ABSTRACT
Introducción: La periodización permite analizar la historia de los procesos y reconocer desde el presente los cambios relevantes. La estrategia cubana de prevención del VIH tiene resultados nacionales e internacionales, sin embargo, existen pocas publicaciones sobre su decursar histórico. Objetivos: Describir los períodos e hitos que caracterizan la estrategia de prevención del VIH. Método: Se utilizó el método cualitativo, con técnicas de observación participante, revisión documental y entrevista a expertos. Resultados: De 1983 a 2022, se identificaron cuatro períodos, denominados preparación y primeros pasos; fortalecimiento de la estrategia; descentralización de las acciones y servicios de prevención y reorientación post COVID-19. Los hitos se identificaron en las áreas de vigilancia epidemiológica, mercadeo social de condones, intersectorialidad y la atención y participación de las poblaciones clave. Conclusiones: La periodización de la estrategia muestra diferentes enfoques aplicados a través del tiempo, el desarrollo en espiral de los diferentes actores de la sociedad hacia la inclusión social y la participación de los sectores sociales y gobierno. Los hitos visibilizan el tránsito de la estrategia de prevención del VIH desde una visión predominantemente centrada en la provisión de servicios de salud por el sector sanitario a una perspectiva compartida, con las poblaciones clave los sectores sociales y gobierno.
Introduction: Periodization allows us to analyze the history of processes and recognize relevant changes from the present. The Cuban HIV prevention strategy has national and international results, however, there are few publications on its historical course. Objectives: Describe the periods and milestones that characterize the HIV prevention strategy. Method: The methodology was qualitative, the techniques of participant observation, documentary review and expert interviews are used. Results: From 1983 to 2021, four periods were identified, called preparation and first steps; strengthening the strategy; decentralization of prevention and post-COVID-19 reorientation actions and services. The milestones were identified in the areas of epidemiological surveillance, social marketing of condoms, intersectorality, and the care and participation of key populations. Conclusions: The periodization of the strategy shows different approaches applied over time, the spiral development of the different actors in society towards social inclusion and the participation of the social sectors and government. The milestones make visible the transition of the HIV prevention strategy from a vision predominantly focused on the provision of health services by the health sector to a shared perspective, with key populations, the social sectors and the government.
ABSTRACT
Given the development of public health, hygiene and epidemiology in Cuba and their linking with primary care, and particularly, the novel approach to health surveillance in its different implementation alternatives, it is necessary to develop new forms and methods for surveillance evaluation at this level. The paper is aimed at presenting methodological proposal for assessing surveillance in primary health care. We made a literature review of known documents, guides or manuals which have been published in Cuba and in other countries and we interviewed a group of experts in this field. An initial instrument was worked out and tested in three health areas of the capital and afterwards, it was modified accordingly. The process of assessment was divided into 4 aspects: structure, process or functioning, results or usefulness and economic evaluation. To assess functioning of surveillance, we took the analysis of its attributes into account, i.e., simplicity, flexibility, acceptability, sensitivity positive predictive value, representativity, opportunity and also integrality and responsiveness capacity. We described steps to be implemented and elements to be considered. Generally, the evaluation should be carried out in a week. The cost of implementing each evaluating process is estimated at 40 Official Announcement. V Workshop of university libraries of Latin and the Caribbean. Upon finishing the evaluation, a report should be submitted with the comprehensive assessment and recommendations for the evaluated level.