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1.
Article in Portuguese | LILACS, COLNAL | ID: biblio-1222420

ABSTRACT

Esse artigo tem por objetivo traçar o histórico das relações da Organização Mundial da Saúde (OMS) com os atores não estatais desde a sua criação até a aprovação do Marco de Cooperação da Organização Mundial da Saúde com Agentes Não Estatais. foi realizada, uma pesquisa documental exploratória, de abordagem qualitativa, com revisão de literatura e de documentos institucionais encontrados na Biblioteca da OMS. Como resultados, verificou-se um aumento no número de atores no Sistema Internacional e uma redução no poder da OMS e na oferta de recursos financeiros por parte dos Estados ao longo da história da Organização e encontrou-se relação entre a maior diversificação nos tipos de atores no sistema internacio- nal e a menor influência OMS nos processos de governança global em saúde.


This study aims to trace the history of the World Health Organization's engagement with non-state actors from its inception to approval of the World Health Organization's Framework of Engagement with Non-State Actors. Exploratory documental research, with a qualitative approach, was carried out, with a review of the literature and institutional documents found in WHO Library. Findings showed an increase in number of actors in the International System and a reduction in the power of the World Health Organization and in the provision of financial resources by its Member States throughout the Organization's history. A relationship was also found between the diversification in the types of actors in the international system and a reduction of World Health Organization's influence in the processes of global health governance.


Este artículo tiene como objetivo rastrear la historia de las relaciones de la Organización Mundial de la Salud (OMS) con actores no estatales desde su creación hasta la aprobación del Marco de Cooperación de la Organización Mundial de la Salud con Agentes No Estatales. Se llevó a cabo una investigación documental exploratoria con enfoque cualitativo, con revisión de la literatura y documentos institucionales encontrados en la Biblioteca de la OMS. Los resultados muestran un aumento en el número de actores en el Sistema Internacional y una reducción en el poder de la OMS y en la provisión de recursos financieros por parte de los Estados a lo largo de la historia de la Organización. También se encontró una relación entre la diversificación de los tipos de actores en el sistema internacional y una reducción de la influencia de la Organización Mundial de la Salud en los procesos de gobernanza sanitaria mundial.


Subject(s)
Humans , World Health Organization/organization & administration , International Agencies/organization & administration , Public Health , Internationality
2.
Braz. J. Pharm. Sci. (Online) ; 56: e18756, 2020. tab, graf
Article in English | LILACS | ID: biblio-1249166

ABSTRACT

The use of medicines can be an indicator of healthcare access. Our aim was to evaluate the consumption of medicine and associated factors among adults in Manaus Metropolitan Region, located in the north of Brazil. A cross-sectional population-based study was conducted with adults, ≥18 years old, selected by probabilistic sampling. The outcome was the use of medicine in the previous 15 days. Poisson regression with robust variance was used to calculate the prevalence ratio (PR) of medicine consumption, with 95% confidence interval (CI). Use of medicines was reported by 29% (95% CI: 28-31%) of the participants. People with good (PR: 0.82, 95% CI: 0.72-0.94) and fair (PR: 0.77, 95% CI: 0.65-0.90) health status were shown to use less medication than those with very good health. People with partners (PR: 1.19, 95% CI: 1.08-1.31), and people who had sought healthcare service in the fortnight (PR: 2.16, 95% CI: 1.97-2.37) showed higher medicine consumption. Medical prescription (80.1%) was the main inductor of consumption; purchasing at a drug store (46.4%), and acquiring through the Brazilian Unified Health System (39.6%) were the main ways to obtain medicines. About one-third of adults in the Metropolitan Region of Manaus used medicines regularly, mainly people with very good health, living with partners, and with recent use of a health service.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Population , Unified Health System , Cross-Sectional Studies/methods , Adult , Drug Utilization/statistics & numerical data , Prescriptions , World Health Organization/organization & administration , Pharmaceutical Preparations/supply & distribution , Health Status , Delivery of Health Care/classification , Economics
4.
Rev. chil. enferm. respir ; 33(3): 180-182, set. 2017.
Article in Spanish | LILACS | ID: biblio-899673

ABSTRACT

Resumen El Convenio Marco para el Control del Tabaco (CMCT) es el primer tratado internacional, negociado bajo el amparo de la OMS como respuesta coordinada a la pandemia del tabaco y fue aprobado en la 56a Asamblea Mundial de la Salud, en mayo de 2003, por unanimidad. Fue suscrito por Chile el 25 de septiembre de 2003 en la sede las Naciones Unidas en Nueva York y ratificado el 13 de junio de 2005 para entrar en vigencia con carácter de ley, el 11 de septiembre de 2005. A partir de esa fecha el marco regulatorio del tabaco en Chile está dado por: • El CMCT; • El Decreto Ley 828 (27/12/1978), que regula temas relacionado con producción y comercialización del tabaco. • La Ley 19.419 (del 6/09/1995), que regula publicidad, promoción, patrocinio y ambientes libres de humo, entre otros. Si bien en nuestro país la legislación para el control del tabaco evidencia una gran producción legislativa, se puede observar que ésta se ha focalizado en algunos temas específicos, quedan pendientes importantes materias establecidas en el CMTC, en las que es necesario avanzar: • Medidas de reducción de la demanda relativas a la dependencia y al abandono del tabaco; • Comisión Coordinadora Control del Tabaco: • Control del Comercio Ilícito.


The Framework Convention on Tobacco Control (FCTC) is the first international treaty, negotiated under the umbrella of WHO as a coordinated response to the tobacco pandemic, and was unanimously approved by the 56th World Health Assembly in May 2003. It was signed by Chile on september 25, 2003 at United Nations headquarters in New York and it was ratified on june 13, 2005 becoming a law, on september 11, 2005. Since that date the regulatory framework of tobacco in Chile is given by: • The WHO Framework Convention on Tobacco Control (FCTC); • Decree Law 828 (27/12/1978), which regulates issues related to the production and commercialization of tobacco; • Law 19.419 (of 09/09/1995), which regulates advertising, promotion, sponsorship and smoke-free environments, among others. Although our country shows a big legislative production, it can be observed that this one has focused on some specific subjects, important matters are still pending established in the CMTC, in which it is necessary to advance: • Demand reduction measures related to tobacco dependence and cessation; • Tobacco Control Coordinating Committee: • Control of Illicit Trade.


Subject(s)
Humans , Adult , Tobacco Use Disorder/prevention & control , Tobacco Use Disorder/epidemiology , International Cooperation/legislation & jurisprudence , World Health Organization/organization & administration , Chile/epidemiology
5.
Ciênc. cuid. saúde ; 15(2): 203-211, Abr.-Jun. 2016. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-974824

ABSTRACT

RESUMO Neste estudo propôs-se desenvolver e validar o conteúdo de um Instrumento de avaliação dos pacientes candidatos à colocação do Cateter Central de Inserção Periférica (CCIP) valvulado, abordando as condições adequadas para seu uso prolongado. Trata-se de uma pesquisa quanti-qualitativa, exploratória e descritiva. A construção do Instrumento ocorreu mediante busca as bases de dados LILACS e PubMed, livros e manuais de capacitação. Para a validação do conteúdo do instrumento foi utilizada a técnica Delphi, em três etapas, com a participação de 11 enfermeiras capacitadas, sendo excluídas as que possuíam a capacitação há menos de um ano ou que não realizavam a técnica há pelo menos um ano. A pesquisa ocorreu no período de março a novembro de 2014. Todas as dimensões incluídas no instrumento inicial obtiveram aprovação de, pelo menos, 72,7%, e duas dimensões atingiram aprovação de 100% dos especialistas. O instrumento foi ajustado quanto à clareza, classificação do perfil do paciente e organização das questões. A versão final do Instrumento possibilitou melhor avaliação e padronização de todas as variáveis que interferem na inserção e manutenção no longo prazo do CCIP valvulado.


RESUMEN El objetivo del estudio fue desarrollar y validar el contenido de un Instrumento de evaluación de los pacientes candidatos a la colocación de Catéter Central de Inserción Periférica (PICC) valvulado, frente a las condiciones adecuadas al uso prolongado. Se trata de una investigación cuanti-cualitativa, exploratoria y descriptiva. La construcción del Instrumento se llevó a cabo a través de la búsqueda en las bases de datos LILACS y PubMed, libros y manuales de capacitación. Para la validez de contenido del instrumento se utilizó la técnica Delphi, en tres etapas, con la participación de 11 enfermeras capacitadas, siendo excluidas del estudio las que poseían la capacitación a menos de un año o que no realizaban la técnica durante al menos un año. La investigación se llevó a cabo entre marzo y noviembre de 2014. Todas las dimensiones incluidas en el instrumento inicial obtuvieron la aprobación de, al menos, el 72,7%, y dos dimensiones alcanzaron la aprobación de 100% de los expertos. El instrumento fue ajustado en cuanto a la claridad, clasificación del perfil del paciente y organización de las preguntas. La versión final del Instrumento permitió una mejor evaluación y estandarización de todas las variables que interfieren en la inserción y en el mantenimiento a largo plazo del PICC valvulado.


ABSTRACT This study proposes to develop and validate the content of an Evaluate Instrument of patients who are candidates to place a valved Peripherally Inserted Central Catheter (PICC), which will discuss the adequate conditions to its long-term use. This is a quanti-qualitative research, with exploratory and descriptive approaches. The construction of the Instrument was supported by searches on LILACS and PubMed databases, as well as books and training manuals. To validate the content of the instrument, the Delphi technique was used, which is subdivided in three stages and with the participation of 11 capacitated nurses, excluding those professionals who were capacitated less than a year ago, or those who did not use the mentioned technique for more than one year. The research took place from March to November 2014. All dimensions included in the initial instrument were approved, with at least 72.7% for a positive score, and two dimensions achieved a 100% approval by the specialists. The instrument was adjusted as suggested in clarity, classification of patient's profile, and organization of questions. The final version of the Instrument enabled better evaluation and standardization of the variables that interfere in the insertion and maintenance of the valved PICC in the long-run.


Subject(s)
Female , Veins/anatomy & histology , Delphi Technique , Central Venous Catheters/standards , World Health Organization/organization & administration , PubMed/standards , Catheters/standards , Ambulatory Care/organization & administration , LILACS/standards , Nurses/standards , Nursing, Practical/education
6.
EMHJ-Eastern Mediterranean Health Journal. 2016; 22 (7): 548-552
in English | IMEMR | ID: emr-181512

ABSTRACT

A novel strain of influenza A virus H1N1 surfaced in Mexico in April 2009 and quickly spread across the globe, turning an epidemic into a pandemic. Within two months, the World Health Organization [WHO] declared an international health emergency and raised the threat bar from level V to level VI, i.e. containment to mitigation. During this time, the WHO Regional Office for the Eastern Mediterranean worked closely with its Member States, other stakeholders and WHO headquarters to manage the situation. This report examines the steps taken as part of this response. Programme documents were reviewed and key personnel interviewed for this study. A hallmark of the response was the establishment of the Strategic Health Operations Centre to bring together experts from different technical backgrounds at regional level. Several lessons were learnt that can provide the basis for standard operating procedures, protocols and guidelines for emergency events in future


Subject(s)
Humans , Influenza A virus , Influenza A Virus, H3N2 Subtype , Polymerase Chain Reaction , Hemagglutinins/genetics , World Health Organization/organization & administration
7.
Rio de Janeiro; s.n; nov. 2014. 125 p. tab, graf, ilus.
Thesis in Portuguese | LILACS | ID: lil-762421

ABSTRACT

Este trabalho tem como objetivo analisar a atual proposta de reforma da Organização Mundial da Saúde (OMS), buscando identificar, descrever e avaliar as mudanças e continuidades entre o processo em curso e outras mudanças organizacionais (chamadas reformas) implementadas no período 1998-2014. Fez-se um repasse sobre a constituição histórica da OMS e os desafios que enfrentou para sua legitimação na arena internacional, incluindo os embates internos e externos que conduziram à discussão contemporâneo sobre sua reforma. O foco do estudo é a proposta de reforma de 2010, elaborada pela Diretora-Geral (DG) Dra. Margaret Chan, que trata do futuro do financiamento da OMS e da incapacidade da organização de responder, de forma rápida e ágil, aos desafios atuais da saúde global, centrados, segundo a DG, na insustentabilidade do atual modelo de gestão, financiamento e programação institucional, frente às necessidades de saúde das populações no século XXI. O estudo analisou as reformas elaboradas pelas gestões desse período, com foco nas propostas orçamentárias e planos de trabalho institucionais. Utilizou-se para análise a articulação entre diferentes abordagens teóricas, relacionadas aos impactos da globalização sobre a saúde das populações; a maior interdependência entre os países e a consequente ampliação da disputa de poder no sistema mundial; a relação entre a conformação do termo saúde global e a dinâmica entre as instituições que atuam na arena internacional do setor, assim como a importância da saúde nas relações internacionais contemporâneas e a chamada governança global na área. A estratégia metodológica foi de estudo de caso, amparada em técnicas qualitativas para o levantamento de dados – revisão bibliográfica; amplo levantamento e análise documental; e observação social direta do autor...


This study examined the current World Health Organisation (WHO) reform proposal with a view to identifying, describing and evaluating changes and continuities between the present process and other organisational changes (termed reforms) implemented between 1998 and 2014. The formation of the WHO was reviewed historically, along with the challenges it faced in gaining international legitimacy, including the internal and external conflicts that led to the present discussion over reform. The focus of the study is the 2010 reform proposal prepared by WHO Director-General (DG) Dr Margaret Chan, which addresses the future of WHO funding and the organisation’s inability to respond, quickly and agilely, to today’s global health challenges, which she sees as centred in a lack of sustainability of the present model of organisational management, funding and planning in light of populations health needs in the 21st century. They study examined the reforms drawn up by the various administrations over the period, focussing on budget proposals and institutional work plans. The analysis deployed a combination of different theoretical approaches relating to the impacts of globalisation on population-wide health; the greater interdependence among countries and the consequent broadening of power disputes in the world system; the relation between the term global health and the dynamics among institutions operating in the international health sector arena; and the importance of health in contemporary international relations and ‘global governance’ of the field...


Subject(s)
Humans , Budgets , Global Health , Health Care Reform , International Cooperation , World Health Organization/economics , World Health Organization/organization & administration
8.
Biomédica (Bogotá) ; 34(supl.1): 9-15, abr. 2014.
Article in English | LILACS | ID: lil-712416

ABSTRACT

The microbes that infect us spread in global and local epidemics, and the resistance genes that block their treatment spread within and between them. All we can know about where they are to track and contain them comes from the only places that can see them, the world´s microbiology laboratories, but most report each patient´s microbe only to that patient´s caregiver. Sensors, ranging from instruments to birdwatchers, are now being linked in electronic networks to monitor and interpret algorithmically in real-time ocean currents, atmospheric carbon, supply-chain inventory, bird migration, etc. To so link the world´s microbiology laboratories as exquisite sensors in a truly lifesaving real-time network their data must be accessed and fully subtyped. Microbiology laboratories put individual reports into inaccessible paper or mutually incompatible electronic reporting systems, but those from more than 2,200 laboratories in more than 108 countries worldwide are now accessed and translated into compatible WHONET files. These increasingly web-based files could initiate a global microbial sensor network. Unused microbiology laboratory byproduct data, now from drug susceptibility and biochemical testing but increasingly from new technologies (genotyping, MALDI-TOF, etc.), can be reused to subtype microbes of each genus/species into sub-groupings that are discriminated and traced with greater sensitivity. Ongoing statistical delineation of subtypes from global sensor network data will improve detection of movement into any patient of a microbe or resistance gene from another patient, medical center or country. Growing data on clinical manifestations and global distributions of subtypes can automate comments for patient´s reports, select microbes to genotype and alert responders.


.


Subject(s)
Humans , Bacterial Infections/drug therapy , Drug Resistance, Bacterial , Global Health , Information Dissemination , International Cooperation , Information Services/organization & administration , Laboratories/organization & administration , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Boston , Bacteria/classification , Bacteria/drug effects , Bacterial Infections/epidemiology , Bacterial Typing Techniques/methods , Computer Systems , Data Collection , Databases, Factual , Electronic Health Records , Epidemiological Monitoring , Geographic Mapping , Hospitals, University/organization & administration , Internet , Information Services/trends , Laboratories/trends , Software , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , World Health Organization/organization & administration
9.
Arq. odontol ; 50(03): 103-112, 2014. tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-850175

ABSTRACT

Objetivo: Avaliar a experiência de cárie dentária, identificar os grupos de polarização e verificar os fatores associados à doença cárie dentária em escolares e pré-escolares do município de Pirassununga, SP Materiais e Métodos: A coleta de dados foi realizada por levantamento epidemiológico em 2006, em pré-escolares de 5 anos (n = 113) e escolares de 12 anos (n = 117). Foram utilizados os códigos e critériospadronizados pela OMS. Em seguida, realizou-se análise de regressão de Poisson entre grupos com presençade cárie dentária (CPOD/ceod > 0) e grupo SiC (Significant Caries Index). Resultados: Aos 5 anos, 62,8% daamostra era composta por crianças livres de cárie, com média do ceod de 2,0 (dp = 2,9) e média do SiC 4,0 (dp =3,6). Aos 12 anos, a média de CPOD foi de 1,2 (dp = 1,9), a média do SiC foi de 3,1 (dp = 2,4) e 53,8% eram livresde cárie. As variáveis que se apresentaram associadas à cárie dentária aos 5 anos no grupo com experiência de cárie dentária (ceod > 0) foram: ter procurado o dentista por motivo de dor/cárie (p = 0,00) e ter como responsável pelo sustento o pai ou a mãe (p = 0,053). No grupo de polarização (SiC) foram: frequência de escovação de 1 a 2 vezes ao dia (p = 0,052) e ter visitado o dentista no último ano (p = 0,025). Aos 12 anos, no grupo com experiência de cáriedentária (CPOD > 0), as variáveis com força de associação foram: meio de transporte ônibus/bicicleta (p= 0,026)e ter faltado à escola por dor/cárie (p = 0,011). No SIC, as variáveis encontradas foram: meio de transporte ônibus/bicicleta (p = 0,034) e ter visitado o dentista no último ano (p = 0,023). Conclusão: Em ambos os grupos etários, na dentição decídua e dentição permanente, em ambos os grupos (CPOD e SiC), a experiência de cárie foi associado a fatores socioeconômicos, sóciocomportamentais e de acesso.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Dental Caries/epidemiology , Toothbrushing , World Health Organization/organization & administration , Socioeconomic Factors , Health Surveys
14.
São Paulo; s.n; 2012. 60 p. tab. (BR).
Thesis in Portuguese | LILACS, BBO | ID: biblio-866512

ABSTRACT

A Paralisia Cerebral (PC) é considerada a principal causa de deficiência física grave na infância, sendo comum o comprometimento motor associado. Esse, por sua vez, é apontado como a maior causa da alta prevalência de problemas na alimentação dessas crianças. Faz parte da função motora orofacial a respiração, a mastigação, a deglutição, a fala, a expressão facial e a aparência, e dessa forma, a disfunção pode comprometer o bem-estar da criança e de seu cuidador, uma vez que, quando presente, interfere na dinâmica interna e na rotina da família. O presente trabalho objetivou correlacionar 2 métodos de avaliação motora orofacial, avaliar a influência do comprometimento funcional orofacial no estado nutricional de crianças e adolescentes com PC e sua associação com condições socioecônomicas. Foram selecionadas 70 crianças e adolescentes com diagnóstico de PC, com idade de 6 a 16 anos (grupo estudo), e 129 crianças normorreativas, pareadas por gênero e idade aos PCs (grupo controle). Para a avaliação motora orofacial foram aplicados os instrumentos Oral Motor Assessment Scale (OMAS) e Nordic Orofacial Test-Screening (NOT-S). A avaliação antropométrica foi baseada nas curvas da Organização Mundial da Saúde (OMS), segundo os critérios do Ministério da Saúde do Brasil. Houve correlação estatisticamente significante entre os métodos de avaliação oromotora (r= -0,439, p<0,0001). Quanto à avaliação nutricional, observamos maior prevalência de estar acima do peso para as variáveis tipo de PC- distônico e misto (p=0,034), mães sem companheiro (p=0,045) e para menor comprometimento oromotor (p=0,028). Concluimos que, o ganho de peso em crianças e adolescentes é favorecido por um melhor desempenho funcional oromotor e fatores sociais.


Cerebral palsy (CP) is the main cause of severe physical impairment during childhood, which has commonly shown motor association. This has been pointed out as the main cause of high prevalence of problems in childrens nutrition. It is part of orofacial motor function: respiration, chewing, swallowing, speaking, facial expression and appearance, and therefore, the impairment can affect childrens well-being. The aim of this study was to correlate 2 methods of oral facial motor evaluation, evaluate the influence of oral facial functional impairment on the nutritional status of children and adolescents with CP, and the association between socioeconomic factors. 70 children and adolescents were selected with definitive CP diagnosis, age range 6-16 yrs and exclusion criteria previously determined, 129 normoreactive children, sex and age-matched to CPs (control group). For the oral facial motor evaluation two evaluation instruments were applied Oral Motor Assessment Scale (OMAS) and Nordic Orofacial Test-Screening (NOT-S). The anthropometric evaluation was based on the World Health Organization (WHO), according to the criteria recommended by the Brazilian Ministry of Health. There was statistically significant correlation between the oral motor methods of evaluation (r=-0.439, p<0.0001). With regards to the nutritional status evaluation, the studied population showed greater prevalence for overweight referring to the variables CP forms, dystonic and mixed (p=0.034), mother with no partnership (p=0.045) and a smaller oral motor impairment (p=0.028). It was concluded that, the weight´s gain by children and adolescents is favoured by a better functional oral motor performance and social factors.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Nutrition Assessment , World Health Organization/organization & administration , Cerebral Palsy/diagnosis
15.
Arq. odontol ; 48(4): 263-269, 2012. tab
Article in Portuguese | LILACS, BBO | ID: lil-698358

ABSTRACT

Objetivo: Identificar as necessidades de tratamento dentário entre idosos brasileiros dentados e os benefícios do método de avaliação direta, proposto pela OMS, a partir da comparação entre os métodos de avaliação direta e indireta, por dente e por indivíduo. Materiais e Métodos: Utilizaram-se dados dos 5.349 idosos examinados no SB Brasil 2002/2003. As avaliações direta e indireta da necessidade de tratamento dentário (NTD) foram estimadas a partir da prevalência de indivíduos com NTD, considerando os idosos dentados como denominador. Calculou-se também o número médio de dentes com necessidade de tratamento.A avaliação direta da NTD foi conduzida em todos os dentes presentes. A avaliação indireta da NTD foi estimada a partir da experiência de cárie das coroas, identificando-se o índice CPO-D e seus componentes. As coroas restauradas com cárie e as cariadas foram consideradas com necessidade. Na comparação entre os métodos direto e indireto, utilizaram-se os testes qui-quadrado e Mann-Whitney (p<0,05). Resultados: Entre os idosos, 2418 (45,2%) eram dentados e a maioria apresentou NTD, independentemente do método de avaliação. Constatou-se maior prevalência de necessidades pelo método direto (69,1%/64,6%) (p<0,001), sendo principalmente de restaurações (49,65%) e extrações (45,39%). A média de dentes com necessidades diferiu entre os métodos, sendo menor no indireto (2,72±3,83) (p<0,001). Conclusão: Há alta prevalência de necessidade restauradora e de extrações entre os idosos brasileiros. Os benefícios na forma de avaliação proposta pela OMS foram evidentes pela estimativa mais fidedigna de maior número de indivíduos/dentes com necessidade de tratamento dentário, além da definição do tipo de tratamento necessário.


Subject(s)
Humans , Male , Female , Aged , Dental Care for Aged/organization & administration , Dental Health Surveys , Health Planning/organization & administration , Public Health Dentistry/organization & administration , World Health Organization/organization & administration
16.
Article in English | LILACS | ID: lil-612967

ABSTRACT

By the end of 2010, Latin America and the Caribbean (LAC) achieved 63% antiretroviral treatment (ART) coverage. Measures to control HIV drug resistance (HIVDR) at the countrylevel are recommended to maximize the efficacy and sustainability of ART programs. Since 2006, the Pan American Health Organization has supported implementation of the WorldHealth Organization (WHO) strategy for HIVDR prevention and assessment through regional capacity-building activities and direct technical cooperation in 30 LAC countries. By 2010, 85 sites in 19 countries reported early warning indicators, providing information about the extent of potential drivers of drug resistance at the ART site. In 2009, 41.9% of sites did notachieve the WHO target of 100% appropriate first-line prescriptions; 6.3% still experienced high rates (> 20%) of loss to follow-up, and 16.2% had low retention of patients (< 70%) on first-line prescriptions in the first year of treatment. Stock-outs of antiretroviral drugs occurred at 22.7% of sites. Haiti, Guyana, and the Mesoamerican region are planning and implementing WHO HIVDR monitoring surveys or threshold surveys. New HIVDR surveillance tools for concentrated epidemics would promote further scale-up. Extending the WHO HIVDR lab network in Latin America is key to strengthening regional lab capacity to support quality assuredHIVDR surveillance. The WHO HIVDR control strategy is feasible and can be rolled out in LAC. Integrating HIVDR activities in national HIV care and treatment plans is key to ensuring the sustainability of this strategy.


Hacia fines del 2010, América Latina y el Caribe lograron una cobertura de tratamiento antirretroviral de 63%. Se recomienda la ejecución de medidas para controlar la farmacorresistencia del VIH a nivel de país para potenciar al máximo la eficacia y la sostenibilidad de los programas de tratamiento antirretroviral. Desde el 2006, la Organización Panamericana de la Salud ha apoyado la aplicación de la estrategia de la Organización Mundial de la Salud (OMS) para la prevención y la evaluación de la farmacorresistenciadel VIH mediante actividades regionales de formación de capacidad y de cooperación técnica directa en 30 países de América Latina y el Caribe. En 2010, 85 centros en 19 países notificaron indicadores de alerta temprana y suministraron información acerca del alcance de los posibles impulsores de la farmacorresistencia enlos centros de tratamiento antirretroviral. En el 2009, 41,9% de los centros no lograron la meta de la OMS de 100% de prescripción de medicamentos de primera línea apropiados; 6,3% todavía tenían tasas elevadas (> 20%) de pérdida de seguimiento y 16,2% tenían una baja retención de pacientes (< 70%) en tratamiento con antirretrovirales deprimera línea en el primer año de tratamiento. Se registraron desabastecimientos de medicamentos antirretrovirales en 22,7% de los centros. Haiti, Guyana y la zona mesoamericana están planificando y ejecutando estudios de vigilancia de la farmacorresistencia del VIH o estudios del umbral de la OMS. Las nuevas herramientas para la vigilancia de la farmacorresistencia del VIH en las epidemias concentradas permitiránuna mejor vigilancia. La ampliación de la red de laboratorios de farmacorresistenciadel VIH acreditados por la OMS en América Latina es fundamental para el fortalecimientode la capacidad de los laboratorios regionales, a fin de de efectuar una vigilancia de la farmacorresistencia del VIH de calidad garantizada...


Subject(s)
Humans , Anti-HIV Agents/pharmacology , Drug Resistance, Viral , HIV-1 , Population Surveillance , World Health Organization/organization & administration , Anti-HIV Agents/supply & distribution , Caribbean Region/epidemiology , Drug Resistance, Viral/genetics , Feasibility Studies , Global Health , Health Plan Implementation , Health Surveys , HIV Infections/epidemiology , HIV Infections/virology , Latin America/epidemiology , Time Factors
17.
Rev. panam. salud pública ; 30(2): 133-143, agosto 2011. ilus, tab
Article in Spanish | LILACS | ID: lil-608297

ABSTRACT

El presente estudio tuvo como objetivos a) conocer en qué medida América Latina y el Caribe (ALC) se vio beneficiada por los aumentos de la asistencia internacional para el desarrollo de la salud (ADS) a nivel mundial y si la tendencia observada después de la Cumbre del Milenio, también fue una tendencia observada en la Región, b) determinar si existen diferencias en la distribución de esta asistencia, según el ingreso bruto per cápita de los países, c) identificar el posible efecto de la crisis financiera internacional de 2008 en la ayuda oficial bilateral y d) comparar las tendencias que tuvo el gasto público salud con respecto a la ADS antes y después de la Cumbre del Milenio Se encontró que la ADS en ALC sigue un curso muy diferente al de otras regiones del mundo. A partir de 1997 se entra en un período de estancamiento fluctuante que se extiende hasta 2008, con desembolsos promedios anuales de US$ 1 200 millones. La banca multilateral tuvo una participación de 79 por ciento de los desembolsos promedios entre 2002 y 2008 en los países de ingreso medio alto, mientras que la ayuda oficial bilateral registró la mayor participación (61 por ciento) en los países de ingresos medios bajos y bajos. En este período la ayuda bilateral tiene un crecimiento anual de 13 por ciento, pero en el año posterior a la crisis los desembolsos caen en US$ 20 millones. El 64 por ciento de la ayuda bilateral provino de Estados Unidos, España y Canadá, y el 29 por ciento de la misma se destinó a VIH/Sida y enfermedades de transmisión sexual. Después de la Cumbre del Milenio la ADS canalizada hacia los gobiernos disminuyó en un 30 por ciento entre 2001-2006 y su participación con respecto al gasto público en salud regional fue de 0,30 por ciento en el mismo período, con una proporción igualmente marginal con respecto al gasto total en salud para 2008 (0,37 por ciento; US$ 2 per cápita). Se concluye que después de la Cumbre del Milenio la ADS en ALC no creció ni logró igualar las tendencias antes del 2000 y el gasto público en salud siguió su tendencia de crecimiento histórico, sin mayores incrementos con respecto al producto interno bruto regional. Frente a este panorama y por ser ALC la región más desigual pero no la más pobre del mundo, resulta imperativo replantearse las formas de pensar, conducir y entregar la cooperación para el desarrollo de la salud con enfoques innovadores y mecanismos alternativos de financiamiento que respondan más y mejor a las realidades de la región.


The purpose of this study is (a) to examine the ways in which Latin America and the Caribbean (LAC) have benefited from increases in international development assistance for health (DAH) at the global level and whether the trend observed after the Millennium Summit has also applied to the Region; (b) to determine whether there are differences in the distribution of this assistance, based on the gross per capita income of each country; (c) to identify the possible effects of the 2008 international financial crisis on official bilateral assistance; and (d) to compare trends in public health expenditure in relation to DAH before and after the Millennium Summit. The study has found that DAH in LAC follows a very different pattern than in other regions of the world. The period from 1997 to 2008 was one of fluctuating stagnation, with average annual disbursements of US$ 1 200 million. Multilateral financial institutions accounted for 79 percent of the average disbursements in the upper-middle income countries between 2002 and 2008, while official bilateral assistance held the greatest share (61 percent) in the low- and lower-middle income countries. Bilateral assistance grew at an annual rate of 13 percent during this period, but in the year after the crisis, disbursements fell to US$ 20 million. Sixty-four percent of bilateral assistance came from the United States, Spain, and Canada, with 29 percent of it being directed to HIV/AIDS and sexually transmitted diseases. After the Millennium Summit DAH channeled to governments decreased 30 percent in the period 2001-2006, and its share of public health expenditure in the region was 0.3 percent for the same period, with an equally marginal proportion in relation to total health expenditure for 2008 (0.37 percent; US$ 2 per capita). The study concludes that after the Millennium Summit, DAH in LAC did not grow nor did it equal the trends prior to 2000, and public health expenditure followed its historical growth trend, without further increases in relation to the regional gross domestic product. Given these realities and the fact that LAC is the world's most unequal region, but not its poorest, it is imperative to reconsider the concepts, management, and delivery of cooperation in the development of health, using innovative approaches and alternative financing mechanisms that respond more effectively to the realities of the region.


Subject(s)
Humans , Financing, Organized/organization & administration , International Cooperation , Public Health/economics , Global Health/economics , Caribbean Region , Developing Countries/economics , Goals , Health Planning Support , Health Services Needs and Demand , Health Expenditures/statistics & numerical data , Health Promotion/economics , Health Promotion/organization & administration , Latin America , Pan American Health Organization/economics , Pan American Health Organization/organization & administration , World Health Organization/economics , World Health Organization/organization & administration
19.
Rev. GASTROHNUP ; 12(1): S14-S19, ene.15 2010. graf
Article in Spanish | LILACS | ID: lil-645076

ABSTRACT

La Organización Mundial de la Salud (OMS) recomienda la alimentación exclusiva al seno, durante al menos los primeros 6 meses de vida del niño, y continuar el amamantamiento junto con las comidas complementarias adecuadas hasta los 2 años de edad; muchos niños verán interrumpida la alimentación al seno en las primeras semanas o meses de vida. Durante décadas pasadas y aún en la actualidad, profesionales mal informados, han advertido a la madre del peligro de desnutrición derivado de la alimentación con leche materna, lo cual ha conducido, a un patrón de crecimiento "ideal", propiciado por la sobrealimentación con sucedáneos de la leche materna. Se plantean dos problemas en la relactación: 1) La decisión de no amamantar y 2) El abandono o destete precoz de la lactancia materna. Cuando las madres reciben un buen apoyo para amamantar, rara vez debería ser necesaria la relactación. Si esta necesidad ocurre frecuentemente, indica que el apoyo a la lactancia materna debe mejorarse. Es posible identificar los factores asociados al éxito o fracaso de la lactancia, así como las acciones que presentan mayor efectividad, acciones específicas realizadas en unidades de atención primaria pueden lograr el inicio y prolongar la duración de la lactancia materna.


The World Health Organization (WHO) recommends exclusive breast-feeding for at least the first 6 months of a child's life and continued breastfeeding with appropriate complementary foods until 2 years of age, many children will be interrupted breast feeding in the first weeks or months of life. During past decades and even today, professional misinformed mother warned of the danger of malnutrition resulting from breast-feeding, which has led to a growth pattern "ideal", led by overeating substitutes breast milk. There are two problems in relactation: 1) The decision not to breastfeed and 2) The abandonment or early weaning of breastfeeding. When mothers receive good support for breastfeeding should rarely be necessary relactation. If this necessity occurs often indicates that support for breastfeeding should be improved. It is possible to identify the factors associated with success or failure of breastfeeding, as well as the actions that have greater effectiveness, specific measures undertaken in primary care units can achieve the onset and prolong the duration of breastfeeding.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Breast Feeding/statistics & numerical data , Breast Feeding/methods , Breast Feeding/trends , Milk, Human , Infant Nutrition Disorders/classification , Infant Nutrition Disorders/prevention & control , Breast Feeding/economics , World Health Organization/organization & administration , Weaning
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