biblioteca virtual en salud

BVS - Literatura Cientifica y Técnica

 

Historico de búsqueda  ()

Su selección  ()

Collapse All  Ocultar
Expand All  Mostrar
Tipo
Texto completo (237)
Idioma
Año
Resultados  1-10 de 758
Enviar resultado
adicionar en sua lista
1.

Plan andino de salud y cambio climático 2020-2025

Organización Panamericana de la Salud; Organismo Andino de Salud-Convenio Hipólito Unanue
| Idioma(s): Español
El Plan andino de salud y cambio climático 2020-2025 establece las acciones necesarias para aumentar la resiliencia de los países andinos a la variabilidad y el cambio climático, proteger la salud de su población y conducir la región hacia un futuro sostenible. Este plan ha sido elaborado por el Organismo Andino de la Salud–Convenio Hipólito Unanue (ORAS-CONHU), en colaboración con la Organización Panamericana de la Salud (OPS), a través de un proceso participativo con los Ministerios de Salud de los países andinos y, por supuesto, el Comité Andino de Salud para la Gestión del Riesgo de Emergencias y Desastres y el Cambio Climático, así como representantes de otras entidades como los Ministerios de Ambiente. El documento, aprobado por los Ministros de Salud de Bolivia (Estado Plurinacional de), Chile, Colombia, Ecuador, Perú y Venezuela (República Bolivariana de) el 16 de abril del 2020, proporciona estrategias para la gestión integral del cambio climático, la intensificación de las redes de cooperación y la integración de los países andinos a través de cuatro líneas estratégicas: trabajo intrasectorial, intersectorial e interdisciplinario; vigilancia del riesgo y la vulnerabilidad; investigación para incidir en políticas públicas; y mitigación y adaptación. Este documento toma como base los Objetivos de Desarrollo Sostenible y la Agenda de Desarrollo Sostenible 2030, el Acuerdo de París de la Convención Marco de las Naciones Unidas sobre el Cambio Climático (CMNUCC), el Marco de Sendái para la Reducción del Riesgo de Desastres, y las propias políticas y planes de los países andinos relacionadas con la gestión del cambio climático, todos coincidentes en la necesidad de generar distintos modos de producción y de consumo, basados en el respeto a la naturaleza como requisito para avanzar en el bienestar social.
adicionar en sua lista
2.

Los últimos pueblos indígenas aislados en América del Sur (Bolivia, Brasil, Colombia, Ecuador, Paraguay, Perú y Venezuela): entre la protección de sus derechos humanos y su papel en la conservación de los bosques tropicales para la década 2020-2030/ The last uncontacted indigenous peoples in South America (Bolivia, Brazil, Colombia, Ecuador, Paraguay, Peru and Venezuela): between the protection of their human rights and their role in the conservation of tropical forests for the decade 2020-2030

Brackelaire, Vincent
;
| Idioma(s): Español
Hasta el momento se han identificado por lo menos 58 pueblos indígenas en aislamiento, sin voluntad de contacto con otros pueblos o con la sociedad circundante, entre Bolivia, Brasil, Colombia, Ecuador, Paraguay, Perú y Venezuela (y específicamente en dos regiones, la Cuenca Amazónica y el Gran Chaco), países en los que también existe un cierto número de pueblos en contacto inicial o contacto intermitente. En América del Sur son llamados Pueblos Indígenas en Aislamiento o en Contacto Inicial (PIACI). Su protección y sobrevivencia están relacionados con el desafío de salvaguardar los territorios más ricos del mundo en biodiversidad de intereses extractivistas de todo tipo, generalmente ilegales y destructivos. El mantenimiento de las formas de vida de estos pueblos que son los más vulnerables del planeta, contribuye directamente a la conservación de los recursos naturales y a la lucha contra los cambios climáticos en los extensos territorios por donde se desplazan. En pocos años, los 7 países avanzaron en la construcción de políticas y normativas de protección de sus PIACI, pero se enfrentan ahora a los desafíos de su implementación, en particular frente a los Objetivos del Milenio y la Agenda 2030. En este sentido, la cooperación entre los países amazónicos ayuda a desarrollar los instrumentos necesarios para su protección, desde sistemas para buscar informaciones sobre ellos y confirmarlas, la implementación de figuras territoriales adecuadas en medio de la depredación amazónica, hasta la definición de protocolos de contacto y medidas de salud específicas para su sobrevivencia. Este estudio presenta una sistematización de la situación de los PIACI en el 2020, los resultados hasta hoy de la estrategia de protección en cada país y los desafíos pendientes para consolidar políticas y recursos durante la próxima década que garanticen la intangibilidad de los territorios que ocupan, en interés de su bienestar y su papel para el futuro del planeta.
adicionar en sua lista
3.

Efectos de la afiliación al Seguro Social General en el Gasto de Bolsillo en Salud de los hogares. Ecuador 2014/ Effects of affiliation to General Social Security on household out-of-pocket health spending. Ecuador 2014

Suin Guaraca, Luis Heriberto; Saetama Flores, Tatiana Rosibe
| Idioma(s): Español
Introducción: La seguridad social se fundamenta en la entrega oportuna de servicios de salud, evitando la falta de protección y el empobrecimiento de las familias que se asocia de manera directa con excesivos gastos de bolsillo. Objetivo: Estimar el efecto que tiene la afiliación al Seguro Social General (SSG) en el Gasto de Bolsillo en Salud (GBS) en los hogares ecuatorianos para el año 2014. Metodología: El efecto se estimó mediante el análisis estadístico Propensity Score Matching y utilizando el programa Stata, sobre una muestra de 22,364 observaciones, de las cuales 7,509 son tratadas ­ hogares afiliados al SSG ­ y 14,855 son de control ­ hogares sin ningún tipo de afiliación ­, datos tomados de la encuesta de Condiciones de Vida realizada por el INEC para el año 2014. Como variable de resultado se utilizó a los gastos de bolsillo y como variable de tratamiento a los hogares en los que al menos, el jefe del hogar este afiliado al Seguro Social General. Resultados: Se encontró un efecto positivo entre la condición de afiliados al SSG y el GBS de los hogares, el afiliado tiene una propensión a realizar mayores gastos privados en salud que el no afiliado, incrementándose aún más si el jefe del hogar es de sexo masculino. Para los dos sexos, la similitud es únicamente en la covariable ingresos, sin embargo, cuando el jefe de hogar es de sexo femenino, las covariables significativas se incrementan. Conclusiones: Los afiliados al SSG muestran un incremento en los GBS lo que significaría una falta de protección financiera a pesar de los aportes mensuales realizados a la seguridad social. Introduction: Social security is based on the timely delivery of health services, avoiding the lack of protection and impoverishment of families that is directly associated with excessive health expenditures. Objective: To estimate the effect that the General Social Security (SSG) affiliation has on Pocket Health Expenditure (GBS) in Ecuadorian households for the year 2014. Methodology: The effect was estimated using the Propensity Score Matching method and using the Stata program, on a sample of 22,364 observations, and only 7,509 are treated - SSG affiliated households - and 14,855 are control - households without any affiliation - data were taken from the Life Conditions survey conducted by the INEC for the year 2014. Health expenditures was used as result variable and households in which at least the head of the household is affiliated to General Social Security was used as treatment variable. Results: A positive effect was found between the condition of members of the SSG and the GBS of the households, the affiliate has a propensity to make higher private health expenses than the unaffiliated, increasing even more if the head of the household is male. For both sexes, the similarity is only in the income covariate, however, when the head of the household is female, the significant covariates increase. Conclusions: The members of the SSG show an increase in the GBS which would mean a lack of financial protection despite the monthly contributions made to social security.
adicionar en sua lista
4.

Developing a deprivation index to study geographical health inequalities in Ecuador.

Peralta, Andrés; Espinel-Flores, Verónica; Gotsens, Mercè; Pérez, Glòria; Benach, Joan; Marí-Dell'Olmo, Marc
| Idioma(s): Inglés
OBJECTIVES: To develop a deprivation index to study health inequalities in 221 areas of Ecuador, to describe the pattern of deprivation in Ecuador, and to explore the applications of the index to study health inequalities by analysing the association between deprivation and mortality in the study areas. METHODS: We performed principal component analyses of available indicators of the 221 cantons of Ecuador. A set of 41 sociodemographic, social capital, and subjective well-being variables were obtained from the 2010 National Population Census and the National Living Conditions Survey 2013-2014. To explore the application of the index in public health, the association between the index and standardised mortality ratios was estimated through a Poisson regression model. RESULTS: The final index was constructed with 17 indicators. The first component explained 51.8% of the total variance of the data. A geographic pattern and a positive association of the index with the standardised mortality ratios of the cantons were observed in both men and women. CONCLUSIONS: We constructed a deprivation index that can identify disadvantaged areas in Ecuador. This index could be a valuable tool for the detection of vulnerabilised populations and the development of interventions and policies adapted to local needs.
adicionar en sua lista
5.

Long-Term Outcomes of a Cohort of Hypertensive Subjects in Rural Ecuador.

Moreira, Juan; Figueroa, Monica Marquez; Anselmi, Mariella; Prandi, Rosanna; Montaño, Cintia Caicedo; Bell, Damon; Betancour, Oscar; Robusto, Fabio; Vannini, Tommaso; Avanzini, Fausto; Tognoni, Gianni; Roncaglioni, Maria Carla
| Idioma(s): Inglés
BACKGROUND: In contrast with the abundance of global epidemiological descriptive data on cardiovascular diseases and their risk factors, information on the outcomes of real populations prospectively followed up in their life and care settings is much rarer, especially in low-income countries. OBJECTIVES: This study sought to evaluate the feasibility and the overall results of a hypertension control program, based mainly on a network of community nonprofessional health promoters, in the poor rural region of Borbon (Ecuador). METHODS: This is a prospective cohort study describing the results of a program of hypertension diagnosis, treatment and follow-up from 2004 to 2015 in the area, carried out mainly by the health promoters. RESULTS: The number of hypertensive patients identified and followed over the years increased from 1,024 in 2004 to 1,733 in 2015. The percentage of patients with no visits during a year was reduced to <10%, whereas the proportion of hypertensive subjects attending all 4 scheduled annual checks approached and, in some years, exceeded 50%. From 2004 to 2015, the proportion of patients at high or very high cardiovascular risk progressively decreased from 26.6% in 2004 to 17.5% in 2015 (p for trend <0.01), whereas the proportion of hypertensive patients at low or very low risk increased from 30.4% in 2004 to 45.0% in 2015 (p for trend <0.01). CONCLUSIONS: In a poor, disadvantaged area, a strategy of control mainly based on the involvement and responsibility of community health promoters (with health professionals as supporters more than direct actors) can achieve adequate follow-up of the population of hypertensive patients and improve their global cardiovascular risk level.
adicionar en sua lista
6.

Estrategias para la atención comunitaria orientada a grupos vulnerables en Ecuador/ Strategies for community care aimed at vulnerable groups in Ecuador

Peraza de Aparicio, Cruz Xiomara; Fonseca Borges, Tania; Inda Mariño, Sandra
| Idioma(s): Español
RESUMEN Las propuestas de modelos de atención comunitaria se sustentan fundamentalmente en la necesidad de estandarizar el lenguaje y la acción de los profesionales en cuanto a la articulación de las diferentes organizaciones y grupos de individuos presentes en la comunidad, en aras del resguardo de su salud. El estudio pretende comentar las estrategias orientadas al abordaje comunitario de carácter inclusivo para la atención de grupos vulnerables. Para ello se hace revisión de los temas desigualdad y vulnerabilidad, claves en la Agenda 2030. En escenarios como las comunidades rurales del Ecuador, la estrategia de atención comunitaria potencia acciones sobre problemas y necesidades de salud detectados como prevalentes, a través de actividades locales dirigidas a promover la salud e incrementar la calidad de vida de los pobladores. ABSTRACT The proposals of community care models are fundamentally based on the need to standardize the language and action of professionals regarding the articulation of different organizations and groups of individuals present in the community, in order to protect their health. The objective of this study is to comment on strategies aimed at an inclusive community approach for the attention of vulnerable groups. To do this, we review the issues of inequality and vulnerability, key in the 2030 Agenda. In scenarios such as rural communities in Ecuador, the community care strategy promotes actions on health problems and needs detected as prevalent, through local activities targeted at promoting health and increasing the quality of life of the inhabitants.
adicionar en sua lista
7.

Universal Health Coverage in Marginalized Populations: A Qualitative Evaluation of a Health Reform Implementation in Rural Ecuador.

Eckhardt, Martin; Carlfjord, Siw; Faresjö, Tomas; Crespo-Burgos, Antonio; Forsberg, Birger C; Falk, Magnus
| Idioma(s): Inglés
In 2008, Ecuador underwent a major health reform with the aim of universal coverage. Little is known about the implementation of the reform and its perceived effects in rural parts of the country. The aim of this study was to explore the perceived effects of the 2008 health reform implementation, on rural primary health care services and financial access of the rural poor. A qualitative study using focus group discussions was conducted in a rural region in Ecuador, involving health staff, local health committee members, village leaders, and community health workers. Qualitative content analysis focusing on the manifest content was applied. Three categories emerged from the texts: (1) the prereform situation, which was described as difficult in terms of financial access and quality of care; (2) the reform process, which was perceived as top-down and lacking in communication by the involved actors; lack of interest among the population was reported; (3) the effects of the reform, which were mainly perceived as positive. However, testimonies about understaffing, drug shortages, and access problems for those living furthest away from the health units show that the reform has not fully achieved its intended effects. New problems are a challenging health information system and people without genuine care needs overusing the health services. The results indicate that the Ecuadorean reform has improved rural primary health care services. Still, the reform faces challenges that need continued attention to secure its current achievements and advance the health system further.
adicionar en sua lista
8.

Drinking water quality in areas impacted by oil activities in Ecuador: Associated health risks and social perception of human exposure.

Maurice, Laurence; López, Fausto; Becerra, Sylvia; Jamhoury, Hala; Le Menach, Karyn; Dévier, Marie-Hélène; Budzinski, Hélène; Prunier, Jonathan; Juteau-Martineau, Guilhem; Ochoa-Herrera, Valeria; Quiroga, Diego; Schreck, Eva
| Idioma(s): Inglés
The unregulated oil exploitation in the Northern Ecuadorian Amazon Region (NEAR), mainly from 1964 to the 90's, led to toxic compounds largely released into the environment. A large majority of people living in the Amazon region have no access to drinking water distribution systems and collects water from rain, wells or small streams. The concentrations of major ions, trace elements, PAHs (polycyclic aromatic hydrocarbons) and BTEX (benzene, toluene, ethylbenzene, xylenes) were analyzed in different water sources to evaluate the impacts of oil extraction and refining. Samples were taken from the NEAR and around the main refinery of the country (Esmeraldas Oil Refinery/State Oil Company of Ecuador) and were compared with domestic waters from the Southern region, not affected by petroleum activities. In most of the samples, microbiological analysis revealed a high level of coliforms representing significant health risks. All measured chemical compounds in waters were in line with national and international guidelines, except for manganese, zinc and aluminum. In several deep-water wells, close to oil camps, toluene concentrations were higher than the natural background while PAHs concentrations never exceeded individually 2 ng·L-1. Water ingestion represented 99% of the total exposure pathways for carcinogenic and non-carcinogenic elements (mainly zinc) in adults and children, while 20% to 49% of the Total Cancer Risk was caused by arsenic concentrations. The health index (HI) indicates acceptable chronic effects for domestic use according the US-EPA thresholds. Nevertheless, these limits do not consider the cocktail effects of metallic and organic compounds. Furthermore, they do not include the social determinants of human exposure, such as socio-economic living conditions or vulnerability. Most (72%) of interviewed families knew sanitary risks but a discrepancy was observed between knowledge and action: religious beliefs, cultural patterns, information sources, experience and emotions play an important role front to exposure.
adicionar en sua lista
9.

Home improvement and system-based health promotion for sustainable prevention of Chagas disease: A qualitative study.

Nieto-Sanchez, Claudia; Bates, Benjamin R; Guerrero, Darwin; Jimenez, Sylvia; Baus, Esteban G; Peeters Grietens, Koen; Grijalva, Mario J
| Idioma(s): Inglés
BACKGROUND: Human transmission of Chagas disease (CD) most commonly occurs in domiciliary spaces where triatomines remain hidden to feed on blood sources during inhabitants' sleep. Similar to other neglected tropical diseases (NTDs), sustainable control of CD requires attention to the structural conditions of life of populations at risk, in this case, the conditions of their living environments. Considering socio-cultural and political dynamics involved in dwellings' construction, this study aimed to explore social factors that contribute or limit sustainability of CD's prevention models focused on home improvement. METHODS AND MAIN FINDINGS: Using Healthy Homes for Healthy Living (HHHL)-a health promotion strategy focused on improvement of living environments and system-based health promotion-as a reference, a qualitative study was conducted. Research participants were selected from three rural communities of a CD endemic region in southern Ecuador involved in HHHL's refurbishment and reconstruction interventions between 2013 and 2016. Folowing an ethnographic approach, data were collected through interviews, participant observation, informal conversations and document analysis. Our results indicate that the HHHL model addressed risk factors for CD at the household level, while simultaneously promoting wellbeing at emotional, economic and social levels in local communities. We argue that sustainability of the CD prevention model proposed by HHHL is enhanced by the confluence of three factors: systemic improvement of families' quality of life, perceived usefulness of control measures, and flexibility to adapt to emerging dynamics of the context. CONCLUSION: HHHL's proposed home improvement, facilitated through system-based rather than disease specific health promotion processes, enhances agency in populations at risk and facilitates community partnerships forged around CD prevention. Although an independent analysis of cost-effectiveness is recommended, structural poverty experienced by local families is still the most important factor to consider when evaluating the sustainability and scalability of this model.
adicionar en sua lista
10.

Geographic shifts in Aedes aegypti habitat suitability in Ecuador using larval surveillance data and ecological niche modeling: Implications of climate change for public health vector control.

Lippi, Catherine A; Stewart-Ibarra, Anna M; Loor, M E Franklin Bajaña; Zambrano, Jose E Dueñas; Lopez, Nelson A Espinoza; Blackburn, Jason K; Ryan, Sadie J
| Idioma(s): Inglés
Arboviral disease transmission by Aedes mosquitoes poses a major challenge to public health systems in Ecuador, where constraints on health services and resource allocation call for spatially informed management decisions. Employing a unique dataset of larval occurrence records provided by the Ecuadorian Ministry of Health, we used ecological niche models (ENMs) to estimate the current geographic distribution of Aedes aegypti in Ecuador, using mosquito presence as a proxy for risk of disease transmission. ENMs built with the Genetic Algorithm for Rule-Set Production (GARP) algorithm and a suite of environmental variables were assessed for agreement and accuracy. The top model of larval mosquito presence was projected to the year 2050 under various combinations of greenhouse gas emissions scenarios and models of climate change. Under current climatic conditions, larval mosquitoes were not predicted in areas of high elevation in Ecuador, such as the Andes mountain range, as well as the eastern portion of the Amazon basin. However, all models projected to scenarios of future climate change demonstrated potential shifts in mosquito distribution, wherein range contractions were seen throughout most of eastern Ecuador, and areas of transitional elevation became suitable for mosquito presence. Encroachment of Ae. aegypti into mountainous terrain was estimated to affect up to 4,215 km2 under the most extreme scenario of climate change, an area which would put over 12,000 people currently living in transitional areas at risk. This distributional shift into communities at higher elevations indicates an area of concern for public health agencies, as targeted interventions may be needed to protect vulnerable populations with limited prior exposure to mosquito-borne diseases. Ultimately, the results of this study serve as a tool for informing public health policy and mosquito abatement strategies in Ecuador.
Resultados  1-10 de 758