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This paper presents the position of the Latin American working group of the International Foundation for Integrated Care (IFIC). The working group brings together various Latin American actors and organizations in support of actions that facilitate the transformation of health systems in the region towards integrated systems that focus on people not as isolated individuals but as subjects of law in the complex social and environmental contexts where they live and interact. The working group proposes nine pillars of integrated care to be used as a conceptual framework for policy development and changes in practices: 1) shared vision and values; 2) population health; 3) people and communities as partners; 4) resilient communities; 5) capacities of human resources for health; 6) governance and leadership; 7) digital solutions; 8) aligned payment systems; and 9) public transparency. Based on these pillars, lines of work are proposed to strengthen alliances and networks, advocacy, research, and capacity-building, in order to help develop health and social systems that are effectively integrated and focused not only on people but also on communities in Latin America. [ABSTRACT FROM AUTHOR]

Objective. In 2014, the Pan American Health Organization member countries signed the Strategy for Universal Access to Health and Universal Health Coverage. In it, they committed to increasing public health expenditure until reaching the benchmark of 6% of gross domestic product (GDP). The objective of this paper is to determine, for each country in the Region, if they can reach this goal by economic growth alone and, if so, how long it would take. Methods. Using World Bank and World Health Organization data, elasticity of public health expenditure with regard to GDP was estimated for each country. Real economic growth and International Monetary Fund projections for 2016-2021 were used to project the expenditure series and determine the year each country would reach 6% of GDP. Results. Six countries have already reached the 6% goal. The Latin American and Caribbean countries that have achieved it are those that have single health systems, based on universal access and coverage. If current prioritization of public health expenditure is maintained, three countries could reach the goal in the next decade. Four more countries would reach it before mid-century, ten in the second half of the century, and one would have to wait until the next century. Finally, 13 countries would never reach the proposed goal. Conclusions. This analysis demonstrates the limitations of economic growth as a source of fiscal space. Other sources will need to be tapped, such as increased tax collection, specific health taxes, and greater efficiency in public spending, which will require social and political dialogue in the countries regarding their commitment to universal health principles. [ABSTRACT FROM AUTHOR]

The objective of this paper is to describe the current situation of mental health in Ecuador. In Ecuador, although the model of community mental health has been integrated into primary health care services for a decade, its implementation does not seem to have the expected results. It is pertinent to explore the causes of this situation and to propose alternatives, taking into account the contributions of social medicine, collective health and participatory action research as emblematic models in Latin America in the field of mental health. For an effective implementation of community mental health in primary care in Ecuador, the role of universities is central, specifically in projects linked to the community and in pre-professional practices in health sciences careers. These projects allow the promotion of community mental health in the first level of health care from a critical perspective, open to complexity and based on the principle that the community is the main active subject of social transformation. [ABSTRACT FROM AUTHOR]

This paper focuses on the study of the terms "conflict", "problem", "solution" and "resolution" appearing on headlines of several Spanish and Latinoamerican newspapers. Specifically, we studied 334 headlines, published between August 10th and November 15th, 2009, in Spanish and American papers, corresponding to the eight dialectal areas considered by Real Academia Española for Diccionario panhispánico de dudas and the Nueva gramática de la lengua española. Our research has a double aim: firstly, to classify the conflicts (or problems) that these headlines show, in order to analyse which are the phenomena named (from a journalistic point of view), with these terms. And, secondly, to study the syntactic-semantic relations that those four terms establish with their immediate cotext, framed by the headline. [ABSTRACT FROM AUTHOR]

This paper will provide a detailed geographic analysis of the reach of yeísmo in a number of Latin American republics (El Salvador, Honduras, Panamá, Cuba, Ecuador, Perú, Bolivia, Chile, Argentina and Uruguay) in order to present an overview of the extent and development of this phonetic phenomenon in the Spanish spoken in America. It thus aims to build on recent studies that have attempted to assess the distribution of this feature throughout the Spanish-speaking world. [ABSTRACT FROM AUTHOR]

This paper will provide a detailed geographic analysis of the reach of yeísmo in a number of Latin American republics (El Salvador, Honduras, Panamá, Cuba, Ecuador, Perú, Bolivia, Chile, Argentina and Uruguay) in order to present an overview of the extent and development of this phonetic phenomenon in the Spanish spoken in America. It thus aims to build on recent studies that have attempted to assess the distribution of this feature throughout the Spanish-speaking world. [ABSTRACT FROM AUTHOR]

Latin America is adopting regulations that bear on medicinal costs and spending. The regulations have four main goals: i) to guarantee a competitive market, ii) to ensure affordability for individual consumers (commercial channel),iii) to contain public spending on medicines (institution channel), and iv) to guarantee efficient spending on medicines.The experience of Latin America differs from that of countries in developed regions. In the latter, the countries and to have similar policies, both in promoting generic medicines and in price control strategies, and in optimizing and containing pharmaceutical expense. In contrast,in Latin America, certain institutional weaknesses impede the consolidation and application of an effective regulatory policy. This paper reviews the experience gained through the adoption of economic regulations aimed at reducing spending and improving access to medicines, suggests lessons learned at the international level, and offers recommendations for the countries of Latin America. Its purpose is to offer key elements to decision-makers and the authorities of the countries concerned in pursuing economic regulation of medicines. [ABSTRACT FROM AUTHOR]

This article discusses the main features of the national health research systems (NHRS) of Argentina, Bolivia, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Honduras, Panama, Paraguay, Peru, Uruguay, and Venezuela, based on documents prepared by their country experts who participated in the First Latin American Conference on Research and Innovation for Health held in April 2008, in Rio de Janeiro, Brazil. The review also includes sources cited in the reports, published scientific papers, and expert opinion, as well as regional secondary sources. Six countries reported having formal entities for health research governance and management: Brazil and Costa Rica's entities are led by their ministries of health; while Argentina, Cuba, Ecuador, and Venezuela have entities shared by their ministries of health and ministries of science and technology. Brazil and Ecuador each reported having a comprehensive national policy devoted specifically to health science, technology, and innovation. Argentina, Brazil, Costa Rica, Cuba, Ecuador, Panama, Paraguay, Peru, and Venezuela reported having established health research priorities. In conclusion, encouraging progress has been made, despite the structural and functional heterogeneity of the study countries' NHRS and their disparate levels of development. Instituting good NHRS governance/management is of utmost importance to how efficiently ministries of health, other government players, and society-at-large can tackle health research. [ABSTRACT FROM AUTHOR]

Objective. To identify validated information available on the relationship between social capital (SC) and health in Latin America and the Caribbean (LAC). Methods. A systematic search for papers published from January 1990-June 2007 was conducted on the Medline, SciELO, LILACS, and the Cochrane Library databases. All of the research and review articles published by scientific journals that evaluated CS and its relationship to health in LAC were included in the analysis. Results. Fifteen articles were found (11 original research and 4 reviews). The health topics examined by the research articles were: (a) mortality and life expectancy, (b) mental health, (c) injuries, (d) nutritional status, and (e) immunization. The validity of these works, the results, and the principal conclusions were analyzed in depth. Conclusions. Despite limitations inherent to the CS concept and the studies identified, it was confirmed that scientific evidence exists to support the possible association between CS and health in LAC. CS could play a protective role in certain health areas, such as injury prevention and mental health; not withstanding, the relationship between CS and health could vary according to CS subtype and socioeconomic context and culture. It is therefore imperative to continue social epidemiology research that thoroughly investigates the relationship between social determinants and specific aspects of health in LAC context. [ABSTRACT FROM AUTHOR]

This paper focuses on the analysis of a group of headlines appearing in pieces of news belonging to the sections of national and international politics, and published -between May 25th and June 11th, 2006- in the e-editions of several Spanish newspapers, as well as in e-editions of newspapers from some American countries (Argentina, Colombia, Cuba, Chile, Ecuador, México, Perú, Puerto Rico, Venezuela and the United States). This article is part of the research project "Norma, discurso y español 'panhispánico' en los medios de comunicación", directed by Ph. D. Ana Ma. Vigara Tauste (UCM), with reference HUM-200500956/FILO (Plan Nacional de I + D + I). [ABSTRACT FROM AUTHOR]

From the data submitted to the Pan American Health Organization (PAHO) by nationwide programs against sexually transmitted diseases (STD), HIV infection, and AIDS (2002), one can estimate the overall prevalence of syphilis among pregnant women to be 3.1% and to range from 1.00% in Peru to 6.21% in Paraguay. According to these data, the incidence of congenital syphilis ranges from 1.4 per 1 000 live births in El Salvador to 12.0 per 1 000 live births in Honduras. Among men who engage in sex with other men, who often classify themselves as heterosexual, as well as in female sex workers, the prevalence of syphilis ranged from 5% to 15%. Factors that determine the persistence of congenital syphilis as a public health problem include a lack of awareness of the seriousness of the problem among politicians, health officials, and health care providers, difficult access to prenatal care and screening services, a low demand for the test among users, and the stigma and discrimination that surround sexually transmitted diseases (STD). This paper seeks to focus the attention of health professionals on maternal and congenital syphilis so they will undertake actions, using an interprogrammatic approach, to eliminate congenital syphilis from Latin America and the Caribbean. Eliminating congenital syphilis will only become possible if interventions targeting vulnerable groups are also implemented. PAHO's role in eliminating congenital syphilis includes determining the baseline situation in the Region as a whole and in each country, developing communication and procurement strategies, supporting nationwide programs, promoting operational research, and facilitating interprogrammatic coordination. [ABSTRACT FROM AUTHOR]