ABSTRACT
The World Health Organization (WHO) has a mandate to promote maternal and child health and welfare through support to governments in the form of technical assistance, standards, epidemiological and statistical services, promoting teaching and training of healthcare professionals and providing direct aid in emergencies. The Strategic and Technical Advisory Group of Experts (STAGE) for maternal, newborn, child and adolescent health and nutrition (MNCAHN) was established in 2020 to advise the Director-General of WHO on issues relating to MNCAHN. STAGE comprises individuals from multiple low-income and middle-income and high-income countries, has representatives from many professional disciplines and with diverse experience and interests.Progress in MNCAHN requires improvements in quality of services, equity of access and the evolution of services as technical guidance, community needs and epidemiology changes. Knowledge translation of WHO guidance and other guidelines is an important part of this. Countries need effective and responsive structures for adaptation and implementation of evidence-based interventions, strategies to improve guideline uptake, education and training and mechanisms to monitor quality and safety. This paper summarises STAGE's recommendations on how to improve knowledge translation in MNCAHN. They include support for national and regional technical advisory groups and subnational committees that coordinate maternal and child health; support for national plans for MNCAHN and their implementation and monitoring; the production of a small number of consolidated MNCAHN guidelines to promote integrated and holistic care; education and quality improvement strategies to support guidelines uptake; monitoring of gaps in knowledge translation and operational research in MNCAHN.
Subject(s)
Adolescent Health , Maternal Health Services , Adolescent , Child , Family , Female , Humans , Infant, Newborn , Nutritional Status , Pregnancy , Translational Science, Biomedical , World Health OrganizationABSTRACT
OBJECTIVE: Describe the perceptions of key actors regarding the disruption of health services for populations that ceased to be prioritized because of the COVID-19 pandemic-pregnant women, newborn, children, adolescents, and women-in countries of Latin America and the Caribbean (LAC) during the first stage of the pandemic. METHODS: In this cross-sectional study, a 35-question survey was administered to key actors in 19 LAC countries between July and September 2020. The respondents were asked for their personal perceptions regarding the situation of social and health services in their country before and during the pandemic. They were also asked for a projection of the situation during the post-pandemic period. RESULTS: In the 691 responses received, the main perception was that coverage in the services analyzed had been high before the pandemic, although their quality was not as highly rated. Both the coverage and quality of services were thought to have declined for adolescents and women. The majority of respondents predicted that all services will continue to function at lower than usual coverage levels for another three months (53.1%) and another 12 months (41.3%). Guaranteeing coverage and access to health services was considered the main policy challenge going forward. The next most needed initiatives noted were financing for actions to support women, children, and adolescents, and protection against violence and promotion of measures to combat it. CONCLUSIONS: Although the pandemic has struck all countries, its effect on the delivery of services in the populations analyzed differs from country to country and according to the types of service. It is essential to invest in national information systems that will make it possible to monitor the different services and identify the populations that need to be prioritized.
OBJETIVOS: Descrever a percepção de atores-chave na interrupção dos serviços de saúde para populações não priorizadas na pandemia grávidas, recém-nascidos, crianças, adolescentes e mulheres em países da América Latina e do Caribe (ALC) durante a primeira fase da pandemia de COVID-19. MÉTODOS: Estudo transversal. Foi realizada uma pesquisa com atores relevantes de 19 países da ALC entre julho e setembro de 2020, com 35 perguntas sobre a percepção pessoal do estado dos serviços sociais e de saúde em seus países antes e durante a pandemia, bem como uma projeção para depois dela. RESULTADOS: Nas 691 respostas, predominou a percepção de que a cobertura dos serviços analisados era alta antes da pandemia, embora a qualidade fosse vista como mais baixa. Notou-se uma redução na cobertura e na qualidade dos serviços a adolescentes e mulheres. A maioria estimou que todos os serviços seguiriam com uma menor cobertura tanto em 3 como em 12 meses (53,1% e 41,3%, respectivamente). Garantir a cobertura e o acesso aos serviços de saúde é o principal desafio político para o futuro, seguido do financiamento de iniciativas para mulheres, crianças e adolescentes, e da proteção e promoção contra a violência. CONCLUSÕES: Embora a pandemia tenha afetado todos os países, o abalo na provisão de serviços para as populações analisadas é heterogêneo entre os países e os tipos de serviço. É preciso investir em sistemas de informação nacionais que permitam monitorar os distintos serviços e identificar as populações que não foram priorizadas.
ABSTRACT
The Health Equity Network of the Americas (HENA) is a multidisciplinary network that promotes knowledge sharing and intersectoral action for equity in health and human rights in the Americas. The objectives of HENA are: 1) to share successful experiences in the development of interventions, considering the social determinants and determination of health, to achieve participatory and community-based health responses; 2) to analyze the health, social, political, environmental and economic impacts of the COVID-19 pandemic; 3) to identify the effects of pandemic care on populations most at risk because of their age and pre-existing health conditions; 4) examine the situation at borders and population movements in the spread of the pandemic and its effects on migrant populations; 5) propose strategies to ensure access to comprehensive care for pregnant women in order to reduce maternal and neonatal suffering, morbidity, and mortality; and 6) analyze violations of human rights and the right to health of historically marginalized populations, including street dwellers and other communities that depend on public spaces and the street for survival. The analytical and intervention models for health equity at HENA are based on various approaches, including social medicine, social epidemiology, medical anthropology, human ecology, and One Health.
La Red de las Américas para la Equidad en Salud (RAES) es una red multidisciplinaria que promueve el intercambio de conocimientos y la acción intersectorial para la equidad en salud y los derechos humanos en las Américas. Los objetivos de la RAES consisten en: 1) compartir experiencias exitosas en el desarrollo de intervenciones, considerando la determinación y los determinantes sociales, para lograr respuestas participativas y comunitarias en salud; 2) analizar los impactos sanitarios, sociales, políticos, ambientales y económicos de la pandemia de COVID-19; 3) identificar los efectos de la atención de la pandemia en las poblaciones de mayor riesgo por su edad y las condiciones de salud preexistentes; 4) examinar la situación de las fronteras y de los movimientos de población en la propagación de la pandemia y de sus efectos en las poblaciones migrantes; 5) proponer estrategias para asegurar el acceso a la atención integral de las mujeres gestantes, con el fin de reducir el sufrimiento, la morbilidad y la mortalidad materna y neonatal; y 6) analizar vulneraciones de derechos humanos y del derecho a la salud de poblaciones históricamente marginalizadas, incluyendo habitantes en situación de calle y otras comunidades que dependen de los espacios públicos y de la calle para sobrevivir. Los modelos analíticos y de intervención para la equidad en salud de la RAES se desarrollan desde varios enfoques, como la medicina social, la epidemiologia social, la antropología médica, la ecología humana y el de Una sola salud.
ABSTRACT
The Health Equity Network of the Americas (HENA) is a multidisciplinary network that promotes knowledge sharing and intersectoral action for equity in health and human rights in the Americas. The objectives of HENA are: 1) to share successful experiences in the development of interventions, considering the social determinants and determination of health, to achieve participatory and community-based health responses; 2) to analyze the health, social, political, environmental and economic impacts of the COVID-19 pandemic; 3) to identify the effects of pandemic care on populations most at risk because of their age and pre-existing health conditions; 4) examine the situation at borders and population movements in the spread of the pandemic and its effects on migrant populations; 5) propose strategies to ensure access to comprehensive care for pregnant women in order to reduce maternal and neonatal suffering, morbidity, and mortality; and 6) analyze violations of human rights and the right to health of historically marginalized populations, including street dwellers and other communities that depend on public spaces and the street for survival. The analytical and intervention models for health equity at HENA are based on various approaches, including social medicine, social epidemiology, medical anthropology, human ecology, and One health.