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1.
Licere (Online) ; 24(02): 341-376, 20210630. ilus
Artículo en Portugués | LILACS | ID: biblio-1282957

RESUMEN

Mesmo que haja algumas pesquisas e estudos, nos âmbitos acadêmico e científico, referentes à gestão, uso e apropriação de espaços públicos nos contextos do esporte e do lazer, notam-se, ainda, lacunas pouco exploradas, como a gestão da informação e a difusão adequada do conhecimento sobre a temática, envolvendo as Políticas Públicas. Desta forma, este estudo, de natureza qualitativa, teve como objetivo, realizar uma revisão sistemática de literatura sobre a produção científica recente, apresentando o estado da arte sobre Políticas Públicas e a gestão de espaços públicos nos contextos do esporte e do lazer. Para tanto, a busca foi realizada nas seguintes bases de dados: Scopus, SPORTDiscus, Web of Science, Pro Quest e SciELO, utilizando os termos booleanos a seguir: "sport and leisure management" OR "sport space" OR "leisure space" OR "sport equipment" OR "leisure equipment" OR "public Sport policy" OR "public leisure policy". Os artigos analisados abrangeram diferentes áreas do conhecimento, tal como, as Ciências do Esporte, Geografia, Arquitetura e Urbanismo e Sociologia. Os dados foram analisados por meio da Técnica de Análise de Conteúdo. Com base nos resultados, pode-se perceber que o tema referente às Políticas Públicas nos contextos do esporte e do lazer tem sido focalizado atualmente, nos estudos, entretanto, os espaços públicos neste contexto ainda são tratados de forma secundária. Este campo de estudo carece de novas pesquisas, com a intenção de aprofundar as investigações sobre a temática.


Despite some research and studies, in academic and scientific fields, and concerning the management, use and appropriation of public spaces in sports and leisure contexts, there are still some gaps that have been insufficiently explored, such as information management and the appropriate knowledge diffusion on the subject, among Public Policies. Thus, this qualitative study aimed to conduct a systematic review on recent scientific production, presenting the state of the art on Public Policies and public spaces management regarding sport and leisure contexts. A search was performed in the following databases: Scopus, SPORTDiscus, Web of Science, Pro Quest and SciELO. The keywords and Boolean terms were: "sport and leisure management" OR "sport space" OR "leisure space" OR "Sport equipment" OR "leisure equipment" OR "public sport policy" OR "public leisure policy". The papers analyzed covered different knowledge areas, such as Sport Sciences, Geography, Architecture and Urbanism, and Sociology. The collected data were analyzed using the Content Analysis Technique. Based on the results, it can be noticed that the theme regarding Public Policies in sport and leisure contexts is focused among the studies; however, public spaces are still treated in a secondary way. This study field needs further researches, with the intention of deepening the knowledge on the subject.


Asunto(s)
Actividades Recreativas , Política Pública , Deportes
2.
Licere (Online) ; 24(02): 418-436, 20210630.
Artículo en Portugués | LILACS | ID: biblio-1282959

RESUMEN

A eficácia das práticas corporais, atividades físicas e esportivas regulares é cientificamente comprovada como vetor de saúde e devem ser fomentadas em todos os ambientes. O objetivo é investigar se, no Século XXI, o governo federal brasileiro formulou políticas públicas que as contemplem no âmbito da Educação Básica em prol da saúde. Metodologicamente é um estudo exploratório documental. Como resultados, a Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, Pesquisa Nacional de Saúde, Pesquisa Nacional por Amostra de Domicílios Contínua e Pesquisa Nacional de Saúde do Escolar são os inquéritos que subsidiam aspolíticas públicas. Conclui que, alinhado com a Política Nacional de Promoção de Saúde de 2006, 2014 e 2017, Lei do SUS, Lei de Diretrizes e Bases da Educação e a Constituição/1988, o Programa Saúde na Escola é a principal política pública interfederativa que as contemplam.


The effectiveness of body practices, regular physical activity and sports is scientifically demonstrated as a health vector and should be adopted in all environments. The goal is to investigate if, in the 21st Century, the Brazilian federal government created public policies that include these practices and activities in the scope of Basic Education in favor of health. Methodologically it is an exploratory documentary study. As a result, Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey, National Health Survey, National Continuous Household Sample Survey and National School Health Survey are the surveys that support public policy and that, in line with The National Health Promotion Policy of 2006, 2014 and 2017, with the SUS Law, the Education Guidelines and Bases Law and the Federal Constitution / 1988, the Health at School Program is the main interfederative and intersectoral public policy.


Asunto(s)
Educación , Política Pública
3.
Rev. enferm. UERJ ; 29: e55486, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS-Express | LILACS | ID: biblio-1254205

RESUMEN

Objetivo: conhecer os aspectos abordados pela produção científica em relação à temática da inclusão da pessoa com deficiência nas instituições de ensino. Método: revisão integrativa da literatura nas bases de dados Medical Literature and Retrivial Sistem on Line, Web of science, SCOPUS e Directory of Open Access Journals. Recorte da busca de 2015 a 2019. Resultados: foram analisados vinte e um artigos. As publicações apresentaram temáticas relacionadas à Políticas de acesso, cotas e currículos e Barreiras e facilitadores da inclusão na educação. Considerações finais: os aspectos abordados pela produção científica evidenciaram que entraves são transversais à vivência dos estudantes em suas experiências acadêmicas. Lacunas curriculares, estereotipação do corpo, crenças, falta de capacitação do corpo docente cerca-nos de evidências de que mais do que quebra de paradigmas diante da pessoa com deficiência, é preciso que existam avanços nas práticas políticas para que barreiras como preconceito, discriminação e segregação não definam as relações humanas.


Objective: to learn what concerns are addressed by scientific production on the theme of inclusion for people with disabilities in educational institutions. Method: this integrative literature review searched the Medical Literature Analysis and Retrieval System on Line, Web of Science, SCOPUS and Directory of Open Access Journals database entries from 2015 to 2019. Results: the twenty-one articles examined addressed themes relating to access policies, quotas and curricula, and barriers and facilitators of inclusion in education. Final considerations: the concerns addressed by the scientific production showed that obstacles are transversal to the students' experience in their academic life. Gaps in curricula, body stereotyping, beliefs, lack of capacity-building for teaching staffs surrounded us with evidence that, more than breaking paradigms regarding people with disabilities, there must be advances in political practices, so that barriers such as prejudice, discrimination, and segregation cease to define human relationships.


Objetivo: conocer los aspectos abordados por la producción científica en relación con el tema de la inclusión de personas con discapacidad en las instituciones de enseñanza. Método: revisión integradora de la literatura en las bases de datos Medical Literature and Retrivial Sistem on Line, Web of science, SCOPUS y Directory of Open Access Journals. Recorte de búsqueda de 2015 a 2019. Resultados: se analizaron veintiún artículos. Las publicaciones presentaron temas relacionados con políticas de acceso, cuotas y currículos y Barreras y facilitadores de la inclusión en la educación. Consideraciones finales: los aspectos abordados por la producción científica mostraron que los obstáculos son transversales a la vivencia de los estudiantes en sus experiencias académicas. Lagunas curriculares, estereotipos del cuerpo, creencias, falta de formación del profesorado nos rodean con evidencias de que, más allá de romper paradigmas ante las personas con discapacidad, son necesarios avances en las prácticas políticas para que barreras como el prejuicio, la discriminación y la segregación no definan las relaciones humanas.

4.
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
5.
BMC Health Serv Res ; 21(1): 1066, 2021 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-34625071

RESUMEN

BACKGROUND: The Evidence-Based Policymaking (EBP) process in Nepal is rife with poor practices where often policymakers are portrayed as perpetrators for such practices. However, we need to think of the EBP as a two-sided coin where both research pull and research push play equally significant roles. This study aimed to assess the perception of Nepalese health policymakers and researchers on EBP and identify appropriate mechanisms to integrate evidence into policies. METHODS: Following the constructivist philosophical paradigm, qualitative research design was used in the study with the grounded theory approach. Purposive sampling was performed, and the 12 in-depth interviews were conducted, where number of interviews was finalized using saturation theory. All interviews were audio-recorded, transcribed, translated to English, coded line by line, and then developed into themes. Thematic analysis technique was used to manually analyze the data. RESULTS: Study participants highlighted that evidence is being utilized during policy formulation but not in the amount it should be, with a preference for anecdotal evidence further reducing the chance. Apart from these barriers, poor credibility of information obtained, poorly targeted dissemination, inadequate policy-based researches, and policymakers and researchers operating within the spheres of their own with a feeble link to channel the flow of information between them were identified by participants. On the other hand, the publication of one-pager research brief, conduction of nationally representative surveys especially quantitative studies, the practice of cost-effectiveness study, and policymaker's involvement during the research were some facilitators identified. CONCLUSIONS: Moreover, the study accentuates that better communication strategies such as the establishment of formal forums with policymakers and researchers, better-targeted dissemination, and identification of priority areas have wide potential to promote a unified front of health policymakers and researchers for EBP.


Asunto(s)
Política de Salud , Formulación de Políticas , Humanos , Nepal , Investigación Cualitativa , Investigadores
6.
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
7.
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
8.
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
9.
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
10.
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
11.
Cad Saude Publica ; 37(10): e00202220, 2021.
Artículo en Portugués | MEDLINE | ID: mdl-34644758

RESUMEN

This study's objective was to estimate the association between self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents in Brazilian workers. This was a cross-sectional study with data from the Brazilian National Health Survey (PNS-2013). The dependent variable was self-reported hearing impairment, and three principal exposures were analyzed: noise, industrial dust, and chemical substances. Logistic regression was performed, estimating crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI). The principal exposure variables were adjusted for each other and by covariables sex, age, workplace, time on the job, and hypertension. 36,442 workers participated in the study. Higher prevalence of hearing impairment was seen in workers exposed to industrial dust (9.9%) (p < 0.001). The older the worker and the longer the time on the job, the higher the prevalence of hearing impairment (p < 0.001). In the adjusted analysis, workers exposed to noise showed 1.65 higher odds of reporting difficulty hearing, when compared to unexposed individuals (p < 0.001). The same was true for workers exposed to industrial dust (OR = 1.36) (p = 0.012). No association was observed between the outcome and exposure to chemical substances (p = 0.120). There was an association between hearing impairment and occupational exposure to noise and industrial dust in Brazilian workers. This emphasizes the importance of strengthening public policies for hearing health and the development of measures for prevention and auditory monitoring in the workplace.

12.
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
13.
Artículo en Español | PAHO-IRIS | ID: phr-54981

RESUMEN

[RESUMEN]. Con millones de personas en el mundo en situación de distanciamiento físico por el COVID-19, las tecnologías de la información y comunicaciones (TICs) se han posicionado como uno de los medios principales de interacción y colaboración. Ya al inicio de este milenio se empezaban a mencionar las siguientes ventajas: mayor acceso a la información y a la prestación de servicios; fortalecimiento educativo; control de calidad de los programas de detección y reducción de los costos de la atención de en salud. Sin embargo, entre las principales barreras de adopción de la telemedicina se encuentran las de índole: tecnológicas; humanas y sociales; psicosociales y antropológicas; de Gobernanza y económicas. En estos 20 años se logró un aumento en los recursos y capacidad técnica, una mejora en la educación digital, un empoderamiento del paciente en su tratamiento y un mayor interés público en esta área. En especial se considera exitosa la conformación de equipos interdisciplinarios, las redes académicas y profesionales y las consultas médicas virtuales. Después de revisar el estado de la telemedicina en la Región de las Américas, los autores recomiendan adoptar medidas urgentes para poner en práctica políticas y programas nacionales de telemedicina, incluyendo el marco normativo y presupuesto necesario, cuya implementación se realice de manera integral e interoperable y que se sustente de redes académicas, de colaboración e instituciones especializadas. Dichas políticas deben generar un contexto habilitante que den sostenibilidad al avance logrado, considerando los aspectos mencionados en las posibles barreras.


[ABSTRACT]. With millions of people in the world in situations of physical distancing because of COVID-19, information and communication technology (ICT) has become as one of the principal means of interaction and collaboration. The following advantages of ICT have been cited since the start of the new millennium: increased access to information and service delivery, educational strengthening, quality control of screening programs, and reduction of health care costs. In the case of telemedicine, however, a number of barriers—especially technological, human and social, psychosocial, anthropological, economic, and governance-related—have stood in the way of its adoption. The past 20 years have seen an increase in the availability of resources and technical capacity, improvements in digital education, empowerment of patients regarding their treatment, and increased public interest in this area. Successes have included the use of interdisciplinary teams, academic and professional networking, and virtual medical consultations. After reviewing the state of telemedicine in the Region of the Americas, the authors recommend the urgent adoption of measures aimed at implementing national telemedicine policies and programs, including a regulatory framework and adequate funding. Implementation of the measures should be integrated and interoperable and include the support of academic networks and the collaboration of specialized institutions. The policies should generate an enabling context that ensures sustainability of the progress achieved, bearing in mind the possible barriers mentioned.


[RESUMO]. Com milhões de pessoas no mundo em situação de distanciamento físico devido à COVID-19, as tecnologias da informação e comunicação (TICs) se enquadraram como um dos meios principais de interação e colaboração. Já no início deste milênio, começaram a ser mencionadas as seguintes vantagens: maior acesso à informação e à prestação de serviços; fortalecimento da educação; controle de qualidade dos programas de detecção e redução dos custos na atenção à saúde. No entanto, entre as principais barreiras de adoção da telemedicina se encontram as de caráter: tecnológico; humano e social; psicossocial e antropológico; de governança e econômico. Nestes 20 anos, houve um aumento nos recursos e na capacidade técnica, uma melhora na educação digital, um empoderamento do paciente em seu tratamento e um maior interesse público nessa área. Em especial, são consideradas bem-sucedidas a constituição de equipes interdisciplinares e as redes acadêmicas e profissionais, e as consultas médicas virtuais. Após revisar o estado da telemedicina na Região das Américas, os autores recomendam a adoção de medidas urgentes para implementar políticas e programas nacionais de telemedicina, incluindo o marco normativo e o orçamento necessário. Essa implementação deve ser realizada de maneira integral e interoperável e sustentada por redes acadêmicas, de parceria e instituições especializadas. Tais políticas devem gerar um contexto favorável, dando sustentabilidade ao avanço obtido e considerando os aspectos mencionados nas possíveis barreiras.


Asunto(s)
Acceso a la Información , Comunicación , Práctica de Salud Pública , Salud Pública , Planificación en Salud , Telemedicina , Acceso a la Información , Comunicación , Salud Pública , Práctica de Salud Pública , Planificación en Salud , Telemedicina , Acceso a la Información , Comunicación , Salud Pública , Práctica de Salud Pública , Planificación en Salud
14.
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
15.
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
16.
Afr J Prim Health Care Fam Med ; 13(1): e1-e8, 2021 Sep 06.
Artículo en Francés | MEDLINE | ID: mdl-34636602

RESUMEN

The first-line physicians' practice in Kisangani city in Democratic Republic of Congo: Towards a typology. BACKGROUND: In the Democratic Republic of the Congo (DRC), for a number of years, there has been a spontaneous and growing phenomenon of physicians operating at the front line of the health system, while this role is traditionally devolved to nurse-practitioners. This phenomenon does not align with the current health policy. AIM: The aim of this paper is to develop and discuss the main types of frontline physicians in the city of Kisangani. SETTING: We conducted a descriptive cross-sectional study in two urban districts in the city of Kisangani. METHODS: The study population consisted of all first-line health facilities that employed at least one physician. The construction of a typology of first-line physicians consisted of three stages: identification and definition of relevant dimensions of analysis; grouping cases based on empirical data; and analysis of significant relationships and establishment of the typology itself. RESULTS: An involvement of physicians in healthcare delivery at the first line was observed in 60% of all first line facilities in the two urban districts. Two main types of first-line physicians were identified: firstly, and by large the most prevalent one (96% of cases), the 'hospital-like physician', and secondly, the much less frequent type of the 'supervision physician'. CONCLUSION: The involvement of physicians in first line healthcare is today a growing phenomenon in the DRC, especially in urban areas. The most dominant expression of this phenomenon is a transposition of the hospital-based physician model to the first line healthcare services, which thereby jeopardizing the specificity of first line healthcare.


Asunto(s)
Atención a la Salud , Instituciones de Salud , Congo , Estudios Transversales , Política de Salud , Humanos
17.
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
18.
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
19.
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
20.
Pan Afr Med J ; 39: 99, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34466201

RESUMEN

Introduction: the provision of basic diagnostic imaging services is pivotal to achieving universal health coverage. An estimated two-thirds of the world's population have no access to basic diagnostic imaging. Accurate data on current imaging equipment resources are required to inform health delivery strategy and policy at national level. This is an audit of Zimbabwean public sector diagnostic ultrasound resources and services. Methods: utilising the Ministry of Health and Child Care (MHCC) database, sequential interviews were conducted with provincial health authorities and local facility managers. Ultrasound equipment, personnel and services in all hospitals and clinics, nationally were recorded, collated, and analysed for the whole country, and by province. Results: of the 1798 Zimbabwean public sector healthcare facilities, sixty-six (n=66, 3.67%) have ultrasound equipment. Ninety-nine (n=99) ultrasound units are distributed across the sonar facilities, representing a national average of 8 units per million people. More than half the equipment units (n=53, 54%) are in secondary-level healthcare facilities (district and mission hospitals), and approximately one-fifth (n=22, 22%) in the central hospitals (quaternary level). The best-resourced province has twice the resources of the least resourced. One-hundred and forty-two (n=142) healthcare workers, from six different professional groups, provide the public sector ultrasound service. Most facilities with sonar equipment (n=64/66, 97%) provide obstetrics and gynaecology services, while general abdominal scanning is available at one third (n=22, 33%). Two facilities with ultrasound equipment have no capacity to offer a sonography service. Conclusion: in order to reach the WHO recommendation of 20 sonar units per million people, an estimated 140 additional sonar units are required nationally. The need is greatest in Masvingo, Midlands and Mashonaland East Provinces. Task-shifting plays a key role in the provision of Zimbabwean sonar services. Consideration should be given to formal training and accreditation of all healthcare workers involved in sonar service delivery.


Asunto(s)
Atención a la Salud/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Ultrasonografía/estadística & datos numéricos , Bases de Datos Factuales , Instituciones de Salud/estadística & datos numéricos , Política de Salud , Humanos , Sector Público , Cobertura Universal del Seguro de Salud , Zimbabwe
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