Participação em saúde nas Américas: mapeamento bibliométrico da produção, impacto, visibilidade e colaboração / Participation in health in the Americas: Bibliometric mapping of production, impact, visibility and collaboration / Participación en salud em las Américas: mapeo bibliométrico de producción, impacto, isibilidade y colaboración

Resumo A participação em saúde tem gerado um grande número de publicações em todo o mundo. Para conhecer as especificidades dessa produção nas Américas, foi realizada uma análise bibliométrica de artigos em inglês, espanhol e português. Foram realizadas buscas na BVS, PubMed, SCOPUS, WOS e SciELO, consolidando uma base de dados com 641 referências. Com auxílio do software VOSviewer, analisamos padrões de citação, coautoria e a distribuição cronológica por países e idiomas. Foi possível verificar o crescimento da produção, a relevância quantitativa e o impacto dos diferentes países. A análise indicou que os EUA concentram o maior número de citações, e o Brasil, apesar de ser o primeiro em número de publicações, é o terceiro em número de citações. O mesmo ocorre com os periódicos brasileiros que, com o maior número de artigos, caem no ranking dos mais citados. Nos dez artigos mais citados, descatam-se trabalhos desenvolvidos nos EUA e Canadá. A análise de coautoria indicou que a Universidade de Toronto, a Fiocruz e a Universidade de Harvard são as que mais têm colaborações formais com outras organizações. Concluímos que existem desigualdades de impacto, visibilidade e internacionalização neste campo, indicando obstáculos para o desenvolvimento científico e das políticas de saúde.

Abstract Participation in health has generated a large number of publications around the world. In order to know the specificities of this production in the Americas, a bibliometric analysis of articles in English, Spanish and Portuguese was carried out. Searches were carried out in the VHL, PubMed, SCOPUS, WOS and SciELO, consolidating a database with 641 references. With the help of the VOSviewer software, we analyzed citation patterns, co-authorship and the chronological distribution by countries and languages. It was possible to verify the growth of production, the quantitative relevance and the impact of the different countries. The analysis indicated that the USA concentrates the largest number of citations and Brazil, despite being the first in number of publications, is the third in number of citations. The same occurs with Brazilian journals that, with the largest number of articles, fall in the ranking of the most cited. The co-authorship analysis indicated that the University of Toronto, Fiocruz and Harvard University have the most formal collaborations with other organizations. We conclude that there are inequalities of impact, visibility and internationalization in this field, indicating obstacles to scientific development and health policies.

Resumen La participación en salud ha generado una gran cantidad de publicaciones alrededor del mundo. Para conocer las especificidades de esta producción en las Américas, se realizó un análisis bibliométrico de artículos en inglés, español y portugués. Se realizaron búsquedas en la BVS, Pubmed, SCOPUS, WOS y SciELO, consolidando una base de datos con 641 referencias. Con la ayuda del software VOSviewer, analizamos los patrones de citación, la coautoría y la distribución cronológica por países e idiomas. Se pudo verificar el crecimiento de la producción, la relevancia cuantitativa y el impacto de los diferentes países. El análisis indicó que EE.UU. concentra el mayor número de citas y Brasil, a pesar de ser el primero en número de publicaciones, es el tercero en número de citas. En los diez artículos más citados se descartan trabajos desarrollados en EE.UU. y Canadá. El análisis de coautoría indicó que la Universidad de Toronto, Fiocruz y la Universidad de Harvard tienen las colaboraciones más formales con otras organizaciones. Concluimos que existen desigualdades de impacto, visibilidad e internacionalización en este campo, indicando obstáculos para el desarrollo científico y las políticas de salud.

Implementation of Participatory Research in Vulnerable Context: Methodological Strategies and Challenges / Implementação de Pesquisa Participativa em Contexto de Vulnerabilização: Estratégias e Desafios Metodológicos / Implementación de la Investigación Participativa en un Contexto de Vulnerabilidad: Estrategias y Desafíos Metodológicos

Abstract Participatory methods contribute to scientific rigor by highlighting the contextual needs, especially of underrepresented populations, making them protagonists in the process of social change. This article aims to present the application of a participatory research method, called Community-Based Participatory Research (CBPR), in a context of social vulnerability in southern Brazil. It seeks to discuss the challenges and strengths of the method, which provides ecological validity for the development of public policies appropriate to the context, while empowering the participants. The research has been carried out since 2019 and, among the inherent challenges, has also faced the difficulties posed by the COVID-19 pandemic. Based on the application of this method in Brazil, the importance of involving participants throughout the research process has been identified, so that policies are developed to meet the needs of the community and are sustained by those most interested.

Resumo Métodos participativos contribuem para o rigor científico ao evidenciarem demandas do contexto, especialmente com populações sub-representadas, tornando-as protagonistas do processo de transformação social. Este estudo objetivou apresentar a aplicação de um método participativo de pesquisa, a Community-Based Participatory Research (CBPR), em um contexto de vulnerabilização social no sul do Brasil. Busca-se discutir os desafios e as potencialidades do método, que oferece recursos de validade ecológica para o desenvolvimento de políticas públicas próprias ao contexto, ao mesmo tempo em que empodera seus participantes. A pesquisa vem sendo realizada desde o ano de 2019 e, dentre os desafios inerentes, também enfrentou as dificuldades impostas pela pandemia de Covid-19. A partir da aplicação deste método em contexto brasileiro, identificou-se a relevância de se envolver os participantes ao longo do processo de pesquisa, a fim de que as ações desenvolvidas sejam desenvolvidas em coerência com as demandas trazidas pela comunidade, e mantidas por aqueles que são seus maiores interessados.

Resumen Los métodos participativos contribuyen al rigor científico al destacar las necesidades del contexto, especialmente de las poblaciones subrepresentadas, haciéndolas protagonistas del proceso de cambio social. Este artículo pretende presentar la aplicación de un método de investigación participativa, denominado Investigación Participativa Basada en la Comunidad (IBCB), en un contexto de vulnerabilidad social en el sur de Brasil. Busca discutir los desafíos y fortalezas del método, con validez ecológica para el desarrollo de políticas públicas, al tiempo que empodera a los participantes. La investigación empezó en 2019 y, entre los desafíos, también se ha enfrentado a las dificultades planteadas por la pandemia de Covid-19. A partir de la aplicación de este método en el contexto brasileño, se ha identificado la importancia de involucrar a los participantes en el proceso de investigación, para que se desarrollen políticas que respondan a las necesidades de la comunidad y sean mantenidas por los más interesados.

Assessing engagement of scheduled tribe communities in the functioning of Village Health Sanitation & Nutrition Committees in India

India is home to the largest population of indigenous tribes in the world. Despite initiative of the National Rural Health Mission, now National Health Mission (NHM) and various tribal development programmes since India’s Independence, disparity in healthcare for Scheduled Tribes (STs) prevails. The constitution of Village Health Sanitation and Nutrition Committees (VHSNCs) in 2007 by the NHM is a step towards decentralized planning and community engagement to improve health, nutrition and sanitation services. VHSNCs are now present in almost all States of the country. However, several reports including the 12th Common Review Mission report have highlighted that these committees are not uniformly following guidelines and lack clarity about their mandates, with no clear visibility of their functioning in tribal areas. Therefore, this review was conducted to assess the participation of the VHSNCs in tribal dominated States in order to know in detail about their functioning and gaps if any that require intervention. Several deviations from the existing guidelines of NHM were identified and we concluded that in order to sustain and perform well, VHSNCs not only require, mobilization and strict monitoring but also motivation and willingness of its members to bring in a radical change at the grassroot level. With continuous supervision and support from both the Government and various non- governmental organizations, handholding, strategic deployment of workforce, community participation and sustained financial support, VHSNCs would be able to facilitate delivery of better healthcare to the indigenous population

HIV epidemic in Mizoram, India: A rapid review to inform future responses

Background & objectives: Mizoram, a northeastern State of India bordering Myanmar, is home to several tribal clans under the ethnic group Mizo: Renthelei, Ralte, Paite, Lai, Hmar, Lusei, Mara, Thado and Kuki. Mizos also reside in the neighbouring northeastern States of Tripura, Assam, Manipur and Nagaland. The majority of Mizo people outside India live across the border in the neighbouring Chin State and Sagaing Region of Myanmar. Over the last decade, Mizoram witnessed a concerning level of rise in HIV prevalence among the general population. The present rapid review was conducted to identify various interventions that could help curb this rising trend. Methods: An electronic search strategy with broad domains of ‘HIV/AIDS’, ‘key population’, ‘community engagement’ and ‘interventions in Mizoram’ using PubMed, Embase and Cochrane was adopted; grey literature were also accessed. Evidence, thus gleaned, were synthesized. Results: Twenty eight resource materials comprising articles, reports and dissertations contributed to the current review. Changing tribal social support structure, early initiation of drugs, sexual debut at an early age and drug–sex interface were identified as factors associated with the progression of HIV epidemic in the State. Issues pertaining to the migration of people across the borders and easy access to drugs continue to be of concern. Churches and youth leaders have a strong influence on the society, at times even constraining access of key population groups to HIV prevention and care services. Tackling stigma and discrimination, ensuring uninterrupted HIV services and creation of an enabling environment in this context seems urgently needed. Incarcerated people in the State have been found with a high level of HIV infection and their linkages with prevention and care services need strengthening. Interpretation & conclusions: This review underscores the importance of drawing upon successful intervention examples from the past such as ‘Friends on Friday’ and Red Ribbon Clubs. Active engagement of community-based organizations in programme planning, implementation and monitoring is essential. Establishment of harm reduction interventions for general and key populations paired with strategic communication appear to be the need of the hour.

Factors associated with community engagement in areas with high and low incidence of local malaria cases in Zanzibar

Introduction: the prevalence of asymptomatic infection in the general population in Zanzibar has declined from above 25% in 2005 to less than 1% in 2010. Despite these achievements, in 2021, the number of malaria cases increased by two folds. This study aimed at understanding the levels of community engagement towards malaria elimination and factors associated with them to provide recommendations that can be used to reinforce community engagement. Methods: a descriptive cross-sectional survey was conducted using structured questionnaires to 431 randomly selected households. The interviewees were the heads of households or representative adults above 18 years. Univariate and multivariate analysis was done to determine the association between social demographic characteristics, malaria knowledge, practicing malaria prevention interventions and status of community engagement. Statistical significance test was declared at P- value <0.05. Results: of all respondents, 261 (60.6%) were not engaged in either planning or implementation of malaria interventions, of which 120 (45.9%) participants were in the high malaria transmission and 141 (54.0%) from the low malaria transmission (P=0.018). Factors significantly associated with increased odds of community engagement were the level of knowledge on malaria (P= 0.002) and factors independently associated with reduced odds of community engagement was the level of malaria burden (P= 0.01). Conclusion: level of malaria knowledge and malaria burden were associated with community engagement. There is a need to increase malaria knowledge in the community based on the existing gaps as this study suggests that having high malaria knowledge can significantly contribute to increased opportunity for community engagement.

Assessing the Effectiveness of Health Preparedness Capacity Building Intervention in Empowering the Urban Poor Community in Rodriguez, Rizal, Philippines

@#<jats:p>This study deals with the public health effects of a natural disaster and some public health principles that can be applied to disaster risk reduction and management, focusing on earthquake preparedness for Barangay San Jose - Rodriguez, Rizal, Philippines. The study showed that the urban poor community has a weak history of engagement, and it explores whether facilitated community interventions can empower and develop community preparedness. It followed a participatory approach involving community leaders and members. The study indicated that enhancing and modifying interventions that match community needs will develop community preparedness in the community, potentially increasing the chances of surviving an earthquake and minimizing its deleterious and damaging impact. Community preparedness will require continuous involvement and a cooperative approach to working with communities to support equal and harmonized development.</jats:p>

Teaching and learning community medicine during the pandemic and beyond: Interactivity as an essential process

@#Medical educators are restricted by the current pandemic in teaching community medicine. Although medical schools suspended the exposure of their students to real community settings, many community medicine educators advocate that learning in community medicine could be sustained during the pandemic as initially experienced in several medical schools in the Philippines. To maximize learning, it is essential to highlight interactivity as an important process in students' learning in whatever mode of delivery. This commentary focuses on the various forms of interactivities in teaching community medicine: student-tostudent, student-to-community, and student-to-teacher. It is suggested that the interactivity between the student and the teacher should be emphasized to address the potential limitations of the other forms.

Knowledge, attitudes, and behavior of teenagers regarding sex in the community of Los Baños, Laguna

@#<p style="text-align: justify;"><strong>BACKGROUND: </strong>The steady rise in the number of teenage pregnancies in Los Baños, Laguna was identified as a public health concern that needs to be addressed immediately given the numerous complications to the teenage mother and her infant.</p><p style="text-align: justify;"><strong>METHODS:</strong> The study used a multicomponent strategy which included 1) a survey of Grades 7-12 students, 2) training of midwives, and 3) advocacy for parents to enhance existing projects on teenage pregnancy.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The survey showed that students value the opinion of friends of the same gender but prefer to get information from a health professional.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The students did not see their parents as a preferred source of information for sexual health. Approximately one-third of the respondents mistakingly believed that teenagers will never get pregnant during their first sexual encounter. Recommendations include training teachers to provide professional advice, inclusion of more schools for the survey, further training on other counselling techniques, and extension of advocacy to other pertinent sectors of the community.</p>

Ten Years of Successful Collaboration between Psychiatrists, a Mental Health Institution and General Practitioners in Primary Care

This paper gives an overview of what the GP Partnership Programme (GPPP), an integrated care programme, has achieved over a span of ten years, since its implementation in 2003 by the Institute of Mental Health, a tertiary mental health institution in Singapore. The GPPP is a collaboration between the GPs and IMH, for the care and management of stable patients with mental illness in the community and primary care setting. Since 2003, more than 1300 patients have been referred through the GPPP to a team of 51 GP-Partners for continued care within the community.