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Objetivo. Describir el impacto del nuevo modelo de actuación que Paraguay implementó en cincos distritos de la Región Central en el último trimestre del 2023, con base en una estrategia integrada desde los servicios de salud para recuperar coberturas con la vacuna trazadora en menores de un año (pentavalente hasta abril del 2023 y hexavalente desde entonces), y la vacuna contra sarampión, parotiditis y rubéola (SPR) para la población de un año. Método. Estudio descriptivo de corte transversal con análisis comparativo entre el período previo (semanas epidemiológicas [SE] 1 y 34 de 2023) y posterior (SE 35 y 52 de 2023) a la intervención de tres indicadores: a) coberturas con las tres dosis de pentavalente o hexavalente, y primera y segunda dosis de SPR; b) productividad en la administración de la tercera dosis de pentavalente o hexavalente y; c) tasas de deserción en la vacunación con pentavalente o hexavalente y SPR. Resultados. Con la intervención, la cobertura promedio semanal con la tercera dosis de pentavalente o hexavalente fue de 1,2%, con un incremento del promedio de 1,0% registrado preintervención. En comparación con el 2022, en el 2023 se incrementó la cobertura con la tercera dosis de vacuna pentavalente o hexavalente en 3,5%, mientras que el incremento con la primera y la segunda dosis de SPR fue de 32,7% y 4%, respectivamente. El promedio de dosis semanales de la tercera dosis de pentavalente o hexavalente se incrementó a 257, y superó las 215 dosis que se administraban previo a la intervención. La tasa de deserción con vacuna pentavalente o hexavalente pasó de 17,9% a 9,2%, mientras que la de SPR pasó de 55,0% a 46,5%. Conclusión. La implementación del nuevo modelo de actuación impactó positivamente en los indicadores, logrando detener la tendencia descendente de coberturas de vacunación registrados en los últimos años.

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The phytomedicine prescription should be carried out with the best clinical opinion. The quality of this process is fundamental to satisfy the users necessities. Objective: To evaluate the quality of phytomedicine prescription for third year comprehensive general medicine residents. Method: A descriptive and longitudinal investigation was carried out on the quality in health systems and services by means of an evaluation of 27 medicine residents and 81 patients of José Martí Pérez polyclinic from Santiago de Cuba, from March, 2021 to the same period in 2022. Theoretical methods as analysis-synthesis and inductive-deductive were used. Among the empiric methods, documental review, guides of observation of the prescribers performance and medical records audit were carried out, as well as interview to prescribers and users. Results: The availability of human resources was adequate; nevertheless, of the 16 criteria evaluated on material resources, just 3 reached the proposed indicator, while 13 (81.3 %) were inadequate. In connection with the knowledge on phytotherapy, 3 indicators exceeded the standard, but just 6 (22.2 %) of those interviewed responded correctly to the concept. The audit of medical records also showed inadequate results. The patients expressed higher satisfaction with the speed and treatment of the doctor; however, they manifested dissatisfaction regarding important ethical criteria in the professional practice. Conclusions: The quality of phytomedicine prescription for the third year comprehensive general medicine residents is inadequate. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El Sistema Indígena de Salud Propio e Intercultural (SISPI) aparece como una apuesta en política pública para materializar la salud intercultural en los territorios indígenas, de tal manera que, en el cuidado de la salud, se incluya la identidad cultural, los saberes y las prácticas medicinales tradicionales. En este trabajo, se analizó la manera como se está llevando a cabo la estructuración del SISPI en el departamento de Amazonas, teniendo en cuenta los avances, limitaciones y retos en los procesos organizativos. Para esto, se desarrollaron talleres en tres comunidades indígenas y se realizaron entrevistas semiestructuradas a los actores sociales (indígenas y estatales) involucrados en el tema de la salud. Se considera que, en el departamento de Amazonas, ha habido un avance en el desarrollo de la primera fase, relacionada con la caracterización sociocultural de los pueblos indígenas. Además, hay adelantos en la construcción del plan de acción para la implementación de este sistema. Si bien hay una noción básica del porqué y para qué se implementa el SISPI, aún no son claros los alcances de la salud propia bajo este sistema.

Introducción: la promoción de servicios de salud ha evolucionado en el tiempo significativamente, pasando de estrategias tradicionales a un auge significativo del uso de estrategias digitales de calidad. A nivel mundial, varias naciones se destacan por su desarrollo en estrategias de promoción sobre todo países de Norteamérica y Europa, en América latina sobresalen Brasil, México y Colombia; Ecuador aún está en proceso de implementación de nuevas estrategias de promoción. Objetivo: analizar las estrategias de promoción en los servicios de salud, en la provincia de Santo Domingo de los Tsáchilas. Método: la investigación sobre estrategias de promoción en servicios de salud se desarrolló un con enfoque cuantitativo, descriptivo y de campo, con la técnica de la encuesta y como instrumento se usó el cuestionario. Resultados: se observó que las estrategias de promoción tradicional más utilizadas por las organizaciones de salud privadas para promocionar sus servicios son las relaciones públicas y la publicidad en radio y televisión; y que los establecimientos de salud utilizan en su mayoría las estrategias digitales en redes sociales y la promoción de contenidos para gestionar la promoción de sus productos y servicios. Conclusiones: al evaluar la percepción de efectividad de las estrategias de promoción tanto tradicionales como digitales aplicadas por las organizaciones de salud para publicitar sus servicios, se destaca la popularidad y efectividad de la promoción en redes sociales, la promoción de contenidos de valor y el email promoción como estrategias clave para llegar al público objetivo en el ámbito de la salud.

Introducción: La calidad de los servicios de salud es un elemento fundamental para mejorar el estado de salud de la población; uno de sus principales medidores es el nivel de satisfacción de los usuarios en relación con el servicio recibido. Objetivo: Identificar el nivel de satisfacción de los usuarios en relación con la calidad del servicio recibido en el área de consulta externa del centro de salud Cebadas. Métodos: Se realizó una investigación descriptiva y transversal. Universo constituido por 219 pacientes atendidos en el servicio de consulta externa. La muestra quedó conformada por 141 pacientes. A cada sujeto de investigación se le aplicó una encuesta para obtener información sobre las variables de investigación: características generales de los pacientes, nivel de satisfacción y factores que inciden en la calidad del servicio. Se utilizó la prueba de t de Student para determinar significación de los resultados. Resultados: Promedio de edad de 48,38 años, predominaron usuarios entre 40-49 años (36,88 %), del sexo femenino (64,54 %) y con nivel de satisfacción medio (46,80 %). Los principales factores identificados como deficientes fueron el déficit de citas médicas y para procedimientos médicos (71,63 %) y problemas con el mobiliario clínico y no clínico (59,57 %). Conclusiones: Existen factores que influyen en la calidad de los servicios de salud; esta situación repercute en el nivel de satisfacción de los usuarios, en el cual predominan los niveles de satisfacción medio y bajo.

This work analyzes the interaction between climate risk, caused by extreme events resulting from the El Niño-Southern Oscillation (ENSO) and/or Climate Change, and its impact on local health services in Ecuador. The analysis focuses on Ecuador's growing vulnerability to the effects of climate change, which exacerbates challenges in the delivery of health services, particularly in the context of severe climate events. The main objective is to analyze the relationship between the number of hectares affected by climate events and the availability and effectiveness of local health services, considering community resilience and health coverage as moderating variables. The methodology uses a linear regression analysis using data from 221 Ecuadorian municipalities, covering variables such as climate risk, health services, community resilience, health coverage, and demographic and socioeconomic factors. The results indicate a significant influence of climate risk on the effectiveness of health services, moderated by community resilience and health coverage. It is observed that areas with greater preparation and health coverage show a better capacity to respond to extreme weather events. Finally, it is important to integrate climate risk management into health services planning, suggesting that greater community resilience and broad health coverage are essential to mitigate the negative impacts of climate change on public health. [ABSTRACT FROM AUTHOR]

Instituto Mexicano del Seguro Social-Bienestar (IMSS-BIENESTAR, in Spanish), the new institution in charge of providing health care to people without social security in the Mexican states that sign agreements for this purpose, will base its medical care on the model of health care for well-being. This model is based on primary health care, which considers: a) integrated health services to meet the health needs of people throughout their lives; b) addressing the broader determinants of health through multisectoral policies and actions; and c) empowering individuals, families, and communities to take charge of their own health. The goal is to meet needs throughout the continuum that goes from health promotion and disease prevention to treatment, rehabilitation, and palliative care, and as close as possible to people's daily environment. The collective care component will be the responsibility of the Federal and State Health Secretariats, as well as the National Public Health Service in conjunction with the health service operators of the sector. The healthcare component will be the responsibility of IMSS-BIENESTAR. This article presents how IMSS-BIENESTAR will implement this care model over the next few years. It proposes regional and zonal multidisciplinary management teams and outlines the indicators that will be used for their evaluation and monitoring. [ABSTRACT FROM AUTHOR]

Copyright of Social Medicine is the property of Social Medicine Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Schizophrenia is a mental health condition that can lead to significant disability and have a major impact on social and occupational functioning. It tends to decrease life expectancy, which could be attributed to a variety of factors, including poor health habits, barriers to healthcare access, and the stigmatization of mental illness. Objective. The main aim of this systematic review is to examine the physical comorbidity of these patients, and their health service utilization. Method. The protocol has been registered with the PROSPERO database (CRD42020139972) and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO, Cochrane Library, and ProQuest Health Research Premium Collection yielded 317 articles, 57 of which were selected. Results. The mortality rate of people with schizophrenia is often at least twice that of the general population. In addition, these individuals may be susceptible to other physical health conditions that can significantly shorten their lifespan: cardiovascular and respiratory diseases, diabetes mellitus, oncologic diseases, and chronic infections. Complications during hospitalization and prolonged length of stay due to comorbidities may impede their access to essential healthcare. Discussion and conclusion. Enhancing the healthcare system is crucial to providing adequate care for these patients. Adopting positive lifestyle choices, reducing substance dependence, and abstaining from unconventional antipsychotics can bolster their life expectancy. It is therefore crucial to implement intervention strategies while training professionals to detect and manage physical comorbidities associated with this disorder. [ABSTRACT FROM AUTHOR]

This article is the result of a research process whose outcome was a monograph where one of the fundamentals of the general social security system in Colombia was analyzed in the city of Barranquilla: accessibility in healthcare services. To achieve this, the characterization of the population accessing healthcare services at levels III and IV in Barranquilla was carried out, considering demographic aspects, types of services, accessibility, and the economy. Data sources such as REPS, SISPRO, and SIVIGILA, which provide quantitative and secondary data, are used. Criteria, variables, and statistical tools used, such as R and ArcGIS, are described. The results are presented in tables, graphs, or maps, highlighting important aspects such as the demographic profile and satisfaction with the services. The results are compared and interpreted with other studies, identifying limitations and biases. It offers a comprehensive view of accessibility to healthcare services in Barranquilla, from data collection and analysis to the presentation of conclusions and recommendations for future actions. In summary, the main conclusions and contributions of the study to the understanding and management of the population using healthcare services in Barranquilla are highlighted. [ABSTRACT FROM AUTHOR]

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La salud pública constituye una fuente principal de atención a las poblaciones en los diferentes contextos en los que se dificulta el acceso al dinero, y las adquisiciones económicas son insuficientes para obtener servicios de salud privados. La parroquia de San Carlos posee varias limitantes en los sistemas de salud pública que pueden obstaculizar el desarrollo sostenible de este contexto rural. El objetivo de este estudio es caracterizar el sistema de salud de la parroquia San Carlos, Quevedo y su relación con el desarrollo sostenible. El estudio realizado es una investigación explicativa, de corte dialéctico, donde se caracteriza el sistema de salud en la parroquia San Carlos, Quevedo y su relación con el desarrollo sostenible en este consejo popular rural. Se trabajó con 15 sujetos, con tiempo de residencia en la comunidad, se aplicaron instrumentos como la entrevista y la observación. Los principales resultados muestran que en la parroquia San Carlos no es la excepción de la realidad de un sistema de salud público limitado a nivel nacional, realidad que es aún más crítica para las zonas rurales como la de esta parroquia, esto se evidencia en el único Subcentro de salud existente al no contar con el personal suficiente, ni los equipos necesarios para brindar una atención oportuna a la población. En la parroquia el servicio de salud con accesibilidad universal, debe constituir la base de un servicio que focaliza la disminución de las desigualdades en salud y las iniquidades en la prestación de servicios y sucede al contrario.

Introducción. El trabajo social sanitario es una especialización multifacética que contribuye activamente al trabajo en equipos sanitarios para prestar una atención integral en los servicios de salud de atención primaria, especializada y salud mental. Este trabajo pretende explorar la literatura internacional para identificar las prácticas desarrolladas por el trabajo social sanitario en equipos interprofesionales en el contexto de pandemia COVID-19. Metodología. Se ha realizado una scoping review siguiendo el método del Instituto Joanna Briggs, de acuerdo con el marco teórico y proceso iterativo propuesto por Arksey y O’Malley y las recomendaciones PRISMA-ScR. Se consultaron ocho bases de datos (Web of Science-Core Collection, Scopus, PubMed, Embase, CINAHL, Social Work Abstracts, Social Services Abstracts y Sociological Abstracts), identificando 18 estudios publicados entre 2020 y 2022 que cumplían los criterios de elegibilidad. Resultados. El análisis temático categorizó los resultados en cuatro tipos de prácticas de relación interprofesional: intervención en crisis, salud mental, salud pública y cuidados al final de la vida. Además, señaló como tema los aprendizajes derivados de ellas: la oportunidad de fortalecer su legitimidad en los servicios de salud y fomentar el reconocimiento de su rol mediante el desempeño y valoración de sus capacidades y competencias; la aportación de elementos facilitadores del trabajo en equipo como la comunicación, apoyo, relaciones cooperativas, adaptación colaborativa y confianza; y la perspectiva de ampliar competencias en espacios de subespecialización en el futuro. Discusión. Los estudios revisados evidencian que el trabajo social sanitario desarrolla predominantemente funciones asistenciales ante la COVID-19 en equipos de atención especializada, y se centra en menor medida en intervenciones de promoción de la salud y prevención de enfermedades en equipos de atención primaria. Además, entre las necesidades abordadas, prevalece la atención ante el bienestar mental, emocional y conductual tanto en poblaciones usuarias como en los miembros de los equipos con los que colabora. Conclusiones. El trabajo social sanitario en equipos interprofesionales en pandemia desempeña idóneamente sus competencias, funciones de liderazgo y aporta factores facilitadores para el trabajo en equipo. Se requiere realizar nuevos estudios empíricos sobre su contribución en equipos interprofesionales para realizar revisiones sistemáticas que permitan evaluar los resultados de las intervenciones, así como identificar buenas prácticas y potenciar su planificación ante nuevas emergencias. También, es necesario fortalecer su legitimidad como profesión esencial y reconocer su importancia dentro de los equipos interprofesionales en diferentes servicios de salud presenciales y virtuales, así como fomentar nuevas competencias en los espacios de subespecialización. La promoción de la educación interprofesional en salud en los planes de estudio de trabajo social es clave para afrontar futuras crisis sanitarias, económicas y medioambientales. En ellas queda por valorar si el trabajo social sanitario estará bien posicionado en equipos interprofesionales para proporcionar una atención integral de forma eficaz en los servicios de salud.

Objetivo. Analizar los elementos de un programa de navegación en Lima que facilitaron la vinculación de hombres que tienen sexo con hombres (HSH) y mujeres transgénero (MT) a la atención del VIH. Materiales y métodos. Realizamos entrevistas a 20 usuarios recibiendo servicios de navegación y a 4 navegadores pares viviendo con VIH. Resultados. El trabajo de los navegadores contribuyó a cubrir una brecha en los servicios para el VIH, brindando acompañamiento personalizado para navegar el sistema de salud y facilitando el proceso de vinculación a la atención médica. Conclusiones. La navegación de pacientes basada en el desarrollo de fortalezas de los usuarios puede ser una estrategia útil y factible para mejorar la vinculación al cuidado médico de HSH y MT en Perú, incorporando navegadores pares a los equipos de salud, horizontalidad en el trato y estrategias de salud pública con mayor participación comunitaria.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Public health constitutes a main source of care for populations in different contexts in which access to money is difficult, and economic purchases are insufficient to obtain private health services. The parish of San Carlos has several limitations in the public health systems that can hinder the sustainable development of this rural context. The objective of this study is to characterize the health system of the San Carlos parish, Quevedo and its relationship with sustainable development. The study carried out is an explanatory, dialectical investigation, which characterizes the health system in the parish of San Carlos, Quevedo and its relationship with sustainable development in this popular rural council. We worked with 15 subjects, with time of residence in the community, instruments such as interview and observation were applied. The main results show that the San Carlos parish is not the exception to the reality of a limited public health system at the national level, a reality that is even more critical for rural areas like this parish, this is evident in the only Existing health subcenter does not have sufficient personnel or the necessary equipment to provide timely care to the population. In the parish, the health service with universal accessibility must constitute the basis of a service that focuses on the reduction of health inequalities and inequities in the provision of services and the opposite happens. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de México is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Compliance with the guidelines for intervention in acute malnutrition by the Local Health Directorates must guarantee comprehensive care processes. However, there are serious deficiencies reflected in comprehensive care. Objective: To evaluate compliance with the comprehensive care guide for acute malnutrition in children under five years of age in the municipalities of Córdoba. Method: Descriptive study in which Local Health Directorates of municipalities in the Department of Córdoba participated. Through interviews, observation and audit of evidence, information was taken to evaluate the percentage of compliance with the Resolution's reagents. Results: The overall level of compliance is medium-low (69%). A wide range of the reagents (87.5%) of event code 113 have moderate to low degrees of compliance, including the control and monitoring of identified cases. Conclusions: Compliance with the guidelines established in the Resolution is deficient. [ABSTRACT FROM AUTHOR]

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Introducción: La reducción de la huella de carbono en todos los sectores es imprescindible como parte de la acción climática, y la ejecución de estrategias específicas incluye el accionar de los servicios de atención sanitaria. Costa Rica se ha destacado por un sólido sistema de salud con enfoque de atención primaria; sin embargo, se documentan pocas evidencias científicas respecto a los roles e impactos del sistema de salud en la reducción de la huella de carbono a nivel nacional. Objetivo: Analizar la producción científica sobre huella de carbono en los servicios de salud a nivel global y contrastarla con la realidad costarricense. Método: Se realizó un mapeo de la literatura en español e inglés en la base de datos Scopus, a partir de términos de tesauros en línea. Se aplicaron criterios de inclusión y exclusión, y se utilizó la herramienta Bibliometrix en el software R para el análisis. Posteriormente, se realizó una revisión integrativa de los documentos seleccionados con apoyo de la plataforma Covidence. Resultados: Se analizaron 46 publicaciones en el análisis bibliográfico y 25 documentos en la revisión de alcance, identificando los temas investigados actualmente para la reducción de la huella de carbono en la atención sanitaria. Estos tópicos incluyen análisis de insumos hospitalarios, gestión de residuos sólidos, técnicas de evaluación de impacto ambiental, diseño de estrategias de sostenibilidad, educación ambiental, infraestructura sanitaria, compras sustentables y consumo energético. Conclusiones: Los estudios, independientemente de la región o país, presentan opciones para mejorar la práctica sanitaria en relación a la huella de carbono, impactando también la salud de las poblaciones. Sin embargo, la mayoría de estos estudios, según la metodología GRADE, presentan baja evidencia debido a las particularidades del diseño metodológico empleado. Las colaboraciones internacionales pueden ser una herramienta útil para avanzar en la implementación de tecnologías y estrategias políticas adaptables a la realidad costarricense, haciendo sostenible el sector salud y, por ende, la atención sanitaria.

Objetivo: El artículo describe una propuesta de modelo de superación profesional del rehabilitador en salud centrado en la orientación familiar como vía de prevención del trastorno por déficit de atención/hiperactividad.Métodos: La autora asume una metodología de orden cuanti-cualitativo. Se emplearon como métodos el análisis documental (Hernádez-Sampieri et at., 2018) y la sistematización del contenido (Expósito & González, 2017; y Mera, 2019). De igual forma se aplicaron entrevistas y encuestas y se realiza la modelación de la superación del rehabilitador en salud con la ayuda de la modelación sistémica estructural.Resultado: El resultado principal del estudio es un modelo pedagógico de superación profesional del rehabilitador en salud caracterizado por la ampliación del desempeño de este profesional a las esferas afectiva y volitiva a través de la orientación de la familia del paciente como vía de prevención del trastorno por déficit de atención/hiperactividad.Conclusión: La superación del rehabilitador en salud puede ser mejorada a partir de la ampliación de sus objetivos y contenidos centrados en la orientación de la familia del paciente como vía de prevención del trastorno por déficit de atención/hiperactividad.

Due to the COVID-19 pandemic, telemedicine has seen a significant boom in employment and an undeniable impact, on healthcare. The objective of the present review was to assess the role that telemedicine and digital health play in comprehensive medical care. The authors relied on hermeneutics to analyze and evaluate the systematic review carried out with the PRISMA 2020 methodology on telemedicine and digital health. Finally, 9 articles were reviewed in the Pubmed database corresponding to the period from 2019 to 2023. The results highlight the growing importance of information and communications technologies in the context of medical care, mainly in the field of the COVID-19 pandemic. This pandemic has driven the adoption of telemedicine and technologies in healthcare, but efforts are required to ensure equity in their implementation.

Objetivo: describir la percepción del cumplimiento de los atributos de la atención primaria de la salud en la población afroperuana durante la pandemia de COVID-19. Materiales y métodos: estudio observacional y transversal, realizado en seis ciudades del Perú, incluyendo a adultos afroperuanos, seleccionados con muestreo intencional. Se aplicó una encuesta en línea utilizando el Primary Care Assessment Tool (PCAT), armonizada para contexto iberoamericano, la cual evalúa atributos de la atención primaria como accesibilidad de los servicios, continuidad de la atención, participación comunitaria e idoneidad cultural, evaluándose con análisis descriptivo. Además, se exploraron factores relacionados como características sociodemográficas y clínicas empleando pruebas de hipótesis. Resultados: la mayoría de los entrevistados percibió un menor cumplimiento de los atributos de la atención primaria (94,8%). En particular, la orientación comunitaria y la continuidad de la atención fueron áreas problemáticas, 92,3 y 92,1%, respectivamente. No se encontró una correlación significativa entre la percepción de cumplimiento de la atención primaria y los factores sociodemográficos y clínicos con excepción del antecedente de tener COVID-19, quienes perciben un menor cumplimiento de los atributos de la atención primaria de salud. La fiabilidad global del PCAT fue de 0,93 con alfa de Cronbach. Conclusiones: existe una percepción generalmente baja de los servicios de atención primaria en la población afroperuana. Se requieren investigaciones futuras para explorar las causas subyacentes de estas percepciones y se deben hacer esfuerzos para mejorar el cumplimiento de los atributos de la atención primaria que se perciben como insuficientes, especialmente la accesibilidad y la continuidad de la atención.

Introducción: La pandemia por COVID-19 ha afectado significativamente la calidad de los servicios de cuidado de la salud. Objetivo: Analizar los efectos en los atributos de la calidad en salud de los servicios de atención de enfermedades diferentes a la COVID-19 en Colombia, durante el periodo 2020-2022. Materiales y métodos: Se analizaron 24 artículos de alcance nacional y otros específicos de departamentos como Antioquia, Córdoba, Santander y Cundinamarca. Resultados: La pandemia por COVID-19 impactó la calidad de los servicios en la atención de enfermedades como cáncer, accidentes cerebrovasculares y de eventos como la interrupción voluntaria del embarazo. Conclusión: La calidad de la salud se vio afectada en todas sus dimensiones durante las fases de la pandemia, especialmente en la población con enfermedades crónicas y relacionadas con la salud infantil y materna. Además, se destacaron respuestas como el uso de la telemedicina y de la atención domiciliaria para contribuir a la calidad de la salud en Colombia.

Objective. Analyzed sociodemographic factors, migration dynamics, health problems and healthcare utilization among female migrants, asylum seekers, and refugees, during the Covid-19 pandemic in Mexico. Materials and methods. This cross-sectional study included 668 female users of migrant shelter services in Mexico. Latent Class Analysis (LCA) was used to create a typology of two classes: economic migration and forced migration. Logistic regression models were used to evaluate the relationship between migration and healthcare utilization. Results. Women forcibly displaced show greater prevalence of health problems (36.1 vs. 24.2%; p=.001). Respiratory and gastrointestinal infections and accidents/injuries prevailed, with no differences between groups. Migrant shelters health services treated 70% of health problems. Conclusions. The typology of migration is associated with differences in the prevalence of health problems and risks. Migrant shelters represent a crucial area for healthcare response efforts. [ABSTRACT FROM AUTHOR]

Objective: To understand the nursing practices in Primary Health Care for the elimination of viral hepatitis. Methods: This is a descriptive, exploratory research with a qualitative approach with Primary Health Care nurses from the mid-north health region of Mato Grosso, using the focus group technique and thematic analysis organized into two categories: Territory and nursing practice and PHC nurses in care coordination. Results: Nurses recognize the territory as a space for health surveillance and intersectoral action, with an emphasis or vaccination coverage, rapid testing, active search for contacts, notification and referral. It exposes fragmentation of care, submission of clinical nursing consultation to medical practice. She works in the managerial and assistance function. The coordination of care was expanded with the decentralization of testing, but with little sharing of information at the levels of care and in the regulation of care, in addition to questions about ethical aspects. They require permanent training spaces for clinical approach and action to microelimination. Conclusion: There is a practice that cooperates in favor of elimination in the coordination of care, but its performance can still be expanded with subsidies of matrix support for the management of care and work. [ABSTRACT FROM AUTHOR]

Objective: to reflect on the contributions of Nursing in mediating society's participation in mitigating the climate change impacts. Method: theoretical and reflective study, based on contemporary literature and international reports, carried out between August and November 2023. Results: to implement, articulate and promote actions that foster connections between Nursing and society, the study identified perceptions of social vulnerability and intersectionality as central elements that determine action, presented by three thematic axes: starting point; strategy; and processes, which respectively represent coping scenarios; governance and Nursing; and collaboration and social participation. Conclusion: it is necessary to review concepts of environmental and societal relations in training and discussion on the subject, in order to help raise awareness among nursing staff. [ABSTRACT FROM AUTHOR]

Objective: to describe the therapeutic itinerary of the premature newborn and the communication between professionals in the Health Care Network. Method: qualitative research with 11 nurses, recruited by snowball technique. Data collection was carried out through semistructured face-to-face and virtual interviews in August 2022. Thematic content analysis was conducted. Results: two categories stood out: "Therapeutic itinerary of premature newborns and referrals" and "Communication between the services of the Health Care Network in the therapeutic itinerary of premature newborns". Conclusion: the therapeutic itinerary of premature newborns is defined from birth, according to health conditions. After discharge from hospital, care is taken by the professionals of Primary Health Care, who will determine referrals to specialized care. Knowing the therapeutic itinerary of premature babies and communication between points of the Health Care Network contributes both to the continuity of care and to the reduction of infant morbidity and mortality. [ABSTRACT FROM AUTHOR]

This article analyzes the perception of municipal health managers about the process of regionalization of health in the State of Rio Grande do Sul. It has a qualitative nature, employing semi-structured interviews with eight municipal health managers, chosen intentionally. In the theoretical approach, the concept of Government Triangle was used, matching it with the categories of thematic analysis. In the government project on the regionalization of health, the means and objectives identified were the Pact for Health, financing, solidarity, access, health consortia, models of supply and contracting of health actions and services. In the capacity of government in the Health Care Networks and the instances of agreement, the ways of conducting, maneuvering and overcoming that emerged from the analysis were the Regional Intermanagers Commission, the decentralization of health services and intersectoriality. As for management and health governance, the interviewees identified the manager not having time and/or not prioritizing the planning and management processes, managers as political figures and without preparation, the technical staff without specific training, the care gaps and the fixation of professionals. The results of this study point to clues about possible paths to be followed in the theme of health management and regionalization. [ABSTRACT FROM AUTHOR]

Background: The medical care paradigm is face-to-face; however, technological development has led to the digital modality. Objective: To determine cost-effectiveness of digital care and face-to-face care at the first level of care. Material and methods: Cost-effectiveness study. 2 groups were integrated: the digital service and the face-to-face service. The sample size was calculated with the percentage formula for 2 groups, and the result was 217 per group. The effectiveness was evaluated in 3 dimensions: the satisfaction of the patient, of the doctor and of the medical assistant. In all 3 cases the Visual analogue scale was used. The cost corresponded to the fixed unit cost estimated with the technique of times and movements adjusted for the duration of care. The statistical analysis included averages, percentages and costeffectiveness ratio. Results: The cost of digital attention is $343.83 and face-toface attention is $171.91 (all estimated in Mexican pesos). From the patient's perspective, the effectiveness in digital care is $9.47 and in face-to-face is $9.25. The cost to reach effectiveness of 10 in face-to-face care is $185.85 and in digital care $363.20. From the physician's perspective, the cost to achieve effectiveness of 10 is $419.13 in digital care and $184.52 in face-to-face care. From the perspective of the medical assistant, to achieve effectiveness of 10, the cost in digital care is $468.43 and in face-to-face $179.83. Conclusions: Currently, the best cost-effectiveness ratio corresponds to face-to-face care; however, digital care is an option that will have to evolve. [ABSTRACT FROM AUTHOR]

Objective. To estimate adolescent use of outpatient services, identifying their health needs and associated socioeconomic factors. Materials and methods. Using data from Ensanut 2018-2019, adolescents (ages 10-19) with health needs and those receiving care from health personnel (users) were identified. Needs were analyzed by sex and socioeconomic status (SES). Logistics models were used to assess the factors associated with the use of health care and choice of provider. Results. 6% of adolescents reported health needs, of whom 64% used outpatient services. Respiratory and gastrointestinal infections were the principal health needs prompting use of services overall. However, by SES, motivations centered on pregnancy for the poor and accidental injuries for the wealthy. One in three adolescents with health needs, particularly the poorest, received no care. Living with a partner and having health insurance were the main predictors of use. Greater schooling among household heads and higher SES correlated with the use of private services. Conclusions. Despite being aware of their health needs, adolescents are the group that uses health services the least in Mexico. Promoting preventative and timely treatment for this population would encourage youths to seek care more often. [ABSTRACT FROM AUTHOR]

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