ABSTRACT
We used a mixed design study to analyze the inequalities and inequities in Maternal Mortality (MM) for Chocó (Colombia) between 2010-2018. The quantitative component consisted of an analytical ecological design, where proportions, ratios, measures of central tendency and rates ratios, rate difference, Gini and concentration indices were calculated to measure inequalities. The qualitative component had a phenomenological and interpretive approach. One hundred thirty-one women died in Choco between 2010-2018. The Maternal Mortality Ratio was 224/100.000 live births. The Gini coefficient was 0.35, indicating inequality in the distribution of the number of MM with respect to live births. The health service offers have been concentrated in the private sector in urban areas (77%). The exercise of midwifery has played an important role in maternal and perinatal care processes, especially in territories where the State has been absent. Nevertheless, it occurs in complex circumstances such as the armed conflict, lack of transportation routes, and income deficits, affecting the timelines and care quality for these vulnerable groups. MM in Chocó has been a consequence of deficiencies in the health system and weaknesses in its infrastructure (absence of a high level of maternal-perinatal care). This is in addition to the territory's geographical characteristics, which increase vulnerability and health risks for women and their newborns. In Colombia, as well as in other countries, many maternal and newborn deaths are preventable because their causes are due to social injustices.
Subject(s)
Maternal Health Services , Midwifery , Pregnancy , Humans , Infant, Newborn , Female , Maternal Mortality , Colombia/epidemiology , Income , Socioeconomic FactorsABSTRACT
Objetivo: describir el manejo de residuos peligrosos hospitalarios generados en los domicilios por usuarios con enfermedades crónicas de una institución prestadora de servicios de salud en la ciudad de Valledupar, Colombia. Materiales y Métodos: estudio de enfoque cuantitativo, la muestra estuvo conformada por 85 usuarios con enfermedades crónicas que cumplieran con los criterios de inclusión, a quienes se les aplicó un cuestionario sobre manejo de residuos peligrosos hospitalarios en casa. Resultados: la población encuestada estuvo expuesta a riesgos relacionados con el manejo de agujas un 40% de los diabéticos, el 55% de quienes padecen enfermedad renal, en contacto con líquido peritoneal, y los usuarios con enfermedad pulmonar obstructiva crónica 36% presentaron reacciones anafilácticas. Además se encontró que el 66% de la población no tiene conocimientos acerca del manejo de estos residuos, cuál es el almacenamiento, recolección, transporte, tratamiento y/o disposición final de los mismos. Conclusión: el estudio reveló que existe una problemática relacionada con el proceso integral de los residuos peligrosos hospitalarios, debido a que la población generadora de estos pertenecen a estratos medios - bajos y asumir la totalidad de los gastos generados es poco viable, además no está capacitada adecuadamente, por tal razón resultó pertinente la elaboración de un manual para el manejo de residuos peligrosos hospitalarios generados en casa, para instruir sobre actividades que realizan estos usuarios, buscando disminuir el impacto en la salud y el ambiente derivados de la producción de estos desechos.
Objective: to describe the management of hazardous hospital waste generated in households by users with chronic diseases from one institution providing health services in the city of Valledupar, Colombia. Materials and Methods: study of quantitative approach, the sample consisted of 85 users with chronic illnesses that met the inclusion criteria, who were given a questionnaire on management of hazardous hospital waste in the home. Results: the survey population was exposed to risks associated with needle handling 40% of diabetics, 55% of those with kidney disease, contact with peritoneal fluid, and users with chronic obstructive pulmonary disease, 36% had anaphylactic reactions . It was also found that 66% of the population had no knowledge about handling these wastes, which involves storage, collection, transportation, treatment and / or disposal thereof. Conclusion: the study revealed that there is a problem related to the whole process of hazardous hospital waste, because the generating population of residues belong to middle strata - low and assuming all of the costs incurred is unfeasible, then there is inadequate training for this reason it was relevant to develop a manual for the management of hazardous hospital waste generated in the home, to educate on activities carried out by these users, seeking to reduce the impact on health and the environment from the production of these wastes .
Objetivo: descrever a gestão de resíduos hospitalares perigosos produzidos pelo sector doméstico por usuários com doenças crônicas de uma instituição que presta serviços de saúde na cidade de Valledupar, Colômbia. Materiais e Métodos: estudo de abordagem quantitativa, a amostra foi composta por 85 usuários com doenças crônicas que preencheram os critérios de inclusão, que foram aplicados um questionário sobre gestão de resíduos hospitalares perigosos em casa. Resultados: a população do estudo foi exposto a riscos associados com a manipulação de agulha 40% dos diabéticos, 55% das pessoas com doença renal, entre em contato com o fluido peritoneal, e os usuários com doença pulmonar obstrutiva crônica, 36% tiveram reações anafiláticas . Constatou-se também que 66% da população não tem conhecimento sobre o manuseio desses resíduos, que é o armazenamento, coleta, transporte, tratamento e / ou eliminação dos mesmos. Conclusão: O estudo revelou que existe um problema relacionado a todo o processo de resíduos hospitalares perigosos, porque a população de geração de resíduos pertencem a estratos médios - baixo e assumir todos os custos incorridos é inviável, então não há nenhuma treinados adequadamente por este motivo foi relevante o desenvolvimento de um manual para a gestão de resíduos hospitalares perigosos gerados em casa, para instruir sobre as actividades realizadas por estes utilizadores, procurando reduzir o impacto sobre a saúde eo ambiente decorrentes da produção destes resíduos.
