Practice of communication strategies of health scientific popularization of menopausal women / 中华医院管理杂志

This paper aims to push health scientific popular knowledge and carry out targeted patient health education for certain patients, based on the demand of health education for specific diseases and population. Taking the female climacteric health scientific popularization as an example, the authors summarized the practice of popularizing scientific education in a tertiary specialized hospital based on the cognitive level and health education needs of outpatients and the general public. A multidisciplinary health scientific popularization team was set up to communicate popular science knowledge to patients and other menopausal women in need through multi-channel and multi-platform forms. Such means include online ones, offline ones, and cooperation with various social organizations. The implementation of health scientific popularization mode meets the needs of patients and the general public. The implementation of this mode of health popularization could improve their self-health management ability and health accomplishment. It provides a good reference for public hospitals to carry out health science popularization.

Prioridade para futuras vacinações contra a Covid-19 no Brasil: os usuários de transporte público devem ser um grupo-alvo? / Prioridad para futuras vacunaciones contra la covid-19 en Brasil: los usuarios de transporte deben ser un grupo objetivo? / Priority for future COVID-19 vaccinations in Brazil: should public transport users be a target group?

Considerando o recente surgimento de vacinas eficazes contra a Covid-19 e os escassos recursos para atender imediatamente à maior parte da população mundial, as sociedades precisam definir a ordem em que os grupos de cidadãos terão acesso às novas vacinas. As campanhas de vacinação devem priorizar a imunização de indivíduos vulneráveis e encarregados de ajudar outras pessoas, reduzindo as perdas humanas e minimizando os danos sociais e econômicos. No Brasil, os usuários de transporte público nas grandes cidades apresentam altos níveis de vulnerabilidade, diante de fatores relacionados à configuração espacial, à organização dos sistemas de transporte e ao alto percentual de pessoas de baixo nível socioeconômico em grandes periferias que dependem exclusivamente do transporte público para acesso a empregos e serviços básicos. A imunização dos usuários do transporte público pode produzir efeitos práticos relevantes no combate à Covid-19 no Brasil, tais como economia de recursos públicos, redução do número de óbitos e maior eficiência no controle setorizado da doença nas cidades. Portanto, sugerimos que os formuladores de políticas devem considerar os usuários frequentes de transporte público das grandes cidades brasileiras como um grupo-alvo nas campanhas de vacinação, dando a esse grupo um certo nível de prioridade com base em um mapeamento de risco adequado em nível local.

Teniendo en cuenta la reciente aparición de vacunas eficaces contra la covid-19 y los escasos recursos para atender de inmediato a la mayoría de la población mundial, las sociedades deben definir el orden en el que los grupos de ciudadanos tendrán acceso a las nuevas vacunas. Las campañas de vacunación deben priorizar la inmunización de personas vulnerables y personas encargadas de ayudar a otras para reducir las pérdidas humanas y minimizar los daños sociales y económicos. En Brasil, los usuarios del transporte público en las grandes ciudades presentan altos niveles de vulnerabilidad, dados los factores relacionados con la configuración espacial, la organización de los sistemas de transporte y el alto porcentaje de personas de nivel socioeconómico bajo dentro de los grandes suburbios que dependen exclusivamente del transporte público para acceder a empleos y servicios básicos. La vacunación de los usuarios del transporte público puede producir efectos prácticos relevantes en el combate a la covid-19 en Brasil, como el ahorro de recursos públicos, la reducción del número de muertes y una mayor eficiencia en el control sectorizado de la enfermedad en las ciudades. Por lo tanto, sugerimos que los formuladores de políticas consideren a los usuarios frecuentes del transporte público de las grandes ciudades brasileñas como un grupo objetivo en las campañas de vacunación y le den a este grupo cierto nivel de prioridad basado en un adecuado mapeo de riesgos a nivel local.

Considering the recent emergence of effective vaccines against COVID-19 and the scarce resources to assist most of the world population immediately, societies need to define the order in which groups of citizens will get access to new vaccines. Vaccination campaigns should prioritize the immunization of vulnerable individuals and people tasked with helping others, thus reducing human losses and minimizing social and economic damage. In Brazil, public transport users in large cities present high levels of vulnerability, due to factors related to the spatial configuration, the organization of transport systems and the high percentage of people of low socio-economic status within large suburbs that depend exclusively on public transport to access jobs and basic services. Immunizing public transport users can produce relevant practical effects in combating COVID-19 in Brazil, such as saving public resources, reducing the number of deaths and achieving greater efficiency in the sectorized control of the disease within cities. Therefore, we suggest that policymakers should consider the frequent users of public transport from large Brazilian cities as a target group in vaccination campaigns, affording this group some priority based on adequate risk mapping at the local level.

Access to free health-care services for the poor in tertiary hospitals of western Nepal: a descriptive study.

Background: Nepal is an underdeveloped country in which half of the total health expenditure is from out-of-pocket payments. Thus, the Government of Nepal introduced universal free health-care services up to the level of district hospitals, and targeted these services to poor and marginalized people in regional and subregional hospitals. The aim of this descriptive study was to explore the implementation and utilization of free health-care services by the target population (poor and marginalized people) in two tertiary-care hospitals in western Nepal, one with a social care unit (Western Regional Hospital) and one without a social care unit (Lumbini Zonal Hospital). Methods: Medical records maintained by the two hospitals for one Nepali calendar year were collected and analysed, along with information from key informant interviews with staff from each hospital and patient exit interviews. Results: Utilization of free health-care services by poor and marginalized people in the two tertiary-care hospitals was suboptimal: only 8.4% of patients using services were exempted from payment in Western Regional Hospital, whereas it was even fewer, at 2.7%, in Lumbini Zonal Hospital. There was also unintended use of services by nontarget people. Qualitative analysis indicated a lack of awareness of free health-care services among clients, and lack of awareness regarding target groups among staff at the hospitals. Importantly, many services were utilized by people from rural areas adjoining the district in which the hospital was situated. Conclusion: Utilization of free health-care services by the target population in the two tertiary-care hospitals was very low. This was the result of poor dissemination of information about the free health-care programme by the hospitals to the target population, and also a lack of knowledge regarding free services and target groups among staff working in these hospitals. Thus, it is imperative to implement educational programmes for hospital staff and for poor and marginalized people. Unintended use of free services was also seen by nontarget groups; this suggests that there should further simplification of the process to identify target groups.

The prevalence of schistosomiasis in school-aged children as an appropriate indicator of its prevalence in the community

School-aged children (6-15 years) from the endemic area of Pernambuco were evaluated both as a target group for and an indicator of schistosomiasis control in the community. Parasitological data were drawn from baseline stool surveys of whole populations that were obtained to diagnose Schistosoma mansoni infection. Nineteen representative localities were selected for assessing the prevalence of schistosomiasis among individuals in the following age groups: 0-5, 6-15, 16-25, 26-40 and 41-80 years. For each locality, the prevalence in each age group was compared to that of the overall population using contingency table analysis. To select a reference group, the operational difficulties of conducting residential surveys were considered. School-aged children may be considered to be the group of choice as the reference group for the overall population for the following reasons: (i) the prevalence of schistosomiasis in this age group had the highest correlation with the prevalence in the overall population (r = 0.967), (ii) this age group is particularly vulnerable to infection and plays an important role in parasite transmission and (iii) school-aged children are the main target of the World Health Organization in terms of helminth control. The Schistosomiasis Control Program should consider school-aged children both as a reference group for assessing the need for intervention at the community level and as a target group for integrated health care actions of the Unified Health System that are focused on high-risk groups.