Salud ambiental infantil en el contexto de la reubicación de familias de campamentos a viviendas sociales / Child health environment in the context of relocating of camp site families to social housing

Introducción: Intervenciones habitacionales destinadas a superar la pobreza pueden generar cambios en la situación de salud de la población infantil, modificando factores de riesgo en el entorno físico y social de niños y niñas. El objetivo fue identificar indicadores de salud ambiental infantil susceptibles de ser modificados con la reubicación de familias desde campamentos a vivienda social. Sujetos y método: Estudio transversal en niños de 2-8 años. Se comparó dos grupos de familias provenientes de campamentos. Un grupo fueron familias reubicadas en viviendas sociales entre 2001 y 2002 (n = 115). El otro grupo corresponde a niños cuyas familias permanecieron en campamentos (n = 88) de la zona poniente de Santiago. Se recolectó información sobre: características socioeconómicas, ambiente intradomiciliario y de barrios, y eventos en salud: síntomas respiratorios, accidentabilidad y cuidado materno infantil. Se emplearon pruebas de x², Fisher y Mann-Whitney para la comparación de los grupos. Resultados: Se identifican diferencias entre los grupos comparados en relación a la tenencia de mascotas, presencia de hongos/humedad en el hogar, tipo de combustibles utilizados y problemas de seguridad percibidos en los barrios (p<0,05). Las familias de campamentos reportan una mayor tenencia de mascotas (73,8% v/s 32,2%%), presencia de huellas de humedad/hongos en el hogar (43,2% v/s 18,3%), uso de leña (39,8% v/s 0,0%), en comparación con familias de viviendas sociales. Residentes de viviendas sociales perciben mayores problemas de seguridad en el barrio, mientras que los niños presentan mayor frecuencia de síntomas relacionados con asma y menor diversidad de accidentes en el hogar comparado con el grupo residente en campamentos. Conclusiones: Entre los factores estudiados, aquellos susceptibles de ser modificados con la reubicación de familias desde campamentos a vivienda social se vinculan a indicadores de calidad del aire interior y seguridad en los barrios. Lo anterior refuerza la necesidad de profundizar en las influencias positivas y negativas de la movilidad residencial de estos grupos, desde una perspectiva centrada en el bienestar infantil.

Introduction: Housing interventions aimed at overcoming poverty can lead to changes in the health status of children by modifying risk factors in their physical and social environment Objective: the aim was to identify children's environmental health factors to change with the relocation of families from slums to public housing. Subjects and method: A cross-sectional study was conducted in children ages 2-8 years old of families relocated to public housing (n=115) who were compared to children residing in slums (n=88) in Santiago, Chile. Family socioeconomic characteristics, indoor environment and neighborhoods were collected. It was included respiratory symptoms, accidents and maternal-child care of children. x², Fisher and Mann-Whitney test were used to compare groups. Results: There were differences in households related to pets keeping, presence of humidity/molds in homes, types of fuels, and perceived safety problems in neighborhoods (p<0.05). The families from slums reported higher tenancy of pets (73.8% v/s 32.2%%), humidity/molds in homes (43.,2% v/s 18.3%), use of wood for heating (39.8% v/s 0.0%), compared with families of public housing. Residents of public housing perceived more safety problems in neighborhood, and children have more asthma related symptoms and have lower diversity of accidents in home. Conclusion: Among the factors studied, indoor air quality and safety in neighborhoods could be linked to changes from the relocation of families. This reinforces the need to deepen the positive and negative influences of residential mobility of these groups focused on child welfare perspective.

Adopting integrated management of childhood illness module at local level in Bangladesh: implications for recurrent costs.

This study estimated the recurrent cost implications of adopting Integrated Management of Childhood Illness (IMCI) at the first-level healthcare facilities in Bangladesh. Data on illnesses of children who sought care either from community health workers (CHWs) or from paramedics over a four-month period were collected in a rural community. A total of 5,505 children sought care. About 75% of symptoms mentioned by mothers were directly related to illnesses that are targeted in the IMCI. Cough and fever represented 64% of all reported complaints. Referral of patients to higher facilities varied from 3% for the paramedics to 77% for the CHWs. Had the IMCI module been followed, proportion of children needing referral should have been around 8%. Significant differences were observed between IMCI-recommended drug treatment and current practice followed by the paramedics. Adoption of IMCI should save about US$ 7 million on drugs alone for the whole country. Proper implementation of IMCI will require employment of additional health workers that will cost about US$ 2.7 million. If the current level of healthcare use is assumed, introduction of IMCI in Bangladesh will save over US$ 4 million.