed in issues related to aging and technology, aging healthfully, end-of-life issues, caregivers for older adults, and growing old in American society. To promote successful aging, we need to hear stories of what it is like to grow old in America. We also need research to better understand the aging process and what is needed for successful aging. In addition, we need policies and resources that help ensure well-trained caregivers who can protect vulnerable older adults and help them age healthfully. Stories of individuals, research, and health care policies need to be connected to create meaningful changes within the health care system. [Journal of Psychosocial Nursing and Mental Health Services, 59(10), 7-11.].


Asunto(s)
Envejecimiento , Atención a la Salud , Anciano , Cuidadores , Política de Salud , Humanos , Estudios Retrospectivos
5.
Health Res Policy Syst ; 19(Suppl 3): 107, 2021 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-34641893

RESUMEN

BACKGROUND: This is the fourth of our 11-paper supplement on "Community Health Workers at the Dawn of New Era". Here, we first make the case for investing in health programmes, second for investing in human resources for health, third for investing in primary healthcare (PHC) workers, and finally for investing in community health workers (CHWs). METHODS: Searches of peer-reviewed journals and the grey literature were conducted with a focus on community health programme financing. The literature search was supplemented with a search of the grey literature for information about national health sector plans, community health strategies/policies, and costing information from databases of various countries' ministries of health, and finally a request for information from in-country partners. RESULTS: The global shortage of human resources for health is projected to rise to 18 million health workers by 2030, with more acute shortages in Africa and South Asia. CHWs have an important role to play in mitigating this shortage because of their effectiveness (when properly trained and supported) and the feasibility of their deployment. Data are limited on the costs of current CHW programmes and how they compare to government and donor expenditures for PHC and for health services more broadly. However, available data from 10 countries in Africa indicate that the median per capita cost of CHW programmes is US$ 4.77 per year and US$ 2574 per CHW, and the median monthly salary of CHWs in these same countries is US$ 35 per month. For a subset of these countries for which spending for PHC is available, governments and donors spend 7.7 times more on PHC than on CHW programming, and 15.4 times more on all health expenditures. Even though donor funding for CHW programmes is a tiny portion of health-related donor support, most countries rely on donor support for financing their CHW programmes. CONCLUSION: The financing of national CHW programmes has been a critical element that has not received sufficient emphasis in the academic literature on CHW programmes. Increasing domestic government funding for CHW programmes is a priority. In order to ensure growth in funding for CHW programmes, it will be important to measure CHW programme expenditures and their relationship to expenditures for PHC and for all health-related expenditures.


Asunto(s)
Agentes Comunitarios de Salud , Atención Primaria de Salud , Política de Salud , Promoción de la Salud , Humanos , Recursos Humanos
6.
Health Res Policy Syst ; 19(Suppl 3): 108, 2021 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-34641901

RESUMEN

BACKGROUND: While the evidence supporting the effectiveness of community health worker (CHW) programmes is substantial, there is also considerable evidence that many of these programmes have notable weaknesses that need to be addressed in order for them to reach their full potential. Thus, considerations about CHW programme performance and its assessment must be taken into account as the importance of these programmes is becoming more widely appreciated. In this paper, the tenth in our 11-paper series, "Community health workers at the dawn of a new era", we address CHW programme performance and how it is assessed from a systems perspective. METHODS: The paper builds on the 2014 CHW Reference Guide, a compendium of case studies of 29 national CHW programmes, the 2018 WHO guideline on health policy and system support to optimize CHW programmes, and scientific studies on CHW programme performance published in the past 5 years. RESULTS: The paper provides an overview of existing frameworks that are useful for assessing the performance of CHW programmes, with a specific focus on how individual CHW performance and community-level outcomes can be measured. The paper also reviews approaches that have been taken to assess CHW programme performance, from programme monitoring using the routine health information system to national assessments using quantitative and/or qualitative study designs and assessment checklists. The paper also discusses contextual factors that influence CHW programme performance, and reflects upon gaps and needs for the future with regard to assessment of CHW programme performance. CONCLUSION: Assessments of CHW programme performance can have various approaches and foci according to the programme and its context. Given the fact that CHW programmes are complex entities and part of health systems, their assessment ideally needs to be based on data derived from a mix of reliable sources. Assessments should be focused not only on effectiveness (what works) but also on contextual factors and enablers (how, for whom, under what circumstances). Investment in performance assessment is instrumental for continually innovating, upgrading, and improving CHW programmes at scale. Now is the time for new efforts in implementation research for strengthening CHW programming.


Asunto(s)
Agentes Comunitarios de Salud , Política de Salud , Programas de Gobierno , Humanos , Investigación Cualitativa
7.
Br J Nurs ; 30(18): 1096-1097, 2021 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-34645348

RESUMEN

In the final instalment of his healthcare policy column, emeritus Professor Alan Glasper, from the University of Southampton, discusses a new report that looks at ways to encourage graduates in other disciplines into nursing.


Asunto(s)
Política de Salud , Medicina Estatal , Humanos , Reino Unido
8.
Sci Rep ; 11(1): 19463, 2021 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-34593931

RESUMEN

In the wake of the COVID-19 pandemic, physical distancing behavior turned out to be key to mitigating the virus spread. Therefore, it is crucial that we understand how we can successfully alter our behavior and promote physical distancing. We present a framework to systematically assess the effectiveness of behavioral interventions to stimulate physical distancing. In addition, we demonstrate the feasibility of this framework in a large-scale natural experiment (N = 639) conducted during an art fair. In an experimental design, we varied interventions to evaluate the effect of face masks, walking directions, and immediate feedback on visitors' contacts. We represent visitors as nodes, and their contacts as links in a contact network. Subsequently, we used network modelling to test for differences in these contact networks. We find no evidence that face masks influence physical distancing, while unidirectional walking directions and buzzer feedback do positively impact physical distancing. This study offers a feasible way to optimize physical distancing interventions through scientific research. As such, the presented framework provides society with the means to directly evaluate interventions, so that policy can be based on evidence rather than conjecture.


Asunto(s)
Conducta , COVID-19/prevención & control , COVID-19/psicología , Distanciamiento Físico , Adulto , Retroalimentación , Femenino , Humanos , Masculino , Máscaras , Persona de Mediana Edad , Modelos Teóricos , Política Pública , Encuestas y Cuestionarios , Adulto Joven
9.
PLoS One ; 16(10): e0258236, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34597333

RESUMEN

BACKGROUND: All healthcare workers (HCWs) in Yongin Severance Hospital were allocated to receive the ChAdOx1 nCov-19 vaccine according to national policy. A report of thrombosis and thrombocytopenia syndrome (TTS) associated with ChAdOx1 nCoV-19 led to hesitancy about receiving the second dose among HCWs who had received the first dose. METHODS: From 7 to 14 May, 2021, we performed a survey to identify the factors associated with hesitancy about receiving the second vaccine dose among HCWs at the hospital who had received the first dose of the vaccine. Based on survey results, a hospital-wide campaign was implemented on 18 May 2021 to improve vaccine coverage. HCWs who completed the second dose completed a self-administered questionnaire to evaluate the effect of the campaign. FINDINGS: Of 1,171 HCWs who had received the first dose of the vaccine, 71.5% completed the online survey, of whom 3.7% refused to take the second dose and 22.3% showed hesitancy. Hesitancy to receive a second dose was significantly associated with age under 30 years and concerns about TTS, and was less common among those who trusted effectiveness and safety of the vaccine. Among HCWs who received the first dose, 96.2% completed vaccination with the second dose between 27 May and 4 June, 2021. Of those who answered the questionnaire asked about the timing of their decision to receive the second dose, 57.1% reported that they were motivated by the hospital-wide campaign. CONCLUSION: A tailored intervention strategy based on a survey can improve COVID-19 vaccination uptake among HCWs.


Asunto(s)
Vacunas contra la COVID-19/administración & dosificación , COVID-19/prevención & control , Personal de Salud/psicología , Adulto , COVID-19/virología , Vacunas contra la COVID-19/efectos adversos , Femenino , Política de Salud , Hospitales , Humanos , Internet , Masculino , Persona de Mediana Edad , República de Corea , SARS-CoV-2/aislamiento & purificación , Encuestas y Cuestionarios , Trombocitopenia/etiología , Trombosis/etiología
10.
PLoS One ; 16(10): e0258132, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34597334

RESUMEN

This confirmatory research investigates the influence of risk framing of COVID-19 on support for restrictive government policy based on two web survey experiments in Russia. Using 2x2 factorial design, we estimated two main effects-factors of risk severity (low vs. high) and object at risk (individual losses vs. losses to others). First, focusing on higher risks had a positive effect on support for the government's restrictive policy. Second, focusing on the losses for others did not produce stronger support for the restrictive policy compared to focusing on personal losses. However, we found a positive moderation effect of such prosocial values as universalism and benevolence. We found that those with prosocial values had a stronger positive effect in the "losses for others" condition and were more willing to support government restrictive policy when others were included. The effects found in our experimental study reveal both positive and negative aspects in risk communication during the pandemic, which may have a great and long-term impact on trust, attitudes, and behavior.


Asunto(s)
COVID-19/patología , Política de Salud , Apoyo Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , COVID-19/virología , Brotes de Enfermedades , Femenino , Gobierno , Humanos , Masculino , Persona de Mediana Edad , Riesgo , Federación de Rusia/epidemiología , SARS-CoV-2/aislamiento & purificación , Encuestas y Cuestionarios , Adulto Joven
11.
PLoS One ; 16(10): e0257757, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34606508

RESUMEN

CONTEXT: The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing structural factors facilitated better outcomes despite different starting points, as understanding of the relative impact of structural aspects should facilitate achieving optimal forward progress. METHODS: Desk study, based on selecting and collecting a range of measures for 48 representative characteristics of 42 countries' demography, society, health system, and policy-making profiles, matched to three pandemic time points. Different analytic approaches were employed including correlation, multiple regression, and cluster analysis in order to seek triangulation. FINDINGS: Population structure (except country size), and volume and nature of health resources, had only minor links to Covid impact. Depth of social inequality, poverty, population age structure, and strength of preventive health measures unexpectedly had no moderating effect. Strongest measured influences were population current enrolment in tertiary education, and country leaders' strength of seeking scientific evidence. The representativeness, and by interpretation the empathy, of government leadership also had positive effects. CONCLUSION: Strength of therapeutic health system, and indeed of preventive health services, surprisingly had little correlation with impact of the pandemic in the first nine months measured in death- or case-rates. However, specific political system features, including proportional representation electoral systems, and absence of a strong single party majority, were consistent features of the most successful national responses, as was being of a small or moderate population size, and with tertiary education facilitated. It can be interpreted that the way a country was lead, and whether leadership sought evidence and shared the reasoning behind resultant policies, had notable effects. This has significant implications within health system development and in promoting the population's health.


Asunto(s)
COVID-19/patología , Democracia , COVID-19/epidemiología , COVID-19/mortalidad , COVID-19/virología , Servicios Médicos de Urgencia , Política de Salud , Humanos , Pandemias , Salud Pública , Resiliencia Psicológica , SARS-CoV-2/aislamiento & purificación , Factores Socioeconómicos
12.
Sci Rep ; 11(1): 19655, 2021 10 04.
Artículo en Inglés | MEDLINE | ID: mdl-34608258

RESUMEN

COVID-19 represents the most severe global crisis to date whose public conversation can be studied in real time. To do so, we use a data set of over 350 million tweets and retweets posted by over 26 million English speaking Twitter users from January 13 to June 7, 2020. We characterize the retweet network to identify spontaneous clustering of users and the evolution of their interaction over time in relation to the pandemic's emergence. We identify several stable clusters (super-communities), and are able to link them to international groups mainly involved in science and health topics, national elites, and political actors. The science- and health-related super-community received disproportionate attention early on during the pandemic, and was leading the discussion at the time. However, as the pandemic unfolded, the attention shifted towards both national elites and political actors, paralleled by the introduction of country-specific containment measures and the growing politicization of the debate. Scientific super-community remained present in the discussion, but experienced less reach and became more isolated within the network. Overall, the emerging network communities are characterized by an increased self-amplification and polarization. This makes it generally harder for information from international health organizations or scientific authorities to directly reach a broad audience through Twitter for prolonged time. These results may have implications for information dissemination along the unfolding of long-term events like epidemic diseases on a world-wide scale.


Asunto(s)
COVID-19/epidemiología , Aislamiento Social , Medios de Comunicación Sociales , COVID-19/patología , COVID-19/virología , Humanos , Pandemias , Política , SARS-CoV-2/aislamiento & purificación , Análisis de Redes Sociales , Red Social
13.
Bridgetown; PAHO; 2021-10-19. (PAHO/ECC/21-0001).
No convencional en Inglés | PAHO-IRIS | ID: phr2-55054

RESUMEN

Founded in 1902 as the independent specialized health agency of the inter-American system, the Pan American Health Organization (PAHO) has developed recognized competence and expertise, providing technical cooperation to its Member States to fight communicable and noncommunicable diseases and their causes, to strengthen health systems, and to respond to emergencies and disasters throughout the Region of the Americas. In addition, acting in its capacity as the World Health Organization’s Regional Office, PAHO participates actively in the United Nations Country Team, collaborating with other agencies, the funds and programs of the United Nations system to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. This 2020 annual report reflects PAHO’s technical cooperation in the countries for the period, implementing the Multi-Country Cooperation Strategy, responding to the needs and priorities of the countries, and operating within the framework of the Organization’s regional and global mandates and the SDGs. Under the overarching theme of Universal Health and the Pandemic – Resilient Health Systems, it highlights PAHO’s response to the COVID-19 pandemic as well as its continuing efforts in priority areas such as communicable diseases, noncommunicable diseases, mental health, health throughout the life course, and health emergencies. It also provides a financial summary for the year under review.


Asunto(s)
Cooperación Técnica , Prioridades en Salud , Sistemas de Salud , Programas Nacionales de Salud , Política de Salud , Cobertura Universal de Salud , Enfermedades Transmisibles , Enfermedades no Transmisibles , Factores de Riesgo , Gestión de Riesgos , Administración Financiera , Salud Mental , Factores Socioeconómicos , Región del Caribe , Barbados
14.
Kingston 7; PAHO; 2021-10-14. (PAHO/JAM/21-0001).
No convencional en Inglés | PAHO-IRIS | ID: phr2-54996

RESUMEN

Founded in 1902 as the independent specialized health agency of the inter-American system, the Pan American Health Organization (PAHO) has developed recognized competence and expertise, providing technical cooperation to its Member States to fight communicable and noncommunicable diseases and their causes, to strengthen health systems, and to respond to emergencies and disasters throughout the Region of the Americas. In addition, acting in its capacity as the World Health Organization’s Regional Office, PAHO participates actively in the United Nations Country Team, collaborating with other agencies, the funds and programs of the United Nations system to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. This 2020 annual report reflects PAHO’s technical cooperation in the country for the period, implementing the Country Cooperation Strategy, responding to the needs and priorities of the country, and operating within the framework of the Organization’s regional and global mandates and the SDGs. Under the overarching theme of Universal Health and the Pandemic – Resilient Health Systems, it highlights PAHO’s response to the COVID-19 pandemic as well as its continuing efforts in priority areas such as communicable diseases, noncommunicable diseases, mental health, health throughout the life course, and health emergencies. It also provides a financial summary for the year under review.


Asunto(s)
Cooperación Técnica , Prioridades en Salud , Sistemas de Salud , Programas Nacionales de Salud , Política de Salud , Acceso Universal a los Servicios de Salud , Cobertura Universal de Salud , Enfermedades Transmisibles , Enfermedades no Transmisibles , Factores de Riesgo , Salud Mental , Servicios de Salud , Administración Financiera , Administración en Salud , Región del Caribe , Jamaica
15.
Artículo en Español | PAHO-IRIS | ID: phr-54975

RESUMEN

[RESUMEN]. Objetivo. En el 2010 se propuso el principio del universalismo proporcional como solución para reducir las desigualdades en materia de salud. Aunque tuvo una gran resonancia, no parece haber sido aplicado ampliamente y no existen directrices sobre cómo aplicarlo. Los dos objetivos específicos de esta revisión sistemática exploratoria fueron: 1) describir el contexto teórico en el que se estableció el universalismo proporcional, y 2) describir cómo los investigadores aplican el universalismo proporcional y las cuestiones metodológicas relacionadas. Métodos. Se buscó en todas las bases de datos de la Web of Science los artículos publicados hasta el 6 de febrero del 2020 que tuvieran como tema “universalismo proporcional” o sus sinónimos “universalismo dirigido” o “universalismo progresivo”. Resultados. Esta revisión de 55 artículos permitió obtener una visión global del universalismo proporcional en cuanto a sus fundamentos teóricos y su aplicación práctica. El principio del universalismo proporcional se basa en las teorías sociales del universalismo y el direccionamiento, y propone vincular estos dos aspectos para lograr una reducción efectiva de las desigualdades en materia de salud. Respecto de su aplicación práctica, las intervenciones basadas en este principio son poco frecuentes y dan lugar a diferentes interpretaciones. Todavía existen muchos desafíos metodológicos y éticos en relación con la concepción y evaluación de las intervenciones relacionadas con el universalismo proporcional, incluida la forma de aplicar la proporcionalidad y la identificación de las necesidades. Conclusión. En esta revisión se llevó a cabo un mapeo de la literatura científica disponible sobre el universalismo proporcional y sus conceptos relacionados. Este principio se basa en teorías sociales. Tal como lo destacaron autores que implementaron intervenciones de universalismo proporcional, su aplicación plantea muchos desafíos, desde el diseño hasta la evaluación. El análisis de las aplicaciones del universalismo proporcional presentado en esta revisión respondió a algunos de ellos, pero los desafíos metodológicos restantes requieren ser abordados en futuras investigaciones.


[ABSTRACT]. Objective. In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it. The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues. Methods. We searched for all articles published until 6th of February 2020, mentioning “Proportionate Universalism” or its synonyms “Targeted universalism” OR “Progressive Universalism” as a topic in all Web of Science databases. Results. This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs. Conclusion. This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.


[RESUMO]. Objetivo. Em 2010, o princípio do Universalismo Proporcional (UP) foi proposto como uma solução para reduzir as desigualdades na saúde. Houve uma grande receptividade, mas o princípio parece não ter sido amplamente aplicado e não há diretrizes sobre como implementá-lo. Os dois objetivos específicos desta análise de escopo foram: (1) descrever o contexto teórico no qual o UP foi estabelecido e (2) descrever como os pesquisadores aplicam o UP e questões metodológicas correlatas. Métodos. Buscamos em todas as bases de dados científicas da Web todos os artigos publicados até 6 de fevereiro de 2020 que mencionavam, como tema, o “Universalismo Proporcional” ou seus sinônimos “Universalismo Visado” ou “Universalismo Progressivo”. Resultados. Essa análise de 55 artigos nos permitiu ter uma visão global relacionada com o UP, suas bases teóricas e sua implementação na prática. Os princípios do UP têm suas raízes nas teorias sociais do universalismo e na definição de metas. A proposta é vincular esses dois aspectos para atingir uma redução efetiva das desigualdades em saúde. Com relação ao aspecto prático da implementação, as intervenções de UP foram raras e levaram a diferentes interpretações. Ainda há muitos obstáculos metodológicos e éticos relativos ao conceito e à avaliação das intervenções de UP, inclusive sobre como aplicar o aspecto da proporcionalidade e a identificação das necessidades. Conclusões. Esta análise fez um mapeamento da literatura científica disponível sobre UP e seus conceitos correlatos. O princípio por trás do UP tem suas origens nas teorias sociais. Como destacam os autores que implementaram as intervenções de UP, sua aplicação produz muitas dificuldades, da elaboração à avaliação. A análise das aplicações de UP fornecidas nesta pesquisa permitiu a obtenção de algumas respostas. No entanto, pesquisas futuras poderiam abordar as dificuldades metodológicas remanescentes.


Asunto(s)
Equidad en Salud , Política de Salud , Factores Socioeconómicos , Equidad en Salud , Política de Salud , Factores Socioeconómicos , Equidad en Salud , Política de Salud , Factores Socioeconómicos
18.
BMC Womens Health ; 21(1): 360, 2021 10 10.
Artículo en Inglés | MEDLINE | ID: mdl-34629077

RESUMEN

BACKGROUND: Violence against women (VAW) is a global challenge, and the health sector is a key entry point for survivors to receive care. The World Health Organization adopted an earlier framework for health systems response to survivors. However, documentation on the programmatic rollout of health system response to violence against women is lacking in low and middle-income countries. This paper studies the programmatic roll out of the health systems response across select five low- and middle-income countries (LMIC) and identifies key learnings. METHODS: We selected five LMIC settings with recent or active programming on national-level health system response to VAW from 2015 to 2020. We synthesized publicly available data and program reports according to the components of the WHO Health Systems Framework. The countries selected are Bangladesh, Brazil, Nepal, Rwanda, and Sri Lanka. RESULTS: One-stop centers were found to be the dominant model of care located in hospitals in four countries. Each setting has implemented in-service training as key to addressing provider knowledge, attitudes and practice; however, significant gaps remain in addressing frequent staff turnover, provision of training at scale, and documentation of the impact of training. The health system protocols for VAW address sexual violence but do not uniformly include clinical and health policy responses for emotional or economic violence. Providing privacy to survivors within health facilities was a universal challenge. CONCLUSION: Significant efforts have been made to address provider attitudes towards provision of care and to protocolize delivery of care to survivors, primarily through one-stop centers. Further improvements can be made in data collection on training impact on provider attitudes and practices, in provider identification of VAW survivors, and in prioritization of VAW within health system budgeting, staffing, and political priorities. Primary health facilities need to provide first-line support for survivors to avoid delays in response to all forms of VAW as well as for secondary prevention.


Asunto(s)
Países en Desarrollo , Violencia , Femenino , Política de Salud , Humanos , Asistencia Médica , Pobreza
20.
BMC Health Serv Res ; 21(1): 1120, 2021 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-34666755

RESUMEN

INTRODUCTION: Social participation is one of the guidelines of the Brazilian health system. Health councils are collegiate instances of participation established by Law 8.142/90. The most recent legal regulation for council organization and functioning was established through Resolution 453/2021. The institution of health councils has a permanent and deliberative nature to act in the formulation, deliberation and control of health policy implementation, including in economic and financial aspects. OBJECTIVE: To evaluate the compliance of health councils with the directives for the establishment, restructuring and operation of the councils from Brazil, based on Resolution 453/2012. METHODS: An exploratory, descriptive study that used the Health Council Monitoring System as a data source. Qualitative variables were selected to identify the characteristics related to the councils' establishment (legal instruments for establishment), the strategies adopted for restructuring (budget allocation, existence of an executive secretariat, provision of a dedicated office) and the characteristics of the health councils' operation (frequency of regular meetings, existence of a board of directors, the election of the board of directors). RESULTS: The study analyzed three groups of characteristics related to the constitution, strategies adopted for restructuring and the functioning of the councils. Regarding the constitution of the councils, the findings revealed that the vast majority was constituted in accordance with the legislation and, therefore, is in compliance with Resolution 453/2021. In the second group of characteristics that describe the restructuring of councils, the study found that less than half of registered councils are in compliance with the standard. And, finally, in the third group of characteristics, it was found that the boards have adopted different frequencies for regular meetings and approximately 50% of the boards studied have a board of directors. CONCLUSIONS: The councils still do not meet the minimum conditions necessary to fulfil their role in the Unified Health System (SUS), as stipulated in Resolution 453/2021. This situation requires monitoring by public oversight agencies. Despite the increase in popular participation with the creation of the health councils, this study demonstrated that most councils still do not meet the minimum conditions for monitoring public health policy. The improvement of the Health Councils Monitoring System (SIACS) to become an instrument for monitoring the councils, with the definition of goals and results, may contribute to the organization of the councils and, therefore, to the realization of social participation in Brazil.


Asunto(s)
Política , Participación Social , Brasil , Participación de la Comunidad , Política de Salud , Humanos , Política Pública
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