ABSTRACT
The concept of older adult is extensively used in day-to-day discussions and public policy. Nonetheless, concrete operational definitions are scarce. This poses a challenge for policymakers when designing initiatives targeted to this population. Chronological age has been traditionally used as the sole criteria for identifying older people (OP). However, there is no consensus about what is the age that should define an elderly. The issue became evident when, in 2018, the Chilean Ministry of Health started a planning process to coordinate health initiatives for OP. Two thresholds had been commonly used-60 and 65 years-and the differences between choosing one and the other were significant. This article intends to structure the debate around age thresholds and the definition of OP in Chile, presenting information and evidence to guide decision-makers when deciding about the issue. Information was based on international guidelines and definitions, laws and practice in the country and epidemiological data. The analysis shows a lack of consensus when dealing with the definition of OP using age thresholds at every level. Results highlight the difficulty of using age as a guide for designing policies for OP and call for a more holistic way for identifying OP as beneficiaries of targeted programmes, considering the heterogeneity of this population and the availability of information. This debate is much needed in many countries that, like Chile, will experience significant demographic changes and face the challenges of healthy ageing.
Subject(s)
Aging , Public Policy , Aged , Chile , HumansABSTRACT
[RESUMEN]. Objetivo. Identificar el conocimiento, acceso y uso del sistema de salud por parte de adolescentes migrantes, y las barreras para el acceso y uso del sistema de salud en dicha población en Chile. Métodos. Estudio exploratorio observacional, de corte transversal, aplicado en jornada participativa con adolescentes migrantes (N=30) de tres comunas de la ciudad de Santiago, Chile. Estudio multimétodos. Se aplicó una encuesta basal sobre el proceso migratorio y las experiencias en el sistema de salud, con análisis descriptivo de datos. Desde lo cualitativo, se realizaron grupos de discusión (n=5) y talleres participativos (n=2) con adolescentes migrantes. Resultados. El 60% de adolescentes afirmó desconocer si está inscrito en el sistema de salud, y la mitad no lo ha utilizado. Se identificó que el tiempo de residencia es un factor relevante para el uso efectivo de algunas prestaciones de salud. Se reconocieron barreras administrativas para acceder al sistema de salud, como situación migratoria, percepción de obligatoriedad de compañía de adultos, y experiencias de discriminación en la atención. Se identificaron necesidades específicas en salud sexual y reproductiva, como acceso a preservativos, y salud mental en relación a la atención de especialistas. Como facilitadores del acceso y uso se destacaron las experiencias de buen trato, y la presencia del sector salud en las escuelas. Conclusiones. Se identificó desconocimiento del sistema de salud, y diversas barreras de acceso y uso de este por parte de adolescentes migrantes. En base a los resultados se proponen recomendaciones generales para el país y la región referidas a la promoción de la salud de este grupo.
[ABSTRACT]. Objective. To identify the knowledge, access, and use of the health system by migrant adolescents, and the barriers to access and use of the health system in that population in Chile. Methods. Observational, cross-sectional exploratory study applied in a participatory workshop with migrant adolescents (N=30) in three municipalities of the city of Santiago, Chile. Multimethods study. A baseline survey on the migration process and experiences in the health system was applied, with descriptive data analysis. From the qualitative point of view, discussion groups (n=5) and participatory workshops (n=2) were carried out with migrant adolescents. Results. Sixty percent of the adolescents said they did not know if they were registered in the health system, and half of them had not used it. Time of residence was identified as a relevant factor for the effective use of some health benefits. Administrative barriers to access the health system were recognized, such as immigration status, perception of obligatory adult companionship, and experiences of discrimination in care. Specific needs were identified in sexual and reproductive health, such as access to condoms, and mental health care from specialists. As facilitators of access and use, experiences of proper treatment and the presence of the health sector in schools were highlighted. Conclusions. Lack of information about the health system and various barriers to access and use by migrant adolescents were identified. Based on the results, general recommendations are proposed for the country and the region to improve the health of migrant adolescents.
Subject(s)
Emigration and Immigration , Adolescent , Health Systems , Latin America , Chile , Emigration and Immigration , Adolescent , Health Systems , Latin AmericaABSTRACT
This article describes the process of developing Chile's National Cancer Plan. This process included an initial diagnostic stage in which various stakeholders were called on to provide different perspectives and proposals. Later, the compiled information was systematized and structured by the Ministry of Health in an action plan with detailed initiatives, objectives, and associated indicators. The Plan was developed along five strategic lines that guide all the proposed actions for the next ten years.The objective of the article is to describe the process by which the Plan was developed, in order to draw several lessons that may be useful in the preparation of other similar plans in Chile and in other countries of the Region.The main lessons learned involve the need for clear diagnoses to make evidence-based proposals, and the importance of conducting this type of planning through a participatory process and with an interdisciplinary approach, resulting in sounder proposals and facilitating their validation and sustainability.
Este artigo descreve o processo de elaboração do Plano Nacional do Câncer no Chile. O processo incluiu uma fase inicial de diagnóstico, na qual foram convocadas várias figuras relevantes nessa área a fim de reunir diferentes perspectivas e propostas. Posteriormente, as informações coletadas foram sistematizadas e estruturadas pelo Ministério da Saúde por meio de um plano de ação no qual foram detalhadas as suas iniciativas e objetivos e os indicadores relacionados. O Plano foi definido em função de cinco linhas estratégicas que servem como base para todas as ações propostas para os próximos 10 anos.O objetivo deste artigo é descrever o processo de elaboração do Plano, com a finalidade de extrair diversas lições que possam ser úteis para a elaboração de outros planos com características semelhantes no Chile e em outros países da Região.As principais lições aprendidas foram a necessidade de estabelecer um diagnóstico claro, que permita fazer propostas baseadas em evidências, e a importância de realizar esse tipo de planejamento por meio de um processo participativo e com uma perspectiva interdisciplinar, o que aumenta a solidez das propostas e facilita a sua validação e sustentabilidade.
ABSTRACT
[RESUMEN]. Este artículo describe el proceso de elaboración del Plan Nacional de Cáncer de Chile. Este proceso incluyó una etapa inicial de diagnóstico en la que se convocó a diversos actores relevantes en el tema, con el fin de recoger distintas perspectivas y propuestas. Más tarde, la información recopilada fue sistematizada y estructurada por el Ministerio de Salud a través de un plan de acción, en el que se detallan sus iniciativas, objetivos e indicadores asociados. El Plan se definió en función de cinco líneas estratégicas a partir de las cuales se desprenden todas las acciones propuestas para los siguientes 10 años. El objetivo del artículo es describir el proceso de elaboración del Plan, con el fin de extraer diversas lecciones que pueden ser útiles para la elaboración de otros planes de características similares en Chile y otros países de la Región. Las principales lecciones aprendidas tienen relación con la necesidad de establecer un diagnóstico claro que permita hacer propuestas basadas en la evidencia, y la importancia de realizar este tipo de planificación a través de un proceso participativo y con una mirada interdisciplinaria, que potencie la solidez de las propuestas y facilite su validación y sostenibilidad.
[ABSTRACT]. This article describes the process of developing Chile’s National Cancer Plan. This process included an initial diagnostic stage in which various stakeholders were called on to provide different perspectives and proposals. Later, the compiled information was systematized and structured by the Ministry of Health in an action plan with detailed initiatives, objectives, and associated indicators. The Plan was developed along five strategic lines that guide all the proposed actions for the next ten years. The objective of the article is to describe the process by which the Plan was developed, in order to draw several lessons that may be useful in the preparation of other similar plans in Chile and in other countries of the Region. The main lessons learned involve the need for clear diagnoses to make evidence-based proposals, and the importance of conducting this type of planning through a participatory process and with an interdisciplinary approach, resulting in sounder proposals and facilitating their validation and sustainability.
[RESUMO]. Este artigo descreve o processo de elaboração do Plano Nacional do Câncer no Chile. O processo incluiu uma fase inicial de diagnóstico, na qual foram convocadas várias figuras relevantes nessa área a fim de reunir diferentes perspectivas e propostas. Posteriormente, as informações coletadas foram sistematizadas e estruturadas pelo Ministério da Saúde por meio de um plano de ação no qual foram detalhadas as suas iniciativas e objetivos e os indicadores relacionados. O Plano foi definido em função de cinco linhas estratégicas que servem como base para todas as ações propostas para os próximos 10 anos. O objetivo deste artigo é descrever o processo de elaboração do Plano, com a finalidade de extrair diversas lições que possam ser úteis para a elaboração de outros planos com características semelhantes no Chile e em outros países da Região. As principais lições aprendidas foram a necessidade de estabelecer um diagnóstico claro, que permita fazer propostas baseadas em evidências, e a importância de realizar esse tipo de planejamento por meio de um processo participativo e com uma perspectiva interdisciplinar, o que aumenta a solidez das propostas e facilita a sua validação e sustentabilidade.
Subject(s)
Neoplasms , Health Planning , Health Systems , Chile , Neoplasms , Health Planning , Health Systems , Health Planning , Health SystemsABSTRACT
OBJECTIVE: To identify the knowledge, access, and use of the health system by migrant adolescents, and the barriers to access and use of the health system in that population in Chile. METHODS: Observational, cross-sectional exploratory study applied in a participatory workshop with migrant adolescents (N=30) in three municipalities of the city of Santiago, Chile. Multimethods study. A baseline survey on the migration process and experiences in the health system was applied, with descriptive data analysis. From the qualitative point of view, discussion groups (n=5) and participatory workshops (n=2) were carried out with migrant adolescents. RESULTS: Sixty percent of the adolescents said they did not know if they were registered in the health system, and half of them had not used it. Time of residence was identified as a relevant factor for the effective use of some health benefits. Administrative barriers to access the health system were recognized, such as immigration status, perception of obligatory adult companionship, and experiences of discrimination in care. Specific needs were identified in sexual and reproductive health, such as access to condoms, and mental health care from specialists. As facilitators of access and use, experiences of proper treatment and the presence of the health sector in schools were highlighted. CONCLUSIONS: Lack of information about the health system and various barriers to access and use by migrant adolescents were identified. Based on the results, general recommendations are proposed for the country and the region to improve the health of migrant adolescents.
ABSTRACT
RESUMEN Este artículo describe el proceso de elaboración del Plan Nacional de Cáncer de Chile. Este proceso incluyó una etapa inicial de diagnóstico en la que se convocó a diversos actores relevantes en el tema, con el fin de recoger distintas perspectivas y propuestas. Más tarde, la información recopilada fue sistematizada y estructurada por el Ministerio de Salud a través de un plan de acción, en el que se detallan sus iniciativas, objetivos e indicadores asociados. El Plan se definió en función de cinco líneas estratégicas a partir de las cuales se desprenden todas las acciones propuestas para los siguientes 10 años. El objetivo del artículo es describir el proceso de elaboración del Plan, con el fin de extraer diversas lecciones que pueden ser útiles para la elaboración de otros planes de características similares en Chile y otros países de la Región. Las principales lecciones aprendidas tienen relación con la necesidad de establecer un diagnóstico claro que permita hacer propuestas basadas en la evidencia, y la importancia de realizar este tipo de planificación a través de un proceso participativo y con una mirada interdisciplinaria, que potencie la solidez de las propuestas y facilite su validación y sostenibilidad.
ABSTRACT This article describes the process of developing Chile's National Cancer Plan. This process included an initial diagnostic stage in which various stakeholders were called on to provide different perspectives and proposals. Later, the compiled information was systematized and structured by the Ministry of Health in an action plan with detailed initiatives, objectives, and associated indicators. The Plan was developed along five strategic lines that guide all the proposed actions for the next ten years. The objective of the article is to describe the process by which the Plan was developed, in order to draw several lessons that may be useful in the preparation of other similar plans in Chile and in other countries of the Region. The main lessons learned involve the need for clear diagnoses to make evidence-based proposals, and the importance of conducting this type of planning through a participatory process and with an interdisciplinary approach, resulting in sounder proposals and facilitating their validation and sustainability.
RESUMO Este artigo descreve o processo de elaboração do Plano Nacional do Câncer no Chile. O processo incluiu uma fase inicial de diagnóstico, na qual foram convocadas várias figuras relevantes nessa área a fim de reunir diferentes perspectivas e propostas. Posteriormente, as informações coletadas foram sistematizadas e estruturadas pelo Ministério da Saúde por meio de um plano de ação no qual foram detalhadas as suas iniciativas e objetivos e os indicadores relacionados. O Plano foi definido em função de cinco linhas estratégicas que servem como base para todas as ações propostas para os próximos 10 anos. O objetivo deste artigo é descrever o processo de elaboração do Plano, com a finalidade de extrair diversas lições que possam ser úteis para a elaboração de outros planos com características semelhantes no Chile e em outros países da Região. As principais lições aprendidas foram a necessidade de estabelecer um diagnóstico claro, que permita fazer propostas baseadas em evidências, e a importância de realizar esse tipo de planejamento por meio de um processo participativo e com uma perspectiva interdisciplinar, o que aumenta a solidez das propostas e facilita a sua validação e sustentabilidade.
Subject(s)
Health Systems/organization & administration , Mass Screening , Health Planning/organization & administration , Health Policy/trends , Neoplasms/diagnosis , ChileABSTRACT
The concept "Biobank" is relatively new in the scientific literature, and is not yet consensually defined, even for the World Health Organization (WHO). However, the use of human samples in biomedical research is a very old activity. The organized development of Biobanks in different places has grown in the last decade. The experience in different countries and continents has been diverse. In this special article we intend to summarize, organize and communicate to the national medical and scientific community, (i) the concept of Biobank, (ii) the international experience and a map of the Research Biobanks working in Chile, (iii) the basic biomedical and essential operational aspects to manage a Biobank for Research and (iv) the impact of a National Network of Biobanks implementation in the Chilean Health System. Ethical and regulatory aspects will not be included, given their intrinsic complexity, which should be discussed elsewhere.
Subject(s)
Biological Specimen Banks/organization & administration , Biomedical Research , Biological Specimen Banks/standards , Chile , HumansABSTRACT
The concept "Biobank" is relatively new in the scientific literature, and is not yet consensually defined, even for the World Health Organization (WHO). However, the use of human samples in biomedical research is a very old activity. The organized development of Biobanks in different places has grown in the last decade. The experience in different countries and continents has been diverse. In this special article we intend to summarize, organize and communicate to the national medical and scientific community, (i) the concept of Biobank, (ii) the international experience and a map of the Research Biobanks working in Chile, (iii) the basic biomedical and essential operational aspects to manage a Biobank for Research and (iv) the impact of a National Network of Biobanks implementation in the Chilean Health System. Ethical and regulatory aspects will not be included, given their intrinsic complexity, which should be discussed elsewhere.
Subject(s)
Humans , Biological Specimen Banks/organization & administration , Biomedical Research , Chile , Biological Specimen Banks/standardsABSTRACT
El marco referencial de Brian Barber relaciona consumo de drogas, depresión, suicidalidad y conductas violentas con estilos parentales: la aceptación de los padres se correlaciona positivamente con iniciativa adolescente, y negativamente con síntomas depresivos y suicidas; el control psicológico con depresión y conducta antisocial, y el control comportamental negativamente con ésta última. Material y métodos: En conjunto con el autor, se adapta el instrumento CNAP y se aplica a una muestra representativa aleatoria trietápica de la Región Metropolitana (n=1447). Resultados: Hay consumo frecuente de alcohol en 26,9 por ciento, tabaco31,2 por ciento, de marihuana 6,9 por ciento, de cocaína u otras drogas2,3 por ciento. Hay ideación suicida en 7,7 por ciento y síntomas depresivos en 6,9 por ciento. La autoagresión predomina en mujeres y la heteroagresión en hombres. Con la edad aumenta el consumo de alcohol (X2=107,95, p=0,0001), de tabaco (X2=63,02, p=0,0001), de marihuana (X2=18,78,p=0,001);y de cocaína(X2=8,995,p=0,06). No hay diferencias por edad en conductas violentas, ideación suicida o síntomas depresivos. A peor relación con los padres mayor consumo, depresión, ideación suicida, y conductas heteroagresivas. Se encuentran coeficientes de correlación de Spearman en la misma dirección de los del estudio internacional CNAP. Conclusiones: Esta encuesta confirma estudios previos sobre sexo, edad y estilos parentales: hay mayor consumo de sustancias químicas y conductas heteroagresivas entre los hombres y de sentimientos depresivos e ideación suicida entre las mujeres. Las conductas estudiadas aumentan con la edad, con excepción de la violencia; estas conductas se correlacionan entre sí, y disminuyen con una buena relación con los padres. El modelo de Barber es confirmado en este estudio en Santiago de Chile, lo que importa en diseño de políticas públicas e intervenciones preventivas.
The referential framework developed by Brian Barber relates the consumption of drugs, depression, suicides and violent conduct to parental styles: acceptance by parents is positively correlated to prosocial adolescent initiative and, negatively, with depressive symptoms and suicidality; psychological control correlates with depression and anti-social behavior and psychological control correlates negatively with the latter. Material and methods: Together with the author, the CNAP survey (developed by Barber et al) was applied to a random trietapic representative sample from the Metropolitan Region (n=1447). Results: Frequent consumption was found in 26.9 percent of all cases, tobacco in 31.2 percent, marihuana in 6.9 percent and cocaine and other drugs in 2.3 percent Suicidal ideation accounted for 7.7 percent and depressive symptoms for 6.9 percent. Self-mutilation was predominant in women and hetero-aggression in men. Consumption increased with age: of alcohol (X2=107.95,p=0.0001), tobacco (X2=63.02,p=0.0001), marihuana (X2=18.78,p=0.001) and cocaine (X2=8.995,p=0.06). There were no age differences with regards to violent conduct, suicidal ideation or depressive symptoms. As relations with parents got worse, so did consumption, depression, suicidal ideation and hetero-aggressive conduct. Spearman correlation coefficients followed the same path as those of the CNAP international study. Conclusions: This survey confirms previous studies as to sex, age and parental styles: there is a greater consumption of chemical substances and hetero-aggressive conduct among men and depression and suicidal tendencies among women. The conduct studied increased with age, with the exception of violence; these conducts were correlated among each other, tending to decrease as relations with parents improved. The Barber model has been confirmed in this study in Santiago, Chile, which is important when it comes to designing public policies and preventive intervention.
