RESUMEN
Early diagnosis of autism spectrum disorder (ASD) is essential for improved outcomes. There is a paucity of data on the prevalence of ASD in low- and middle-income countries (LMIC), but early identifcation may be further delayed in those communities. In this paper, recent studies on strategies for the early detection of ASD, and the prevalence of ASD in LMIC are reviewed. The limitations that can arise in the early identifcation of ASD in LMIC communities are discussed, and screening tools and strategies that can be helpful are identifed. The goal is to recommend models that are culturally appropriate and scientifcally valid, easily integrated within community settings while strengthening community systems and reducing disparities in the early identifcation of ASD. Starting locally by simplifying and demystifying the ASD identifcation process and building community connections will inform global researchers and policymakers while making a diference in the lives of the children and families afected by ASD.
RESUMEN
Objetivo: Evaluar y sintetizar la evidencia científica que presente información sobre la efectividad de las intervenciones preventivas realizadas por los trabajadores comunitarios en salud materna y salud infantil a nivel hogar. Metodología: Se realizó una revisión sistemática de la literatura. La búsqueda se realizó desde 1966 a 2014 en las diferentes bases de datos: Medline, Embase, Lilacs, Cochrane, CINHAL, OMS series y google schollar. Se incluyeron estudios tipo experimental o cuasi experimentales que abordaran la incorporación de trabajadores comunitarios en intervenciones de prevención primaria para salud materna e infantil. Se realizó una síntesis narrativa de los resultados. Resultados: se identificó un total de 12 560 referencias; de estas se tamizaron 6234. Se incluyeron en esta revisión, posterior a una evaluación de calidad metodológica, 19 estudios. De estos se identificaron diseños como ensayos clínicos controlados, ensayos por conglomerados, estudios de antes y después, estudios observacionales analíticos tipo casos y controles y estudios de corte transversal. Se identificaron actividades de promoción y prevención para malaria, adherencia a la lactancia materna, cuidados del recién nacido, cuidados y soporte para el momento del parto. En todos los escenarios se demostró efectividad de la inclusión del trabajador comunitario en los desenlaces de adherencia y reducción de mortalidad materna e infantil. Conclusiones: La inclusión de los trabajadores comunitarios es efectiva en la reducción de la mortalidad materna e infantil en países de bajos y medianos ingresos. Además de ello, mejora el acceso y la cobertura a los servicios de salud de poblaciones vulnerables.
Objective: To evaluate and synthesize scientific evidence that reports on the effectiveness of preventive interventions by community workers in maternal and child health at the household level. Methods: A systematic literature review was conducted. The search was conducted from 1966-2014 in different databases: Medline, Embase, Lilacs, Cochrane, CINAHL, WHO and google Schollar series. Experimental or quasi-experimental studies that addressed the incorporation of community workers in primary prevention interventions for maternal and child health were included. A narrative summary of the results was performed. Results: A total of 12 560 references were identified, of these 6234 references were screened. They were included in this review, after an assessment of methodological quality, 19 studies. Of these 19 studies designs as controlled clinical trials, cluster tests, before and after studies, analytical observational case-control studies and cross-sectional studies we were identified. Advocacy and malaria prevention, adherence to breastfeeding, newborn care, care and support during childbirth were identified. In all scenarios, including the effectiveness of Community worker in the outcomes of adherence and reduction of maternal and infant mortality it was demonstrated. Conclusions: Inclusion of community workers is effective in reducing maternal and infant mortality in low- and middle-income. Moreover it is improving access and coverage of health services to vulnerable populations.
RESUMEN
Objetivo: Explorar la autopercepción sobre condiciones laborales y salud en inmigrantes colombianos en Alicante, España. Material y método Estudio cualitativo descriptivo mediante 11 entrevistas y 2 grupos de discusión en trabajadores con y sin permiso de trabajo y residencia de más de 6 meses en la provincia de Alicante (España), durante los meses de noviembre de 2006 a enero de 2007. Se realizó análisis narrativo de contenido y se obtuvieron categorías mixtas de acuerdo y disenso. Resultados: La inmigración es entendida como un proyecto para mejorar las condiciones socioeconómicas del trabajador inmigrante y su familia. El reconocimiento social y laboral puede evitar la aparición de fenómenos de exclusión y discriminación. Las personas entrevistadas asociaron sus problemas de salud con sus condiciones de vida, manifestando que constituyen limitaciones para la realización de actividades cotidianas. Conclusiones: La situación laboral y de salud es considerada desde una perspectiva multidimensional, asociada a condiciones biológicas y socioculturales. Sería necesaria una mayor acción política para mejorar la situación económica, laboral y de salud de la población inmigrante.
Objective: Exploring the self-perceptions of a group of migrants from Colombia living in Alicante , Spain , regarding their working conditions and health. Material and methods This was a qualitative and descriptive research was conducted on a group of Colombian workers (with and without legal permission to work) having lived in Alicante ( Spain ) for more than 6 months. 11 interviews were carried out, plus 2 focal groups, from November 2006 to January 2007. The interviews were recorded and transcribed. A narrative analysis of the contents was carried out, a mixture of categories being obtained from different viewpoints. Results: Immigration was understood as being an action for improving an immigrant worker and family's socioeconomic conditions. Work and social recognition should lead to avoiding exclusion and discrimination. The people interviewed had associated their health problems with their living conditions. Such problems were considered to be a limitation on carrying out their daily activities. Conclusions: Working and health situations were perceived from a multi-dimensional perspective associated with biological and socio-cultural conditions. More political action should be taken for improving immigrant people's economic, work and health conditions.