Primary health care as a tool to promote equity and sustainability; a review of Latin American and Caribbean literature.

Primary health care (PHC) has increased in global relevance as it has been demonstrated to be a useful strategy to promote community access to health services. Multilateral organizations and national governments have reached a consensus regarding the basic principles of PHC, but the application of these varies from country to country due to the particularities of local health systems.This article aims to review and summarize PHC strategies and the configuration of health networks in Latin American and Caribbean countries.The review was carried out using keywords in at least 9 databases. Papers in languages other than English, Portuguese, and Spanish were excluded, while non-refereed articles and regional gray literature were incorporated. As a result, 1,146 papers were identified. After three instances of analysis, 142 articles were selected for this investigation. Data were analyzed according to an analysis by theme.The evidence collected on health reforms in the region reflects the need to intensify care strategies supported by PHC and care networks. These must be resilient to changes in the population's needs and must be able to adapt to contexts of epidemiological accumulation.

Prevalencia de lesiones de piel asociadas a la dependencia física en geriátricos e instituciones de salud de Tunja / Prevalence of skin lesions associated with physical dependence in nursing homes and health institutions in Tunja

OBJETIVOS: Determinar la prevalencia puntual de lesiones de piel asociadas a la dependencia física, realizar caracterización sociodemográfica de las personas afectadas, caracterizar las lesiones con base en disposiciones del Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas (GNEAUPP), el National Pressure Ulcer Advisory Panel (NPUAP) y el European Pressure Ulcer Advisory Panel (EPUAP) y establecer la habilidad del personal de salud para el reconocimiento y clasificación de las lesiones de piel asociadas a dependencia. METODOLOGÍA: Estudio multicéntrico descriptivo de prevalencia puntual en instituciones de servicios de salud de tercer nivel y centros gerontológicos de Tunja, Colombia. RESULTADOS: Participaron cuatro instituciones. La muestra fue de 409 personas, 24 de las cuales presentaron lesiones de piel asociadas a la dependencia para una prevalencia del 5,86%. De los afectados, el 41,6% eran hombres y el 58,4% mujeres; el 79,1% con 50 años o más; en cuanto a la procedencia, el 53,8% pertenecía al área urbana y el 46,2% a la rural; un 56,6% de los pacientes pertenecían al régimen subsidiado, el 30% al contributivo y 13,4% al especial. La etiología de las lesiones estuvo discriminada de la siguiente manera: por presión, 67,3%; LESCAH, 13,4%; MARSI, 11,5% y desgarros cutáneos, 7,7%. CONCLUSIONES: la prevalencia encontrada se relaciona con resultados de estudios colombianos previos, la afectación es mayor en mujeres y la mayor frecuencia de ocurrencia de lesiones corresponde a las ocasionadas por la presión y cizalla; las lesiones de piel asociadas a la dependencia se presentaron con mayor frecuencia en personas de procedencia urbana. El 75% de las personas que diligenciaron la encuesta reportaron no haber recibido capacitación institucional para identificación y clasificación de lesiones de piel asociadas a la dependencia

OBJECTIVES: To determine the exact prevalence of skin lesions associated with dependence physical, conduct socio-demographic characterization of those affected, characterizing lesions based on provisions of the National Group for the Study and advice on Pressure Ulcers and Chronic Wounds (GNEAUPP), the National Pressure Ulcer Advisory Panel (NPUAP) and the European Pressure Ulcer Advisory Panel (EPUAP), establish the ability of health personnel to recognize and classify lesions associated with dependence. METHODOLOGY: descriptive multicenter point prevalence in third level health care institutions and gerontology centers from Tunja, Colombia. RESULTS: four institutions participated, the sample was 409 people, 24 had lesions associated with dependence for a prevalence of 5.86%; of those affected 41.6% were men and 58.4% women, 79.1% with ≥50 years regarding the origin 53.8% belonged to urban zones and 46.2% rural zones; 56.6% of patients belonged to the subsidized health scheme, 30% to contributory health scheme 13.4% to special. The etiology of lesions was discriminated as follows: pressure 67.3%; LESCAH 13.4%; MARSI 11.5% and 7.7% skin tears. CONCLUSIONS: The prevalence found is related to results of Colombian previous studies, the effect is greater in women and increased frequency of occurrence of injuries corresponds to those caused by pressure and mechanical friction, LPAD occurred more often in people of origin urban. 75% of people who completed the survey reported not having received institutional training for identification and classification (LPAD)