ABSTRACT
This paper describes the implementation of five Safe Abortion Information Hotlines (SAIH), a strategy developed by feminist collectives in a growing number of countries where abortion is legally restricted and unsafe. These hotlines have a range of goals and take different forms, but they all offer information by telephone to women about how to terminate a pregnancy using misoprostol. The paper is based on a qualitative study carried out in 2012-2014 of the structure, goals and experiences of hotlines in five Latin American countries: Argentina, Chile, Ecuador, Peru and Venezuela. The methodology included participatory observation of activities of the SAIH, and in-depth interviews with feminist activists who offer these services and with 14 women who used information provided by these hotlines to induce their own abortions. The findings are also based on a review of materials obtained from the five hotline collectives involved: documents and reports, social media posts, and details of public demonstrations and statements. These hotlines have had a positive impact on access to safe abortions for women whom they help. Providing these services requires knowledge and information skills, but little infrastructure. They have the potential to reduce the risk to women's health and lives of unsafe abortion, and should be promoted as part of public health policy, not only in Latin America but also other countries. Additionally, they promote women's autonomy and right to decide whether to continue or terminate a pregnancy.
Subject(s)
Abortion, Criminal/prevention & control , Abortion, Induced , Health Knowledge, Attitudes, Practice , Health Services Accessibility/organization & administration , Hotlines/organization & administration , Abortifacient Agents, Nonsteroidal/therapeutic use , Abortion, Induced/methods , Abortion, Induced/standards , Developing Countries , Female , Feminism , Humans , Interviews as Topic , Latin America , Misoprostol/therapeutic use , Pregnancy , Safety , South America , Women's Health , Women's RightsABSTRACT
BACKGROUND: Puerto Rico (PR) has a lower smoking prevalence than the United States (14.8% vs. 21.2%, respectively); nevertheless, the five leading causes of death are associated with smoking. There is a need to implement evidence-based tobacco control strategies in PR. OBJECTIVES: The Outreach Pilot Program (OPP) was designed to engage communities, health professionals, and researchers in a network to advance health promotion activities and research to increase the use of the PR Quitline (PRQ) among smokers and promoting policies in support of smoke-free workplaces. METHODS: Using community-based participatory research (CBPR) methods, the OPP mobilized a network of community and academic partners to implement smoking cessation activities including referrals to the PRQ, adoption of evidence-based smoking cessation programs, and promotion of smoke-free legislation. RESULTS: Eighty organizations participated in the OPP. Collaborators implemented activities that supported the promotion of the PRQ and smoke-free workplaces policy and sponsored yearly trainings, including tobacco control conferences. From 2005 to 2008, physician referrals to the PRQ increased from 2.6% to 7.2%. The number of annual smokers receiving cessation services through the PRQ also increased from 703 to 1,086. The OPP shepherded a rigorous smoke-free law through participation in the development, promotion, and implementation of the smoke-free workplaces legislation as well as the creation of the PR Tobacco Control Strategic Plan, launched in 2006. CONCLUSIONS: This project demonstrates the feasibility of developing a successful and sustainable community-based outreach program model that enlists the participation of academic researchers, community organizations, and health care providers as partners to promote tobacco control.
Subject(s)
Cooperative Behavior , Health Promotion/organization & administration , Smoking Cessation/methods , Tobacco Smoke Pollution/prevention & control , Workplace/organization & administration , Community Participation , Community-Based Participatory Research , Community-Institutional Relations , Health Policy , Hotlines/organization & administration , Humans , Puerto Rico , Referral and Consultation/organization & administration , UniversitiesABSTRACT
OBJECTIVE: To determine whether a centralised telephone intervention reduces the incidence of death or admission for worsening heart failure in outpatients with chronic heart failure. DESIGN: Multicentre randomised controlled trial. SETTING: 51 centres in Argentina (public and private hospitals and ambulatory settings). PARTICIPANTS: 1518 outpatients with stable chronic heart failure and optimal drug treatment randomised, stratified by attending cardiologist, to telephone intervention or usual care. INTERVENTION: Education, counselling, and monitoring by nurses through frequent telephone follow-up in addition to usual care, delivered from a single centre. MAIN OUTCOME MEASURE: All cause mortality or admission to hospital for worsening heart failure. RESULTS: Complete follow-up was available in 99.5% of patients. The 758 patients in the usual care group were more likely to be admitted for worsening heart failure or to die (235 events, 31%) than the 760 patients who received the telephone intervention (200 events, 26.3%) (relative risk reduction = 20%, 95% confidence interval 3 to 34, P = 0.026). This benefit was mostly due to a significant reduction in admissions for heart failure (relative risk reduction = 29%, P = 0.005). Mortality was similar in both groups. At the end of the study the intervention group had a better quality of life than the usual care group (mean total score on Minnesota living with heart failure questionnaire 30.6 v 35, P = 0.001). CONCLUSIONS: This simple, centralised heart failure programme was effective in reducing the primary end point through a significant reduction in admissions to hospital for heart failure.
Subject(s)
Ambulatory Care/organization & administration , Cardiac Output, Low/mortality , Hospitalization/statistics & numerical data , Hotlines/organization & administration , Aged , Ambulatory Care/statistics & numerical data , Argentina , Cardiac Output, Low/therapy , Chronic Disease , Female , Follow-Up Studies , Hotlines/statistics & numerical data , Humans , Middle Aged , Patient Compliance , Prognosis , Quality of LifeABSTRACT
Artículo sobre las diferentes líneas gratuitas que asisten en casos de emergencia e informan sobre diferentes temas médicos en la Ciudad de Buenos Aires
Subject(s)
Hotlines/instrumentation , Hotlines , Hotlines/organization & administration , Hotlines/supply & distribution , Hotlines/trends , HotlinesABSTRACT
Artículo sobre las diferentes líneas gratuitas que asisten en casos de emergencia e informan sobre diferentes temas médicos en la Ciudad de Buenos Aires
Subject(s)
Hotlines , Hotlines/instrumentation , Hotlines/organization & administration , Hotlines/supply & distribution , Hotlines/trendsABSTRACT
El servicio de atención telefónica para madres se encuentra incluído dentro del programa Pediatra en Casa, y está dirigido a la madre embarazada y en época de lactancia. Provee información necesaria, y cuenta con una guardia telefónica durante las 24 hs. del día
Subject(s)
Pediatrics , Hotlines/instrumentation , Hotlines/organization & administration , Hotlines , Pregnancy , Health ServicesABSTRACT
Informa sobre características del servicio de orientación telefónica e incluye el análisis de datos sobre atención en salud mental en el sector público
Subject(s)
Mental Health , Hotlines/instrumentation , Hotlines/organization & administration , Hotlines , Health StatisticsABSTRACT
Informa sobre características del servicio de orientación telefónica e incluye el análisis de datos sobre atención en salud mental en el sector público
Subject(s)
Health Statistics , Hotlines , Hotlines/instrumentation , Hotlines/organization & administration , Mental HealthABSTRACT
El servicio de atención telefónica para madres se encuentra incluído dentro del programa Pediatra en Casa, y está dirigido a la madre embarazada y en época de lactancia. Provee información necesaria, y cuenta con una guardia telefónica durante las 24 hs. del día