Organización y administración de los programas de control de las enfermedades transmisibles en los países en desarrollo
Organization and administration of communicable disease control programs in developing countrie
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s.d., 1980
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Para ser eficaz, la extensión de los servicios de atención primaria de salud que contengan un componente de enfermedades transmisibles se debe coordinar correctamente con los especialistas en enfermedades transmisibles responsables de esas actividades. El fracaso común en lograr dicha coordinación indica una necesidad importante y un peligro: el peligro de que el deterioro del control de las enfermedades transmisibles pueda producir una gran decepción respecto al concepto de atención integrada de salud (AU)
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Item Integrated approach for noncommunicable disease management in the Americas(2022)[ABSTRACT]. An overview of an integrated approach to improve noncommunicable disease (NCD) management is pre- sented, along with tools on integrating NCD management as part of health system strengthening in the Americas. The study is based on an analysis of Pan American Health Organization/World Health Organization (PAHO/WHO) data and publicly available information on NCD care and capacity, disruptions in NCD services, and guidance on NCD management. Gaps in NCD care are highlighted, in which an estimated 43.0% of men and 28.0% of women with hypertension in Latin America remain undiagnosed; and for those with diabetes, 32.8% in Central and South America are undiagnosed. Yet, only 17/35 countries (49%) in the Americas report having evidence-based national guidelines for NCD management through a primary care approach and only 7/35 countries (20%) report provision of drug therapy, including glycaemic control for eligible persons. To improve NCD management, an integrated approach is needed to coordinate and deliver care across the levels of the health system. This includes increasing primary care capacity and competencies to address multiple chronic conditions, and integration with other complementary programs to avoid missing opportunities for NCD diagnosis and management. An integrated approach to NCD management, and implementation of avail- able tools, should be part of rebuilding health systems after the COVID-19 pandemic.Item A cross-sectional analysis of investigator needs for non-communicable disease research at the University of the West Indies, Mona(2021)[ABSTRACT]. Objective. To describe the needs of academic staff conducting non-communicable disease (NCD) research at the University of the West Indies, Mona Campus in Jamaica. Methods. Utilizing a cross-sectional design an online survey was created using the research electronic data capture application (REDCap); it was disseminated via email to 708 academic staff members in the Faculties of Medical Sciences and Science & Technology between September and November 2018. Participants were asked to indicate their level of access to expertise, training and equipment for conducting research. Descriptive analysis was conducted using STATA version 14. Results. Most respondents were women (74.2%), predominantly scientists (33.1%) or specialist physicians (22.6%). Less than 2/3 of respondents reported publishing research findings in peer reviewed journals, with a quarter not disseminating their research findings in any medium. Resources for field research/data collection, epidemiological methods and principles, and data management/data analysis were generally available. However, there was limited access to training, expertise and equipment in emerging techniques for NCD research such as metabolomics, bioinformatics/analysis of large-scale data sets and health economics. Additional challenges included limited access to financing for research, inadequate workspace and poor administrative support for conducting research. Conclusions. There is a need for more local research seed funding, stronger administrative support for researchers, and opportunities for training in cutting edge NCD research techniques. Jamaican researchers could benefit from being part of a regional research centre of excellence with critical research skills and equipment that builds research networks and strengthens the NCD research response.Item Patrones de utilización de la atención de salud en países en desarrollo: Función del medio tecnológico en la derivación de la demanda de atención de salud(1993)Los servicios de atención sanitaria, junto con varios factores intermedios (mediatos) que determinan la salud, como el saneamiento ambiental y la nutrición, influyen en el estado de salud en forma directa. En las publicaciones de economía a esto se le llama tecnología productora de salud. Aunque en muchos estudios se reconoce que la demanda de atención depende de esta tecnología, llamada también demanda "derivada", esta revisión demuestra que hasta ahora son pocos los estudios que han podido incorporar dicha tecnología plenamente a la hora de estimar los principales factores que determinan el uso de servicios de atención sanitaria. Si se comprende el medio tecnológico es posible explicar hasta cierto punto por qué gran parte de la población carece de acceso a la atención de salud, aun cuando los factores financieros no parecen constituir una barrera. Además, la poca utilización de los servicios de salud puede ser sencillamente un indicio de la baja productividad de los mismos cuando faltan otros factores complementarios, como la nutrición, el agua limpia y el saneamiento. Por último, la tecnología productora de salud es a menudo un proceso polietápico (de consultas múltiples). Los estudios sobre la demanda de atención sanitaria describen de forma incompleta los patrones de utilización de los servicios pertinentes porque se concentran en un solo acontecimiento, como la primera consulta por un episodio de enfermedad. Los investigadores deben de obtener información más completa sobre la interación de todos los factores que inciden en la producción de la salud, así como la disponibilidad y accesibilidad de los mismos. Las metodologías multidisciplinarias pueden ser útiles para este fínItem Lessons learned from the implementation of integrated serosurveillance of communicable diseases in the Americas(2023)[ABSTRACT]. Objective. Systematize the experience and identify challenges and lessons learned in the implementation of an initiative for integrated serosurveillance of communicable diseases using a multiplex bead assay in coun- tries of the Americas. Methods. Documents produced in the initiative were compiled and reviewed. These included concept notes, internal working papers, regional meetings reports, and survey protocols from the three participating countries (Mexico, Paraguay, and Brazil) and two additional countries (Guyana and Guatemala) where serology for sev- eral communicable diseases was included in neglected tropical diseases surveys. Information was extracted and summarized to describe the experience and the most relevant challenges and lessons learned. Results. Implementing integrated serosurveys requires interprogrammatic and interdisciplinary work teams for the design of survey protocols to respond to key programmatic questions aligned to the needs of the countries. Valid laboratory results are critical and rely on the standardized installment and roll-out of laboratory tech- niques. Field teams require adequate training and supervision to properly implement survey procedures. The analysis and interpretation of serosurveys results should be antigen-specific, contextualizing the responses for each disease, and triangulated with programmatic and epidemiological data for making decisions tailored to specific population socioeconomic and ecologic contexts. Conclusions. Integrated serosurveillance as a complementary tool for functional epidemiological surveil- lance systems is feasible to use and key components should be considered: political engagement, technical engagement, and integrated planning. Aspects such as designing the protocol, selecting target populations and diseases, laboratory capacities, anticipating the capacities to analyze and interpret complex data, and how to use it are key.Item Economics of Noncommunicable Diseases(2018)[ABSTRACT]. The global health burden of noncommunicable diseases (NCDs) is large and growing, and this group of diseases already accounts for 70% of total deaths. Global evidence indicates that the high health burden of NCDs translates into significant economic and social costs that threaten to diminish the quality of life of millions of individuals, impoverish families, jeopardize universal health coverage, and increase health disparities within and between countries. Evidence consistently shows that the NCD epidemic cannot be tackled through interventions and policies in the health sector alone. In particular, prevention measures that address NCD risk factors involve a range of sectors including finance, trade, education, agriculture, and transportation. As economics has become the common language among decision makers across sectors, it is imperative that health authorities leverage economic information to more effectively communicate the urgency of tackling NCDs and related risk factors. This thematic issue of the Pan American Journal of Public Health makes economic evidence available in the Americas to assist countries in integrating economic approaches into their NCD prevention and control policies.