ABSTRACT
Background and objectives: In low- and middle-income countries, the leading cause of neonatal mortality is perinatal asphyxia. Training in neonatal resuscitation has been shown to decrease this cause of mortality. The program "Helping Babies Breathe" (HBB) is a program to teach basic neonatal resuscitation focused on countries and areas with limited economic resources. The aim of the study was to determine the effect of the implementation of the HBB program on newborn outcomes: mortality and morbidity. Material and Methods: A systematic review was carried out on observational studies and clinical trials that reported the effect of the implementation in low- and middle-income countries of the HBB program on neonatal mortality and morbidity. We carried out a meta-analysis of the extracted data. Random-effect models were used to evaluate heterogeneity, using the Cochrane Q and I2 tests, and stratified analyses were performed by age and type of outcome to determine the sources of heterogeneity. Results: Eleven studies were identified. The implementation of the program includes educational strategies focused on the training of doctors, nurses, midwives, and students of health professions. The poled results showed a decrease in overall mortality (OR 0.67; 95% CI 0.57, 0.80), intrapartum stillbirth mortality (OR 0.62; 95% CI 0.51, 0.75), and first-day mortality (OR 0.70; 95% IC 0.64, 0.77). High heterogeneity was found, which was partly explained by differences in the gestational age of the participants. Conclusions: The implementation of the program HBB in low- and medium-income countries has a significant impact on reducing early neonatal mortality.
Subject(s)
Asphyxia Neonatorum , Midwifery , Infant , Pregnancy , Female , Infant, Newborn , Humans , Resuscitation/methods , Asphyxia Neonatorum/therapy , Stillbirth/epidemiology , Infant Mortality , Midwifery/educationABSTRACT
Introducción: La educación médica en Colombia ha sido un tema ampliamente debatido y que han requerido múltiples cambios. En la actualidad, se encuentran diversas organizaciones a nivel mundial que se encargan de la formulación de recomendaciones para mejorar la educación médica y la atención integral a las personas, con la salud pública como piedra angular del proceso. Objetivo: Identificar la importancia de la Salud Pública en el proceso educativo de los profesionales de la salud colombianos. Desarrollo: El potencial de la educación médica para crear recomendaciones que promuevan la atención integral, la calidad humana y las estrategias para mejorar la salud de la población dentro del proceso, debe ser reconocido desde la importancia de incluir a la salud pública durante el pregrado, lo que prospectivamente le permite al profesional de la salud una adecuada y apropiada preparación para su vida laboral, así como el conocimiento de las necesidades de la población y la posibilidad de anticiparse a estas por medio del uso de la atención primaria de salud. Conclusiones: Con el fin de favorecer los diferentes niveles de prevención, desde la promoción de la salud y las políticas públicas, se disminuyen las brechas de inequidad en salud desde los determinantes sociales en salud. Asimismo, debe existir un equilibrio entre el modelo biomédico tradicional y el enfoque social de las profesiones de la salud, ya que la vida del estudiante promedio de medicina se encuentra, en su mayoría, dentro de un escenario hospitalario, lo que propicia la idea del modelo hospitalocentrista y deja de lado la mirada integral(AU)
Introduction: Medical education in Colombia has been a widely debated topic and has required multiple changes. Currently, several organizations worldwide are responsible for formulating recommendations to improve medical education and comprehensive care for people, being public health the cornerstone of the process. Objective: To identify the importance of public health in the educational process of Colombian health professionals. Development: The potential of medical education to create recommendations that promote comprehensive care, human quality and strategies for improving the health of the population within the process must be recognized based on the importance of including public health during undergraduate formation, which prospectively allows health professional an adequate and appropriate training for their working life, as well as the knowledge of the needs of the population and the possibility of anticipating them through the use of primary health care. Conclusions: In order to favor the different levels of prevention, from the promotion of health and public policies, the inequality gaps in health are reduced based on the social determinants of health. Likewise, there must be a balance between the traditional biomedical model and the social approach of the health professions, since the life of the average medical student is mostly within a hospital setting, which fosters the idea of hospitalocentrist model and set aside the comprehensive perspective(AU)
