ABSTRACT
Enfoque de implementación A: entregando políticas, legislación, planes y presupuesto; enfoque de implementación B: traduciendo políticas, en acciones aceleradas a gran escala; enfoque de implementación C: aprendiendo mientras se hace y haciendo mejor aprendiendo
Subject(s)
Humans , Male , Female , Nutritional Physiological Phenomena , Bolivia , United NationsABSTRACT
Sin desconocer algunso avances que se han obtenido a partir de las reformas introducidas al sistema de justicia penal en Bolivia y con ellas la asignacion de un rol absolutamente protagonico al Ministerio Publico en cuanto concierne a la potesdad de ser el titular de la accion penal publica, encargado de perseguir los delitos, se han detectado problemas importantes que impiden que este organo del Estado cumpla adecuadamente su funcion. Estas dificultades emergen de dos fuentes claramente establecidas y analizadas: una relativa a los recursos humanos y otra a la falta de los medios tecnicos y recursos requeridos. Desde una optica fundamental de su rol procesal relacionada con los recursos humanos, se ha establecido que los Fiscales no cumplen adecuadamente su funcion basica debido a una falta de capacitacion, una adecuada seleccion y la politizacion en la designacion de esos funcionarios, pues los Fiscales en actual ejercicio han accedido a sus cargos sin haber sido sometidos previamente a los diferentes procesos de seleccion y evaluacion; asimismo tampoco han sido convocados para concurrir a un concurso interno de evalacuion y menos se ha realizado una nueva convocatoria externa de evaluacion...
Subject(s)
Criminal LawABSTRACT
Measles incidence in Bolivia declined after the introduction of campaign strategies in the 1980s. From 1990 to 1993, the peak incidence of measles (59 cases/100,000 population) was in 1992. In 1994, after the goal of interruption of measles transmission was adopted, a national vaccination campaign targeting children <15 years old was conducted and achieved 96% coverage. During 1995-1997, cases declined, although routine coverage was <90% in most years. During 1998-2000, a nationwide epidemic occurred among 2567 case-patients, most of whom were unvaccinated. A national vaccination campaign, with strong supervision, was conducted during November and December 1999 and targeted areas with low coverage. Only 122 cases were confirmed in 2000, with the last confirmed case occurring in October. Crucial to the control of the outbreak were sufficient resources and political support, intensive local planning, door-to-door vaccination with strict supervision, and rapid house-to-house coverage monitoring that improved accountability at the local level and timely and thorough outbreak investigations.
Subject(s)
Immunization Programs/methods , Measles Vaccine/administration & dosage , Measles/prevention & control , Adolescent , Bolivia/epidemiology , Child , Child, Preschool , Humans , Immunization Programs/standards , Incidence , Infant , Measles/epidemiology , Measles/transmission , Measles virus , Population SurveillanceABSTRACT
The purpose of this paper is to discuss methods recommended and used by the Pan American Health Organization (PAHO) to monitor the interruption of indigenous measles transmission in the Region of the Americas. The methods used include house-to-house monitoring of vaccination coverage as a supervisory tool during both campaigns and routine vaccination; thoroughly investigating all measles outbreaks; performing routine surveillance, including weekly reporting from at least 80% of reporting units; and validating routine surveillance through active-case searches at health care institutions and schools and in the community. The strategies described have helped PAHO to increase the authority and accountability of vaccine program managers at the local, provincial, and national levels. Their efforts have permitted the Region of the Americas to reduce to three the number of countries with indigenous measles transmission and to reach a record low of 503 measles cases in 2001.
Subject(s)
Mass Vaccination/methods , Measles/prevention & control , Population Surveillance/methods , Americas/epidemiology , Guidelines as Topic , Humans , Incidence , Mass Vaccination/standards , Measles/epidemiology , Measles Vaccine/administration & dosage , Pan American Health OrganizationABSTRACT
This study evaluated the performance, acceptability, and appropriateness of a new, single-use, prefilled injection device called UniJect for an outreach immunization application.6 Between April and June 1995, UniJect devices were used by 36 traditional birth attendants to administer tetanus toxoid injections to 2 240 pregnant women during routine, antenatal home visits in the Northern, Ichilos, and Warnes Districts of Santa Cruz, Bolivia. Because tetanus toxoid is relatively heat stable, the traditional birth attendants were able to keep the tetanus toxoid-filled UniJect devices in their homes for up to one month without refrigeration. The devices were stored, transported, and disposed of in an outreach carrier designed to reduce the risks of improper handling and disposal. Data were collected from injection recipients, traditional birth attendants, and supervisors via observation, questionnaires, and post-study interviews. The performance of the UniJect device and its acceptability among all groups was very high. The traditional birth attendants used UniJect properly and safely; there were no reports or observations of device misuse, reuse, or needle-stick. Advantages cited included the fact that the device required no assembly, offered assured sterility, and reduced vaccine wastage sometimes associated with multi-dose vials. The ability to store and transport the vaccine-filled devices without ice also greatly simplified logistics.
En este estudio se evaluaron el rendimiento, la aceptabilidad y la conveniencia de la inmunización antitetánica extrainstitucional con un nuevo dispositivo hipodérmico de una sola dosis, el UniJect®. De abril a junio de 1995, el dispositivo UniJect aprestado de fábrica con una sola dosis de toxoide tetánico fue utilizado por 36 parteras tradicionales para vacunar a 2 240 mujeres embarazadas durante las visitas domiciliarias prenatales de rutina en los distritos Norte, Ichilos y Warnes de Santa Cruz, Bolivia. Ya que el toxoide tetánico es termoestable, las parteras pudieron mantener los dispositivos UniJect sin refrigeración en sus hogares por un período de hasta un mes. Los UniJect se guardaron, transportaron y desecharon en portadores extrainstitucionales diseñados para reducir los riesgos de manipularlos y desecharlos de forma inadecuada. Se recolectaron datos de las mujeres vacunadas, las parteras tradicionales y sus supervisores, mediante observación, cuestionarios y entrevistas realizadas después del estudio. Todos los grupos consideraron muy satisfactorios el rendimiento y la aceptabilidad del dispositivo UniJect. Las parteras tradicionales lo usaron de forma apropiada y cuidadosa; no hubo informes ni observaciones de mala utilización, reúso o puntazos accidentales. Se mencionaron, como ventajas del dispositivo, que no requiere montaje, asegura la esterilidad y reduce el desperdicio de vacuna que a veces ocurre con las ampollas de dosis múltiples. Además, todo el procedimiento se simplifica porque los dispositivos pueden almacenarse y transportarse sin necesidad de hielo.
Subject(s)
Humans , Female , Pregnancy , Immunization Schedule , Prenatal Care , Tetanus Toxoid/administration & dosage , Bolivia , Disposable Equipment , Home Care Services , Injections, Intravenous/instrumentation , Needles , Syringes , Vaccination/instrumentationSubject(s)
Immunization Schedule , Home Care Services , Injections, Intravenous , Vaccination , Prenatal Care , Tetanus Toxoid , Bolivia , Disposable Equipment , Needles , SyringesABSTRACT
El manual tiene el objetivo facilitar la aplicación de las normas referentes a la bioseguridad aplicada a la administración de vacunas en los establecimientos de salud de Bolivia.
Subject(s)
Humans , Male , Female , Injections , Vaccines , Waste Products , BoliviaABSTRACT
El propósito de este manual es apoyar a los funcionarios de salud del país, sector público, privado, Iglesia, ONGs, etc. que tienen en cada rincón de nuestra patria desarrollan actividades de vacunación y vigilancia epidemiológica de las enfermedades inmunoprevenibles
