106 results
Search Results
2. Service Needs, Context of Reception, and Perceived Discrimination of Venezuelan Immigrants in the United States and Colombia.
- Author
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Scaramutti, Carolina, Schmidt, Renae Danielle, Ochoa, Lucas Gregorio, Brown, Eric Christopher, Vos, Saskia Renee, Mejia Trujillo, Juliana, Perez Gomez, Nicolas Augusto, Salas-Wright, Christopher, Duque, Maria, and Schwartz, Seth
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MENTAL health services ,VENEZUELANS ,COMMUNITY organization ,HEALTH services accessibility ,PERCEIVED discrimination ,IMMIGRANTS - Abstract
Executive Summary: Millions of Venezuelans have fled their country in hopes for a better future outside the political and financial turmoil in their home country. This paper examines the self-reported needs of Venezuelans in the United States and Colombia. Specifically, it looks at perceived discrimination in each country and its effect on the service needs of Venezuelan immigrants. The authors used data from a larger project conducted in October to November 2017 to perform a qualitative content analysis on the specific services that participants and others like them would need following immigration. The sample consisted of 647 Venezuelan immigrant adults who had migrated to the United States (n = 342) or Colombia (n = 305). Its findings indicate statistically significant differences between the two countries. Venezuelan immigrants in the United States were more likely to identity mental health and educational service needs, while those in Colombia were more likely to list access to healthcare, help finding jobs, and food assistance. When looking at perceived discrimination, means scores for discrimination were significantly greater for participants who indicated needing housing services, who indicated needing assistance enrolling children in school and who indicated needing food assistance, compared to participants who did not list those needs. Venezuelans who had experienced greater negative context of reception were less likely to indicate needing mental health services, where 11.9 percent of those who did not perceive a negative context of reception responded that they needed mental health services. Evaluating existing service networks will be essential in working to bridge the gap between the services provided to and requested by Venezuelans. Collaboration between diverse government actors, community-based organizations (CBOs) and other stakeholders can help identify gaps in existing service networks. CBOs can also facilitate communication between Venezuelan immigrants and their new communities, on the need to invest in necessary services. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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3. A social innovation model for equitable access to quality health services for rural populations: a case from Sumapaz, a rural district of Bogota, Colombia.
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Bautista-Gómez, Martha Milena and van Niekerk, Lindi
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SOCIAL participation ,HEALTH services accessibility ,MIDDLE-income countries ,QUALITATIVE research ,LOW-income countries ,HEALTH equity ,RURAL population - Abstract
Background: Despite efforts to extend Universal Health Coverage in Colombia, rural and remote populations still face significant challenges in accessing equitable health services. Social innovation has been growing in Colombia as a creative response to the country's social problems including access to healthcare. This paper presents the findings of a social innovation case study, which was implemented in the rural area of Sumapaz in Colombia, with the purpose of holistically addressing the health needs of the local population and enhancing health service access. Methods: A case study methodology was used to investigate and understand the process by which the Model of Integral Health Care for Rural Areas was developed and how the various strategies were defined and implemented. Qualitative methods were used in the data collection and all data was analysed using Farmer et al. staged framework on grassroots social innovation which includes growing the idea; implementing the idea; sustainability and diffusion. Results: The social innovation model was designed as a co-learning process based on community participation. The model was implemented adopting a holistic health approach and considerate of the conditions of a rural context. As a result of this process, access to quality health services were enhanced for the vulnerable rural community. The model has also provided outcomes that transcend health and contribute to individual and community development in different areas eg. agriculture. Conclusion: The Model of Integral Health Care for Rural Areas is a social innovation in health that demonstrates how Universal Health Coverage can be achieved for vulnerable populations through a series of creative strategies which fill systemic voids in access and co-ordination of care, as well as in addresings upstream environmental factors responsible for ill-health. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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4. A social innovation model for equitable access to quality health services for rural populations: a case from Sumpaz, a rural district of Bogota, Colombia.
- Author
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Gomez, Martha Milena Bautista and van Niekerk, Lindi
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MEDICAL quality control ,HEALTH services accessibility ,MIDDLE-income countries ,RURAL conditions ,AGRICULTURE ,HOLISTIC medicine ,HUMAN services programs ,CASE studies ,AT-risk people ,LOW-income countries ,RURAL population ,DIFFUSION of innovations ,MEDICAL needs assessment ,INSURANCE - Abstract
Background: Despite efforts to extend Universal Health Coverage in Colombia, rural and remote populations still face significant challenges in accessing equitable health services. Social innovation has been growing in Colombia as a creative response to the country's social problems including access to healthcare. This paper presents the findings of a social innovation case study, which was implemented in the rural area of Sumapaz in Colombia, with the purpose of holistically addressing the health needs of the local population and enhancing health service access. Methods: A case study methodology was used to investigate and understand the process by which the Model of Integral Health Care for Rural Areas was developed and how the various strategies were defined and implemented. Qualitative methods were used in the data collection and all data was analysed using Farmer et al. staged framework on grassroots social innovation which includes growing the idea; implementing the idea; sustainability and diffusion. Results: The social innovation model was designed as a co-learning process based on community participation. The model was implemented adopting a holistic health approach and considerate of the conditions of a rural context. As a result of this process, access to quality health services were enhanced for the vulnerable rural community. The model has also provided outcomes that transcend health and contribute to individual and community development in different areas eg. agriculture. Conclusion: The Model of Integral Health Care for Rural Areas is a social innovation in health that demonstrates how Universal Health Coverage can be achieved for vulnerable populations through a series of creative strategies which fill systemic voids in access and co-ordination of care, as well as in addresings upstream environmental factors responsible for ill-health. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Forced Migration and Reproductive Rights: Pregnant Women Fleeing Venezuela.
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Hawkins Rada, Cindy
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ACCESS to primary care ,RIGHT to health ,REPRODUCTIVE rights ,REFUGEES ,WOMEN refugees ,EMIGRATION & immigration ,PREGNANT women ,FORCED migration ,WOMEN'S rights ,MEDICAL care costs ,HEALTH services accessibility - Abstract
Copyright of Anuario Colombiano de Derecho Internacional is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2022
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6. Stigma-related access barriers and violence against trans women in the Colombian healthcare system.
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Ritterbusch, Amy E., Correa Salazar, Catalina, and Correa, Andrea
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ACTION research ,COMMUNITY health services ,GROUNDED theory ,HEALTH services accessibility ,HEALTH status indicators ,INTERVIEWING ,RESEARCH methodology ,MEDICAL quality control ,PUBLIC health ,SOCIAL stigma ,VIOLENCE ,PATIENTS' rights ,QUALITATIVE research ,TRANSGENDER people ,THEMATIC analysis ,CONTENT mining - Abstract
Drawing from qualitative research conducted in a participatory action research framework with 28 transgender women in Colombia, this paper presents the stigma-related barriers to healthcare experienced by trans women and their experiences of multi-level violence within the healthcare system. The authors also discuss how advocacy work was conducted as part of the research process and how trans community leaders were involved throughout the project in order to promote policy-relevance and community-based implementation of findings. The paper concludes with a discussion of how the experiences of violence and stigmatisation within the health care system is linked to broader processes of structural stigma reproduced within Colombian society. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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7. Barriers to treatment for opioid use disorder in Colombia.
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Borda, Juan P., Friedman, Hannah, Buitrago, Jhon, Isaza, Maritza, Herrera, Paula, Krawczyk, Noa, and Tofighi, Babak
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NARCOTICS ,STATISTICS ,THERAPEUTICS ,SUBSTANCE abuse ,HEALTH services accessibility ,AUTOMOBILES ,ANALGESICS ,CROSS-sectional method ,PSYCHOLOGY of drug abusers ,ATTITUDE (Psychology) ,PUBLIC health ,DRUG withdrawal symptoms ,MEDICAL care costs ,PRIMARY health care ,MEDICAL care use ,QUESTIONNAIRES ,DISEASE prevalence ,DESCRIPTIVE statistics ,METHADONE hydrochloride ,STATISTICAL sampling ,SYMPTOMS - Abstract
Background: In Colombia, the rapid rise of illicit opioid use has become a major public health concern. Medications for opioid use disorder (MOUD) are well established and effective. However, access to MOUD remains suboptimal in this country. This paper aims to understand barriers to accessing MOUD in Colombia to inform the integration of this treatment modality in health systems. Methods: This study is a cross-sectional survey among persons with opioid use disorder (OUD) not enrolled in MMT in four Colombian cities with high known OUD prevalence. Survey domains consisted of the Barriers to Treatment Inventory, attitudes pertaining to MOUD treatments, and perceptions regarding interventions to ease access to Methadone. Results: A total of 84 subjects completed the survey. The most commonly endorsed barriers were related to admission difficulties, including concerns with "too many steps to get into treatment" (84.3%), experiencing withdrawal symptoms (78.1%), being placed on waiting lists (48.2%), and cost (44.6%). Nearly all participants were receptive to Methadone dispensation in primary care (96.4%) or mobile vans (91.6%). Conclusions: Findings from this study highlight persistent barriers to linking with MOUD among adults with OUD in Colombia requiring increased outpatient treatment programs, flexible methadone dosing, and administrative and financial support for patients. [ABSTRACT FROM AUTHOR]
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- 2021
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8. Tírala Plena: findings from the formative research to inform the initiative "Reaching those most left behind through comprehensive sexuality education for out-of-school young people" in Colombia.
- Author
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Vega Casanova, Jair, Blanco, Johanna, Rovira, Natalia Buitrago, Pulido Jaramillo, Diana Matilde, Pacheco, Karen Adrians, and Camacho-Hubner, Alma Virginia
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HIV infection epidemiology , *PREVENTION of sexually transmitted diseases , *SEXUALLY transmitted disease treatment , *HIV prevention , *VIOLENCE prevention , *EPIDEMIOLOGY of sexually transmitted diseases , *IMMIGRANTS , *MEMORY , *FOCUS groups , *INJECTIONS , *HEALTH services accessibility , *SOCIAL norms , *RURAL conditions , *PSYCHOLOGICAL vulnerability , *GROUNDED theory , *TUBAL sterilization , *INTERVIEWING , *VIOLENCE , *SEX education , *SEX education for teenagers , *HEALTH literacy , *GENDER , *ATTITUDES toward illness , *MEDICAL protocols , *TEENAGE pregnancy , *RESEARCH funding , *QUESTIONNAIRES , *ACCESS to information , *ATTITUDES toward pregnancy , *METROPOLITAN areas , *CONDOMS , *INDUSTRIAL research , *ADULT education workshops , *CONTRACEPTIVE drugs , *HEALTH promotion - Abstract
This paper presents the results of formative research conducted from January to June 2020 in the Department of Atlántico, Caribbean region of Colombia, whose findings were used as inputs to design the national strategy for comprehensive sexuality education (CSE) outside school – Tírala Plena – including its curriculum. This is within the framework of the multi-country project coordinated by UNFPA and WHO aimed at generating evidence on the role of facilitators in the delivery of CSE in non-school contexts. The research was carried out in four municipalities in northern Colombia, in rural and marginal urban contexts with conditions of vulnerability for the adolescent population, including a strong presence of migrant populations from Venezuela. A total of 150 male and female adolescents ages 10–17 participated in the formative research. Workshops such as patchwork quilt, body mapping and talking maps were used as methods to gather information. The groups were divided by sex and age (10–13 years old and 14–17 years old). Knowledge, attitudes and social norms regarding adolescent pregnancy, sexually transmitted infections, including human immunodeficiency virus, and gender-based violence, were identified in adolescents (schooled and not schooled, but with minimal or no access to CSE). All of the above enabled us to establish a set of recommendations for the strengthening of the CSE strategy Tírala plena. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Methodological challenges in researching activism in action: civil society engagement towards health for all.
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Bodini, Chiara, Baum, Fran, Labonté, Ronald, Legge, David, Sanders, David, and Sengupta, Amit
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ACTION research ,HEALTH services accessibility ,RESEARCH methodology ,MEDICAL care use ,HEALTH policy ,POLITICAL participation ,PUBLIC administration ,PUBLIC health ,RESEARCH funding ,SOCIAL change ,PATIENT participation ,CONSUMER activism ,HEALTH literacy - Abstract
Civil society engagement around health care and population health improvement is an important driver towards Health for All. Research can improve the effectiveness of health activism by examining the resources, structures and strategies of civil society engagement. However, research to support such engagement faces epistemological and methodological challenges which call for specific research strategies. A four year multi-country study was undertaken by the People's Health Movement, a global network working for health for all. The research took place in six countries (Brazil, Colombia, DR Congo, India, Italy, South Africa) and globally, and was directed to understanding five domains of civil society engagement: movement building; campaigning and advocacy; capacity building; knowledge generation, access and use; and engaging with governance. The research plan and methods of data collection and analysis were tailored to address the objective of improving activist practice, while negotiating research challenges identified during the design phase. Results include insights into the practice of civil society engagement in relation to the five domains of activist practice, as well as experience gained in managing six methodological challenges which we describe as: making meaning, aligning research and action, managing power relations, valuing experiential knowledges, chaos and contingency, challenging preconceptions. Researching activism can produce useful insights into practice as well as support continuous improvement in the effectiveness of such activism. However, there are significant methodological challenges that can be addressed through appropriate strategies. More research, building on the approach described in this paper, can contribute to more effective civil society activism for health. [ABSTRACT FROM AUTHOR]
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- 2020
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10. Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020.
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Cuervo, Luis Gabriel, Villamizar, Carmen Juliana, Cuervo, Daniel, Zapata, Pablo, Ospina, Maria B., Valencia, Sara Marcela, Polo, Alfredo, Suárez, Ángela, Bula, Maria O., Miranda, J. Jaime, Millan, Gynna, Cuervo, Diana Elizabeth, Owens, Nancy J., Piquero, Felipe, Hatcher-Roberts, Janet, Paredes, Gabriel Dario, Navarro, María Fernanda, Minotta, Ingrid Liliana, Palta, Carmen, and Martínez-Herrera, Eliana
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HEALTH services accessibility ,CROSS-sectional method ,PREDICTION models ,AUTOMOBILE driving ,HOSPITAL radiological services ,DESCRIPTIVE statistics ,TIME series analysis ,POPULATION geography ,STATISTICS ,QUALITY assurance ,HEALTH equity ,TIME ,ALGORITHMS ,EDUCATIONAL attainment - Abstract
In this study, we evaluated and forecasted the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion, using a new people-centred methodology with an equity focus. Furthermore, we identified 1–2 optimal locations where new services would maximise accessibility. We utilised open data and publicly available big data. Cali is one of South America's cities most impacted by traffic congestion. Methodology: Using a people-centred approach, we tested a web-based digital platform developed through an iterative participatory design. The platform integrates open data, including the location of radiotherapy services, the disaggregated sociodemographic microdata for the population and places of residence, and big data for travel times from Google Distance Matrix API. We used genetic algorithms to identify optimal locations for new services. We predicted accessibility cumulative opportunities (ACO) for traffic ranging from peak congestion to free-flow conditions with hourly assessments for 6–12 July 2020 and 23–29 November 2020. The interactive digital platform is openly available. Primary and secondary outcomes: We present descriptive statistics and population distribution heatmaps based on 20-min accessibility cumulative opportunities (ACO) isochrones for car journeys. There is no set national or international standard for these travel time thresholds. Most key informants found the 20-min threshold reasonable. These isochrones connect the population-weighted centroid of the traffic analysis zone at the place of residence to the corresponding zone of the radiotherapy service with the shortest travel time under varying traffic conditions ranging from free-flow to peak-traffic congestion levels. Additionally, we conducted a time-series bivariate analysis to assess geographical accessibility based on economic stratum. We identify 1–2 optimal locations where new services would maximize the 20-min ACO during peak-traffic congestion. Results: Traffic congestion significantly diminished accessibility to radiotherapy services, particularly affecting vulnerable populations. For instance, urban 20-min ACO by car dropped from 91% of Cali's urban population within a 20-min journey to the service during free-flow traffic to 31% during peak traffic for the week of 6–12 July 2020. Percentages represent the population within a 20-min journey by car from their residence to a radiotherapy service. Specific ethnic groups, individuals with lower educational attainment, and residents on the outskirts of Cali experienced disproportionate effects, with accessibility decreasing to 11% during peak traffic compared to 81% during free-flow traffic for low-income households. We predict that strategically adding sufficient services in 1–2 locations in eastern Cali would notably enhance accessibility and reduce inequities. The recommended locations for new services remained consistent in both of our measurements. These findings underscore the significance of prioritising equity and comprehensive care in healthcare accessibility. They also offer a practical approach to optimising service locations to mitigate disparities. Expanding this approach to encompass other transportation modes, services, and cities, or updating measurements, is feasible and affordable. The new approach and data are particularly relevant for planning authorities and urban development actors. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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11. Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives.
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Horrill T, McMillan DE, Schultz ASH, and Thompson G
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- Colombia, Colonialism, Delivery of Health Care trends, Health Services, Indigenous trends, Humans, Qualitative Research, Health Services Accessibility standards, Health Services, Indigenous standards
- Abstract
As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer-reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically., (© 2018 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.)
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- 2018
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12. Struggles for the right to health at work in Colombia: The case of associations of workers with work-related illnesses.
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Torres-Tovar, Mauricio and Luna-García, Jairo Ernesto
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OCCUPATIONAL disease diagnosis ,OCCUPATIONAL disease prevention ,OCCUPATIONAL disease risk factors ,ACTION research ,BLUE collar workers ,FOCUS groups ,HEALTH services accessibility ,ERGONOMICS ,HUMAN rights ,WORK-related injuries ,INDUSTRIAL hygiene ,INDUSTRIAL relations ,INDUSTRIAL safety ,INTERVIEWING ,LOBBYING ,RESEARCH methodology ,OCCUPATIONAL diseases ,RISK assessment ,SOCIAL security ,STRIKES & lockouts ,SURVEYS ,LABOR unions ,WORK capacity evaluation ,WORK environment ,QUALITATIVE research ,PSYCHOSOCIAL factors ,QUANTITATIVE research ,DESCRIPTIVE statistics ,DISEASE complications - Abstract
The neoliberal reforms of the early 1990s in Colombia, mainly labour and social security reforms, transformed capital-labour relations and contributed to the erosion of working conditions and health protection at work, with devastating impacts on workers' health. In the context of these dramatic changes, Colombian workers mobilised around collective identities that have shaped new forms of workers' struggle and resistance. Since 2006, associations of workers suffering work-related illnesses have been active in Colombia. The associated workers engaged in collective actions have demanded from employers, the Ministry of Work, occupational risk administrators, disability rating boards and the judicial system the recognition of certain diseases as being of occupational origin and that these entities guarantee corresponding labour, economic and social security rights. This paper describes and analyses the dynamics of the struggle for the right to health at work undertaken by these associations in Colombia, adopting an analytical perspective inspired by collective action theory. [ABSTRACT FROM AUTHOR]
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- 2019
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13. Motivations for using misoprostol for abortion outside the formal healthcare system in Colombia: a qualitative study of women seeking postabortion care in Bogotá and the Coffee Axis.
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Ortiz, Juliette, Blades, Nakeisha, and Prada, Elena
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HEALTH services accessibility ,HEALTH self-care ,HEALTH attitudes ,QUALITATIVE research ,RESEARCH funding ,INTERVIEWING ,MISINFORMATION ,MOTIVATION (Psychology) ,MISOPROSTOL ,WOMEN'S health ,ABORTION ,PATIENT aftercare ,SOCIAL stigma - Abstract
Copyright of Reproductive Health is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
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14. A Mixed-Methods Study Exploring Colombian Adolescents' Access to Sexual and Reproductive Health Services: The Need for a Relational Autonomy Approach.
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Brisson, J., Ravitsky, V., and Williams-Jones, B.
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HEALTH services accessibility ,REPRODUCTIVE health ,AUTONOMY (Psychology) ,RESEARCH funding ,MEDICAL care ,INTERVIEWING ,DECISION making ,EXPERIENCE ,RESEARCH methodology ,SEXUAL health - Abstract
This study's objective was to understand Colombian adolescents' experiences and preferences regarding access to sexual and reproductive health services (SRHS), either alone or accompanied. A mixed-method approach was used, involving a survey of 812 participants aged eleven to twenty-four years old and forty-five semi-structured interviews with participants aged fourteen to twenty-three. Previous research shows that adolescents prefer privacy when accessing SRHS and often do not want their parents involved. Such findings align with the longstanding tendency to frame the ethical principle of autonomy as based on independence in decision-making. However, the present study shows that such a conceptualization and application of autonomy does not adequately explain Colombian adolescent participants' preferences regarding access to SRHS. Participants shared a variety of preferences to access SRHS, with the majority of participants attaching great importance to having their parents involved, to varying degrees. What emerges is a more complex and non-homogenous conceptualization of autonomy that is not inherently grounded in independence from parental involvement in access to care. We thus argue that when developing policies involving adolescents, policymakers and health professionals should adopt a nuanced "relational autonomy" approach to better respect the myriad of preferences that Colombian (and other) adolescents may have regarding their access to SRHS. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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15. Mapping mental health care services for children and youth population in Colombia's Pacific: potential for boundary spanning between community and formal services.
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Weber, Sanne, Carranza, Francy, Rengifo, Juan Roberto, Romero, Camilo, Arrieta, Sergio, Martínez, Karina, Pinilla-Roncancio, Mónica, Fenton, Sarah-Jane, Casas, Germán, Jackson, Paul, and Aranguren, Juan Pablo
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INSTITUTIONAL cooperation ,WELL-being ,HEALTH services accessibility ,STRATEGIC planning ,SOCIAL support ,RESEARCH methodology ,INTERVIEWING ,MENTAL health ,COMMUNITY mental health services for teenagers ,QUALITATIVE research ,CONTINUUM of care ,COMPARATIVE studies ,INTERPROFESSIONAL relations ,SCHOOLS ,HEALTH care teams ,GOVERNMENT policy ,INTERPERSONAL relations ,RESEARCH funding - Abstract
Background: Conflict and violence can impact on the mental health of children and young people, who are in a crucial stage of their personal growth. Not much is known about the provision of mental health care to young people in conflict-affected areas. Community-based care can be essential, as state-led services are often scarce in conflict contexts, like Colombia's Pacific region where this research was conducted. According to the WHO, such care is ideally provided in the form of a network of interconnected services, offered by different actors beyond the formal health sector. This article describes the relationship between the formal and community mental health systems in Colombia's Pacific region, and identifies ways of improving their interaction. Methods: Qualitative data were collected through 98 semi-structured interviews with community organisations, schools, international organisations and state institutions. These interviews aimed to identify the strategies used to promote young people's mental health and the interactions between the different providers. Boundary spanning theory was used to analyse how different actors and forms of mental health care provision could coordinate better. Results: Community organisations and schools use a wide array of strategies to attend to the mental health of children and young people, often of a collective and psychosocial nature. State institutions offer more clinically focused strategies, which are however limited in terms of accessibility and continuity. International organisations aim to strengthen state capacity, but often struggle due to high staff turnover. Although mental health care pathways exist, their effectiveness is limited due to ineffective coordination between actors. Conclusions: To make sure that the variety of strategies to improve young people's mental health effectively reach their beneficiaries, better coordination is needed between the different actors. Mental health care pathways should therefore integrate community organisations, while community connectors can help to manage the coordination between different actors and forms of clinical and psychosocial support. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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16. Whoever wants better healthcare simply pays more: citizens' perception about voluntary private health insurance in Colombia.
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Patiño-Lugo, Daniel Felipe, Vélez, Claudia Marcela, Díaz-Hernández, Diana Patricia, Salazar-Blanco, Olga Francisca, González-Arango, Juan Esteban, Velásquez-Correa, Juan Carlos, Rodríguez-Corredor, Leydi Camila, Vélez-Marín, Viviana María, and Velásquez-Salazar, Pamela
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HEALTH services administrators ,HEALTH services accessibility ,RESEARCH methodology ,HEALTH facility administration ,PRIVATE sector ,INTERVIEWING ,PUBLIC health ,QUALITATIVE research ,SOCIAL security ,HEALTH insurance ,PUBLIC sector ,RESEARCH funding ,HEALTH equity ,PUBLIC opinion ,INSURANCE - Abstract
Copyright of International Journal for Equity in Health is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
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17. Effects of managed care mechanisms on access to healthcare: results from a qualitative study in Colombia.
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Vargas I, Unger JP, Mogollón-Pérez AS, and Vázquez ML
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- Colombia epidemiology, Delivery of Health Care organization & administration, Delivery of Health Care statistics & numerical data, Health Services Accessibility organization & administration, Humans, Insurance, Health organization & administration, Insurance, Health statistics & numerical data, Managed Care Programs organization & administration, Models, Organizational, Organizational Case Studies, Qualitative Research, Health Services Accessibility statistics & numerical data, Managed Care Programs statistics & numerical data
- Abstract
Background: Managed competition has underpinned most health sector reforms aimed at improving access and efficiency, in Latin America and other countries. The aim of the paper is to analyse barriers to healthcare that emerge from the introduction of managed care mechanisms in Colombia., Methods: Qualitative, exploratory, and descriptive-interpretative research was carried out on the basis of case studies of four healthcare networks, comprised of insurers and their providers. Individual semi-structured interviews were conducted with a theoretical sample of informants (managers, professionals, and users), between 24 and 61 per network. The final sample size was reached by saturation of information. An inductive thematic content analysis was conducted. The study areas were two municipalities of Colombia, in which most of the population live in poverty., Results: A number of managed care mechanisms that act as barriers to access were identified by all informants, regardless of area and type of insurance regime. These mechanisms act directly on the patient (authorizations, fragmented insurance) or on the providers (purchasing mechanisms or limits to medical practice). The predominant mechanism appears to be related to the type of agreement established between insurers and providers. The reason for these barriers, according to informants, is insurers' search for profitability. As a consequence, there is delay in or no access to adequate treatment. This is particularly evident in secondary care., Conclusion: A variety of managed care strategies that effectively hinder access to healthcare have been introduced by insurers, casting doubt on the usefulness of their application in low-income countries and profit-making contexts., (Copyright © 2012 John Wiley & Sons, Ltd.)
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- 2013
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18. Dengue and health care access: the role of social determinants of health in dengue surveillance in Colombia.
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Carabalí JM and Hendrickx D
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- Colombia, Humans, Insurance Coverage, Insurance, Health, Dengue, Health Services Accessibility, Population Surveillance, Social Determinants of Health
- Abstract
Based on a first-hand experience from Colombia in the context of a local dengue research project, this paper illustrates how social determinants of health are associated with public health and how they can affect disease surveillance systems. The paper shows how various issues related to dengue case notification procedures and health insurance systems in Colombia are intertwined with more structural socio-economic factors. We argue that there is a need for public health interventions and health related research to acknowledge and consider the important role social determinants play in public health dynamics.
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- 2012
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19. Dignity and the right of internally displaced adolescents in Colombia to sexual and reproductive health.
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Bosmans M, Gonzalez F, Brems E, and Temmerman M
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- Adolescent, Colombia, Female, Humans, Male, Program Evaluation, Qualitative Research, United Nations organization & administration, Vulnerable Populations, Adolescent Health Services, Health Services Accessibility legislation & jurisprudence, Human Rights legislation & jurisprudence, Personhood, Refugees, Reproductive Health Services, Sex Education
- Abstract
In Colombia, national policies and laws on the protection of vulnerable populations pay specific attention to the sexual and reproductive health needs and rights of internally displaced adolescents. This paper describes how a United Nations Population Fund (UNFPA)-supported programme (September 2000-August 2004) on the sexual and reproductive health of internally displaced adolescents contributed to restoring their dignity as a precursor to promoting their sexual and reproductive health rights. Different forms of the arts were used as basic techniques to discover their body and to provide sexual and reproductive health information and education. The arts were found to play a key role in restoring their dignity. Although dignity appeared to be a determinant of greater awareness of rights, it did not lead to increased empowerment with regard to rights. The availability of and access to sexual and reproductive health services remains a problem and displaced populations continue to have little or no power to hold their authorities accountable., (© 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.)
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- 2012
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20. Co-Designing a Strategy for Implementing the SPARC Holistic Needs Assessment Tool in the Colombian Clinical Context.
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Mendieta, Cindy V., de Vries, Esther, Calvache, Jose Andrés, Ahmedzai, Sam H., Prue, Gillian, McConnell, Tracey, and Reid, Joanne
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HEALTH services accessibility ,HOLISTIC medicine ,HUMAN services programs ,MEDICAL referrals ,RESEARCH funding ,NEEDS assessment ,INTEGRATED health care delivery ,MEDICAL needs assessment ,PALLIATIVE treatment ,EVALUATION - Abstract
In Colombia, timely access to palliative care (PC) is hampered by difficulties in identifying and referring to necessary services. The SPARC (Sheffield Profile for Assessment and Referral for Care) instrument provides a holistic needs assessment to improve referrals for different forms of care. SPARC was recently validated in Colombian Spanish (SPARC-Sp) but has not yet been implemented in clinical practice. We undertook workshops that aimed to co-design an implementation strategy to inform a future trial testing SPARC-Sp in the Colombian healthcare system. Workshop attendees included patients, informal caregivers, healthcare professionals, volunteers, administrative staff and decision makers. Discussions within the workshops refined implementation and dissemination strategies for SPARC-Sp in practical scenarios. Results include the need for education, clarification and demystification of PC and the lack of time and skills of professionals to identify patients' needs. Attendees recognized SPARC-Sp as a valuable tool for highlighting patients' concerns, whose adaptations are needed in Colombia to address the low literacy of the population and specificities of the healthcare system. We proposed local adaptations to SPARC-Sp and produced five educational videos aimed at health professionals, patients and caregivers to strengthen understanding of holistic needs in PC while building a strategy for SPARC-Sp implementation in the Colombian context. [ABSTRACT FROM AUTHOR]
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- 2023
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- View/download PDF
21. Barriers and facilitators to palliative care for patients with non-curable cancer in Colombia: perspectives of allied health and social care professionals.
- Author
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Mendieta, Cindy V., de Vries, Esther, Gomez-Neva, Maria Elizabeth, Muñoz-Escudero, Angela Maria, Calvache, Jose Andrés, and McConnell, Tracey
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TUMOR prevention ,HEALTH services accessibility ,FOCUS groups ,HUMANISM ,POPULATION geography ,CANCER patients ,SOCIAL worker attitudes ,MEDICAL referrals ,COMMUNICATION ,HEALTH attitudes ,DESCRIPTIVE statistics ,THEMATIC analysis ,PALLIATIVE treatment ,ALLIED health personnel - Abstract
Background: Palliative care aims to improve the quality of life of people with life-limiting illness and their families by addressing physical, psychological, social and spiritual suffering. Allied Health and Social Care Professionals (AHSCP) are key to delivering comprehensive, high quality palliative care. In recent years, Colombia has developed changes in the legal, and regulatory framework for access to palliative care but barriers and facilitators to palliative care for patients with non-curable cancer have not been explored from the perspective of AHSCP. Method: This study aims to address this knowledge gap in two cities in Colombia: one in a medium-sized city in a rural area (Popayan) and one in a highly urbanized area (Bogota). Two focus groups with AHSCP were conducted using the World Cafe method, and a subsequent thematic analysis was performed to establish the main barriers and facilitators. Results: A wide range of 18 AHSCPs attended the two World Cafe groups in Popayan and Bogota. As a result of this iterative process, we established five thematic areas: (i) Humanizing care, (ii) Normalizing palliative care: referral at the time of diagnosis, (iii) Misunderstandings related to palliative care, (iv) Barriers within the health system, and (v) Geographic barriers. Conclusion: This study provided the perspectives of AHSCPs in Colombia in relation to barriers and facilitators in the framework of comprehensive palliative care attention. Participants identified misconceptions about palliative care, which are explained by the lack of inclusion of this area in the educational programs of health professionals and AHSCPs, along with the limited supply and access to palliative care, especially in rural areas. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
22. Improving the availability and accessibility of opioids for the treatment of pain: the International Pain Policy Fellowship.
- Author
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Bosnjak S, Maurer MA, Ryan KM, Leon MX, and Madiye G
- Subjects
- Analgesics, Opioid economics, Colombia, Global Health, Health Status Indicators, Humans, Pain economics, Palliative Care, Patient Care, Serbia, Sierra Leone, Analgesics, Opioid therapeutic use, Fellowships and Scholarships, Health Policy trends, Health Services Accessibility, Health Services Needs and Demand, Internationality, Pain drug therapy
- Abstract
Opioid analgesics are simultaneously indispensable medicines for the treatment of moderate to severe pain and are harmful when abused. The challenge for governments is to balance the obligation to prevent diversion, trafficking, and abuse of opioids with the equally important obligation to ensure their availability and accessibility for the relief of pain and suffering. Over the last 30 years, significant progress has been made toward improving access to opioids as measured by increasing global medical opioid consumption. However, this progress is marked by ongoing large disparities among countries, with most increases in medical opioid consumption attributed to high-income countries, not low- and middle-income countries (LMICs). The International Pain Policy Fellowship (IPPF) was developed by the Pain & Policy Studies Group, with the central goal of developing national leaders from LMICs and empowering them to improve availability and accessibility of opioids for the treatment of pain. To date, two classes of fellows have been selected, representing 17 fellows from 15 countries. Progress achieved by the leadership of three fellows from Sierra Leone, Colombia, and Serbia is highlighted in this paper. The fellows from each country were successful at initiating collaboration with relevant governmental bodies, national authorities, and professional societies, which resulted in a new supply of oral opioids in Sierra Leone and Serbia, and improvements in the distribution of already available opioids in Colombia. All fellows were instrumental in facilitating evaluation of national policy. The IPPF program empowers fellows with the necessary knowledge, skills, and guidance to improve the availability and accessibility of opioids for the treatment of pain.
- Published
- 2011
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23. [Access to health care in Colombia].
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Vargas-Lorenzo I, Vázquez-Navarrete ML, and Mogollón-Pérez AS
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- Colombia, Humans, Health Services Accessibility
- Abstract
Objectives: Contributing towards improving knowledge about access to health services in Colombia following health-sector reform, highlighting the main results and gaps in research., Methods: Original papers were systematically reviewed through a comprehensive search and analysis of original papers published between 1994 and 2009. After selection criteria had been applied, 27 papers were included in the review. Analysis was based on Aday Aday & Andersen and Gold's theoretical frameworks, distinguishing between potential and actual healthcare access and considering the characteristics of the population, health services and insurers influencing service use., Results: There was little explanatory analysis of service use applying determinant models; this was also partial (limited to geographical areas, diseases or specific groups). Likewise, only a few studies analysed contextual factors influencing service use (health policies and health providers and insures) or social actors' perspectives. The available studies did not seem to indicate increased actual access (except for subsidised system users) but, on the contrary the existence of barriers relating to population (insurance coverage, income and education) and health service factors (geographic and organizational accessibility and quality of care)., Conclusions: This review led to identifying important limitations in the analysis of healthcare access in Colombia and highlighted the need for further research on actual access and the better incorporation of context variables and actors perspectives in understanding the impact of reform on health service use.
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- 2010
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24. [What do living standard surveys show about the health system in Colombia?].
- Author
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Zambrano A, Ramírez M, Yepes FJ, Guerra JA, and Rivera D
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- Colombia, Health Services statistics & numerical data, Humans, Insurance Coverage, Preventive Health Services statistics & numerical data, Program Evaluation standards, Social Security, Health Care Reform organization & administration, Health Services Accessibility statistics & numerical data, Health Services Needs and Demand organization & administration, National Health Programs organization & administration, Quality of Health Care standards, Quality of Life
- Abstract
This paper analyzes the main advances in health coverage and health services demand in Colombia using the 1997 and 2003 living standards surveys. The study showed an increase in health coverage associated with expansion of the subsidized care system, although a large proportion of the population is still not entitled to health care. The type of entitlement also directly affects the demand for services. There was an increase in preventive medical consultations in 2003 and a decrease in the use medical care for acute illness, due mainly to lack of money. Access to medicines increased from 1997 to 2003, as reflected by a decrease in out-of-pocket expenditure on medicines.
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- 2008
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25. [Access to cervical cytology in Medellín, Colombia during 2006].
- Author
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Restrepo Zea J, Mejía Mejía A, Valencia Arredondo M, Tamayo Acevedo L, and Salas Zapata W
- Subjects
- Adult, Age Factors, Colombia, Cross-Sectional Studies, Data Collection, Female, Humans, Logistic Models, Middle Aged, Health Services Accessibility, Health Services Needs and Demand, Uterine Cervical Neoplasms prevention & control, Vaginal Smears statistics & numerical data
- Abstract
Background: The burden of illness of cervical cancer has not decreased enough in developing countries. For that reason is important to improve coverage, access and effectiveness of cervical cancer screening programs. The objective of this paper is to analyze women's access to the cervical cytology programme of the Secretary of Health of Medellín (Colombia)., Methods: An analysis was made of 1,519 records of women from a cross-sectional study conducted in an urban area of Medellin (Colombia). Descriptive analysis was conducted and a Logit model was estimated for analysing recent cervical cytology (cytology performed less than 36 months prior to the survey)., Results: 68.7% of women had a recent cytology, 17.2% did not have recent cytology and 14.2% of women attended for the first time to the service. The probability of having a recent cytology increased with age, women with family history of cervical cancer, women with personal history of sexually transmitted infections, women with some education and women who are (or were) married or in a stable union., Conclusions: The demand for cytology appears to be concentrated; a limited number of women assist frequently while others don't practice it or stop assisting.
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- 2007
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26. Strengthening user participation through health sector reform in Colombia: a study of institutional change and social representation.
- Author
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Mosquera M, Zapata Y, Lee K, Arango C, and Varela A
- Subjects
- Attitude to Health, Colombia, Community-Institutional Relations, Consumer Organizations, Humans, Knowledge, Leadership, National Health Programs legislation & jurisprudence, National Health Programs organization & administration, Organizational Case Studies, Organizational Innovation, Public Health Administration, Surveys and Questionnaires, Urban Population, Community Participation statistics & numerical data, Developing Countries, Health Care Reform, Health Plan Implementation, Health Services Accessibility legislation & jurisprudence, Managed Competition legislation & jurisprudence
- Abstract
The challenge of achieving community participation as a component of health sector reform is especially great in low- and middle-income countries where there is limited experience of community participation in social policy making. This paper concentrates on the social representations of different actors at different levels of the health care system in Colombia that may hinder or enable effective implementation of the participatory policy. The study took place in Cali, Colombia and focused on two institutional mechanisms created by the state to channel citizen participation into the health sector, i.e. user associations and customer service offices. This is a case study with multiple sources of evidence using a combination of quantitative and qualitative social science methods. The analysis of respondents' representations revealed a range of practical concerns and considerable degree of scepticism among public and private sector institutions, consumer groups and individual citizens about user participation. Although participation in Colombia has been introduced on political, managerial and ethical grounds, this study has found that health care users do not yet have a meaningful seat around the table of decision-making bodies.
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- 2001
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27. Políticas públicas, sistema de salud y mujeres con VIH/SIDA en Colombia: un análisis crítico.
- Author
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Quintero, Marcela Arrivillaga, Posada, Martha Lucía Alzate, and Aldana, Bernardo Useche
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HIV-positive women ,AIDS in women ,PUBLIC health ,MEDICAL care ,HEALTH services accessibility ,EQUALITY - Abstract
Copyright of Revista Gerencia y Políticas de Salud is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2009
28. Experience of a TelEmergency program in Colombia South America: descriptive observational study between 2019 and 2021.
- Author
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Vallejo-Bocanumen, Carlos E., Pérez-Martínez, Daniel, Quiceno-Salazar, Diana Carolina, Mejía-Gonzalez, Yésica Paola, García-Cano, Juan F., and Martínez-Pérez, Diana C.
- Subjects
MEDICAL care ,MEDICAL personnel ,HEALTH services accessibility ,SCIENTIFIC observation ,HOSPITAL care - Abstract
Introduction: Colombia has 50,912,429 inhabitants, but only 50–70% of the population can effectively access health care services. The emergency room (ER) is a main contributor to the in-hospital care system since up to half of the admissions come through it. Telemedicine has become a tool to facilitate effective access to health care services, improve the timeliness of care, reduce diagnostic variability, and reduce costs associated with health. The aim of this study is to describe the experience of a Distance Emergency Care Program through Telemedicine (TelEmergency) to improve specialist access for patients at the Emergency Room (ER) in low- and medium-level care hospitals in Colombia. Methods: An observational descriptive study of a cohort including 1,544 patients during the program's first two years was conducted. Descriptive statistics were used to analyze the available data. The data are presented with summarized statistics of sociodemographic, clinical, and patient-care variables. Results: The study included a total of 1,544 patients, and the majority were adults between 60 and 79 years of age (n = 491, 32%). More than half were men (n = 832, 54%), and 68% (n = 1,057) belonged to the contributory health care regime. The service was requested from 346 municipalities, 70% (n = 1,076) from intermediate and rural settings. The most common diagnoses were related to COVID-19 (n = 356, 22%), respiratory diseases (n = 217, 14%), and cardiovascular diseases (n = 162, 10%). We observed 44% (n = 681) of local admissions either under observation (n = 53, 3%) or hospitalization (n = 380, 24%), limiting the need for hospital transfers. Program operation data revealed that 50% (n = 799) of requests were answered within two hours by the medical staff. The initial diagnosis was modified in 7% (n = 119) of the patients after being evaluated by specialists at the TelEmergency program. Conclusions: This study shows the operational data collected during the first two years after the implementation of the TelEmergency program in Colombia, the first of its kind in the country. Its implementation offered specialized timely management of patients at the ER in low- and medium-level care hospitals, where there is no availability of specialized doctors. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
29. Parents' Perception of Barriers to the Comprehensive Management of Children With Cleft Lip and Palate in Bogota, Colombia.
- Author
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González-Carrera, María Clara, Ruiz, Jaime Alberto, Mora-Díaz, Ingrid Isabel, Pereira de Souza, David, Restrepo-Pérez, Luis Fernando, Bendahan, Zita, Bautista, Gloria Rocío, and Díaz-Báez, David
- Subjects
PARENT attitudes ,CAREGIVER attitudes ,HEALTH services accessibility ,TIME ,CLEFT palate ,QUANTITATIVE research ,FISHER exact test ,CLEFT lip ,QUALITATIVE research ,CHI-squared test ,DESCRIPTIVE statistics ,SOCIAL classes ,RESEARCH funding ,MEDICAL appointments ,EDUCATIONAL attainment - Abstract
Object: To identify the perception of barriers to the comprehensive management of cleft lip and palate (CLP) by parents/caregivers of Colombian children with this condition. Setting and Sample Population: Fifty parents/caregivers of children with CLP under 12 years attending a center specialized in the management of craniofacial congenital conditions in Bogota, Colombia. Materials and Methods: This study consisted of 2 phases: a quantitative phase (descriptive cross-sectional) and a qualitative phase (focus group [FG]). Chi-square and Fisher exact tests were used to analyze the association variables. The barriers and alternative ways to overcome barriers were analyzed in the FG. Results: Comprehensive management was mostly defined as access to multiple treatments (54%), and this concept was expanded in the FG toward understanding CLP at all levels. Monoparental families spend their income on treatments (29%) than nuclear families (0%) (P =.001). All parents with high education levels were familiar with healthcare centers specialized in CLP as opposed to 66.7% of parents with basic primary education (P <.05). Regarding the timeliness of appointments, 12.2% of parents earning between 1 and 2 minimum wages reported some kind of difficulty, whereas those earning less than one minimum wage reported difficulties in 66.7% of cases (P =.046). Conclusions: All participants reported barriers, which increased or decreased depending on their socioeconomic status. The FG allowed the discussion of alternatives to overcome barriers, such as structural, solidarity, and self-management actions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
30. The color of child survival in Colombia, 1955–2005.
- Author
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Palacio Chaverra, Andrés
- Subjects
BLACK people ,CHI-squared test ,CHILD mortality ,HEALTH care reform ,HEALTH services accessibility ,INSURANCE ,MOTHERS ,PROBABILITY theory ,RACE ,RESEARCH funding ,STATISTICAL sampling ,WHITE people ,LOGISTIC regression analysis ,SOCIOECONOMIC factors ,HEALTH equity ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Objective(s):Colombia has the third largest black population in the Americas after Brazil and the USA. In 2005 mortality rate under 5 in Colombia was 21.5 per 1000, with a reduction of 82% between 2005 and 1955. That rate is not in line with rates for Cuba (6.8), Chile (9.1) or Costa Rica (10.4). Here we aim to provide evidence that a further reduction of child mortality relates to the unspoken racial gap in a pioneering country in family planning and praised in the 2000 WHO report as having the world’s fairest health care reform in terms of coverage and financial access. Design:The lack of nationally representative data to estimate black/white differences in child mortality is overcome by using the ratio of children born and alive as the measure of mortality and the 2005 census data from IPUMS-I, which provides racial categories based on self-identification. The working sample contains 617,985 mothers between 15 and 49 years of age, of whom 7.7% have experienced the death of at least one child. Using individual weights, a logistic regression is regressed on race, individual and community socio-economic status (SES), and demographic variables. Second, a model by cohort is regressed to capture the evolution of the racial gap over time. Third, interactions are run to examine the racial gap across SES groups. Results:The chances of losing a child are over 25% higher among black mothers relative to white mothers after controlling for individual and community SES characteristics. The racial gap remains stagnant and high for the period 1955–2005. The racial gap also is robust to changes in education and income levels. Conclusion:Failing to account for race slows down the improvement of child survival in Colombia relative to other countries of the region. [ABSTRACT FROM PUBLISHER]
- Published
- 2018
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31. Comparison of the epidemiology of disorders of gut–brain interaction in four Latin American countries: Results of The Rome Foundation Global Epidemiology Study.
- Author
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Schmulson, Max J., Puentes‐Leal, Gerardo A., Bustos‐Fernández, Luis, Francisconi, Carlos, Hani, Albis, López‐Colombo, Aurelio, Palsson, Olafur S., Bangdiwala, Shrikant I., and Sperber, Ami D.
- Subjects
EPIDEMIOLOGY ,PSYCHOLOGICAL factors ,GENERAL practitioners ,HEALTH services accessibility ,HEARTBURN ,INTERNET surveys ,IRRITABLE colon - Abstract
Background: In Latin America, there are scarce data on the epidemiology of DGBI. The Rome Foundation Global Epidemiology Study (RFGES) Internet survey included 26 countries, four from Latin America: Argentina, Brazil, Colombia, and Mexico, with a 40.3% prevalence of Rome IV DGBI. We aimed at comparing the prevalence of DGBI and associated factors among these countries. Methods: The frequency of DGBI by anatomical region, specific diagnoses, sex, age, diet, healthcare access, anxiety, depression, and HRQOL, were analyzed and compared. Results: Subjects included Argentina n = 2057, Brazil = 2004, Colombia = 2007, and Mexico = 2001. The most common DGBI were bowel (35.5%), gastroduodenal (11.9%), and anorectal (10.0%). Argentina had the highest prevalence of functional diarrhea (p = 0.006) and IBS‐D; Brazil, esophageal, gastroduodenal disorders, and functional dyspepsia; Mexico functional heartburn (all <0.001). Overall, DGBI were more common in women vs. men and decreased with age. Bowel disorders were more common in the 18–39 (46%) vs. 40–64‐year (39%) groups. Diet was also different between those with DGBI vs. those without with subtle differences between countries. Subjects endorsing criteria for esophageal, gastroduodenal, and anorectal disorders from Mexico, more commonly consulted physicians for bowel symptoms vs. those from Argentina, Brazil, and Colombia. General practitioners were the most frequently consulted, by Mexicans (50.42%) and Colombians (40.80%), followed by gastroenterologists. Anxiety and depression were more common in DGBI individuals in Argentina and Brazil vs. Mexico and Colombia, and they had lower HRQOL. Conclusions: The prevalence of upper and lower DGBI, as well as the burden of illness, psychological impact and HRQOL, differ between these Latin American countries. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
32. Rehabilitación de la baja visión: un asunto incipiente.
- Author
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Pilar Oviedo-Cáceres, María del, Natalia Arias-Pineda, Karen, and Cristina Palencia-Flórez, Diana
- Subjects
REHABILITATION of blind people ,HEALTH services accessibility ,RESEARCH methodology ,SUBURBS ,INTERVIEWING ,PHENOMENOLOGY ,RIGHT to health ,DESCRIPTIVE statistics ,PEOPLE with disabilities ,PATIENT compliance ,DISEASE management - Abstract
Copyright of Revista Cuidarte is the property of Universidad de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
- View/download PDF
33. Closing the Gap Between Formal and Material Health Care Coverage in Colombia.
- Author
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LAMPREA, EVERALDO and GARCÍA, JOHNATTAN
- Subjects
HEALTH insurance & economics ,HEALTH insurance laws ,HEALTH insurance statistics ,PUBLIC health ,HEALTH care reform ,HEALTH services accessibility ,HEALTH status indicators ,HEALTH insurance ,INTENSIVE care units ,MEDICAL appointments ,MATERNAL mortality ,OPERATING rooms ,PEDIATRICS ,POPULATION geography ,TAXATION ,GOVERNMENT regulation ,SOCIOECONOMIC factors - Abstract
This paper explores Colombia's road toward universal health care coverage. Using a policy-based approach, we show how, in Colombia, the legal expansion of health coverage is not sufficient and requires the development of appropriate and effective institutions. We distinguish between formal and material health coverage in order to underscore that, despite the rapid legal expansion of health care coverage, a considerable number of Colombians--especially those living in poor regions of the country--still lack material access to health care services. As a result of this gap between formal and material coverage, an individual living in a rich region has a much better chance of accessing basic health care than an inhabitant of a poor region. This gap between formal and material health coverage has also resulted in hundreds of thousands of citizens filing lawsuits--tutelas--demanding access to medications and treatments that are covered by the health system, but that health insurance companies--also known as EPS-- refuse to provide. We explore why part of the population that is formally insured is still unable to gain material access to health care and has to litigate in order to access mandatory health services. We conclude by discussing the current policy efforts to reform the health sector in order to achieve material, universal health care coverage. [ABSTRACT FROM AUTHOR]
- Published
- 2016
34. Characterization of the population affiliated to the subsidized health insurance scheme in Colombia: a systematic review and meta-analysis.
- Author
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Mora-Moreo, Laura, Estrada-Orozco, Kelly, Espinosa, Oscar, and Melgarejo, Lorena Mesa
- Subjects
RELATIVE medical risk ,HEALTH services accessibility ,META-analysis ,CONFIDENCE intervals ,SOCIAL determinants of health ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,STAKEHOLDER analysis ,PUBLIC health ,WORLD health ,HEALTH care reform ,HEALTH insurance ,DECISION making ,DESCRIPTIVE statistics ,POPULATION health ,PATIENT Protection & Affordable Care Act ,MEDLINE ,DATA analysis software ,INSURANCE ,EPIDEMIOLOGICAL research - Abstract
Background: Some reports suggest there are differences in health needs between the population affiliated to the subsidized health insurance scheme (SS) and those affiliated to the contributory health insurance scheme (CS) in Colombia. The objective of this study was to identify the epidemiological profile of the population affiliated to the SS in Colombia and to compare the main epidemiological features of the SS to the CS. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, the search was carried out from 1993, with no other restriction. The information was synthesized into five categories according to the most important risk populations. We estimated combined incidences from epidemiological surveillance data, prevalence ratio, and other measures to estimate the difference between the studied groups. A 95% confidence interval was considered. A random effects model was used weighted by the inverse of the variance of the cumulative incidence calculated for each disease. The risk of bias was assessed using the Joanna Briggs Institute's critical appraisal tools. Results: A total of 16,236 articles were identified; 14,972 were excluded after title and abstract screening, 725 articles were verified as full text, and finally 268 articles were included. The relative risk of non-communicable and communicable diseases was lower in the SS than in the CS (RR: 0.37 and 0.72, respectively, p-value < 0.05). However, the risk of presenting obstetric and maternal conditions in the SS versus the CS was RR 1.55 for frequent conditions during early childhood, and for other diseases it was RR 1.28 with a p-value of < 0.05. The use of health services was different by scheme, with less demand, access, and provision being found in health services in the SS. Conclusions: This study allowed us to conclude that there are differences in the incidence, prevalence, and use of health services between health affiliation schemes (SS and CS) in Colombia, thereby assisting in decision-making for stakeholders. Trial registration: PROSPERO Registration number CRD42021279234. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
35. A comparison of resource use of insured and uninsured venezuelan migrants: evidence from the hospital setting.
- Author
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Prada, Sergio I., Pulgarín-Rodríguez, Edwin, Hincapié-Zapata, Lina, and Pizarro, Ana Beatriz
- Subjects
IMMIGRANTS ,HOSPITALS ,HEALTH services accessibility ,MEDICAL care costs ,RETROSPECTIVE studies ,MEDICAL care use ,HEALTH insurance reimbursement ,HEALTH insurance ,COST analysis ,AT-risk people ,COST effectiveness ,HOSPITAL care - Abstract
Background: There is no characterization of resource use in the hospital setting for immigrants in Colombia, we aimed to describe the resource use by Venezuelan immigrants, comparing those enrolled in the national health insurance system with those with and without the ability to pay. Methods: Retrospective review in the billing data system of our Hospital from 2011 to 2020. We collected information for 6,837 hospital episodes associated with 1,022 Venezuelan patients, hospital's billing information for all services rendered was extracted. Results: The mean cost per patient event were 4,595 USD for those without the ability to pay, costing 2.37 times more than a legal resident insured. Care in the ICU, inpatient days, surgery, and OB-GYN department consume most resources provided to vulnerable migrants. Discussion: Enrolment in the national health insurance may allow better access to health services by vulnerable Venezuelan migrants and thus reduce resource use for the health system. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
36. Maternal Care and Pregnancy Outcomes of Venezuelan and Colombian Refugees.
- Author
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Weigel, M. Margaret and Armijos, Rodrigo X.
- Subjects
MATERNAL health services ,IMMIGRANTS ,HEALTH services accessibility ,PREMATURE infants ,CONFIDENCE intervals ,ANALYSIS of variance ,PREGNANCY outcomes ,LOW birth weight ,REFUGEES ,DESCRIPTIVE statistics ,CHI-squared test ,CESAREAN section ,PRENATAL care ,INSTITUTIONAL care ,LOGISTIC regression analysis ,ODDS ratio ,APGAR score - Abstract
Background: Ecuador is a major host country for Colombians fleeing violence and Venezuelans escaping a complex humanitarian crisis, many of whom are pregnant women. Methods: We used national birth registry data (2018–2020) to compare the maternal care and infant outcomes of Venezuelan and Colombian immigrants with Ecuadorian nationals. Results: Venezuelan immigrants had a lower adjusted odds (AOR) for adequate prenatal care (AOR = 0.64;95%CI = 0.62,0.67) but a higher AOR for institutional (AOR = 2.68;95%CI = 1.84,3.93) and C-section delivery (AOR = 1.28;95%CI = 1.23,1.32) and birthing infants who were moderate-late preterm (AOR = 1.12;95%CI = 1.05,1.20), very preterm (AOR = 1.20;95%CI = 1.04,1.40), extremely pre-term (AOR = 1.65;95%CI = 1.27,2.14), low birthweight (LBW) (AOR = 1.11;95%CI = 1.05,1.17), very LBW (AOR = 1.35;95%CI = 1.12,1.62), and extremely LBW (AOR = 1.71;95%CI = 1.36,2.16). Colombians had decreased AORs for adequate prenatal care (AOR = 0.82;95%CI = 0.78,0.87) but increased AORs for institutional (AOR = 2.03;95%CI = 1.19,3.46) and C-section deliveries (AOR = 1.07;95%CI = 1.01,1.13) and birthing infants with moderate-late preterm (AOR = 1.17;95%CI = 1.05,1.30) but not LBW. Discussion: The findings underscore the need to address the causes of adequate prenatal care, excess C-sections, and poorer infant outcomes among refugee and immigrant women, especially Venezuelans. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
37. Poisonously single-minded: public health implications of the pharmaceuticalization of leishmaniasis in Colombia.
- Author
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Pinto-García, Lina
- Subjects
LEISHMANIASIS diagnosis ,ANTIPROTOZOAL agents ,SKIN diseases ,THERAPEUTICS ,LEISHMANIASIS ,INTERDISCIPLINARY research ,HEALTH services accessibility ,RURAL conditions ,RESEARCH methodology ,ATTITUDE (Psychology) ,PUBLIC health ,ANTHROPOLOGY ,INTERVIEWING ,PATIENTS' attitudes ,ORGANOMETALLIC compounds ,VECTOR-borne diseases ,RESEARCH funding ,ETHNOLOGY ,ALTERNATIVE medicine - Abstract
Cutaneous leishmaniasis is a vector-borne disease transmitted by sandflies that causes skin ulcers. In Colombia, this disease mainly affects rural populations and combatants of the armed conflict. The state management of leishmaniasis is pharmaceuticalized – centered on a highly toxic drug called Glucantime. Drawing on critical views of the pharmaceuticalization of public health and the implications of the massive use of drugs in colonial contexts and developing countries, this article establishes an interdisciplinary dialogue between biomedical literature and ethnographic data. I explore the consequences of a public health model based on an old, toxic, and potentially deadly pharmaceutical to control a mostly benign skin disease. I argue that while it is necessary to guarantee that all people have access to antileishmanial therapies, there remain dangers associated with Glucantime that puts into question its predominant use in Colombia. This case shows that pharmaceutical access alone, and drug-centered models in particular, not only represent limited views of public health but can have disastrous consequences for those affected by disease and marginalization. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
38. Supporting healthcare workers caring for ex-combatants: incentives among Colombian providers with FARC ex-combatants.
- Author
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Reynolds, Christopher W., Duarte, Andrés, Fricke, Adrienne, Gómez Restrepo, Carlos, Patiño, Andres, Arbelaez, Christian, Moretti, Katelyn, and Aguiar, Leonar G.
- Subjects
RESEARCH ,HEALTH education ,HEALTH services accessibility ,SOCIAL support ,ATTITUDES of medical personnel ,GROUNDED theory ,RESEARCH methodology ,PROFESSIONAL employee training ,MEDICAL personnel ,LABOR demand ,INTERVIEWING ,QUANTITATIVE research ,PHENOMENOLOGY ,QUALITATIVE research ,LABOR supply ,PSYCHOSOCIAL factors ,LABOR incentives ,DESCRIPTIVE statistics ,INTERPERSONAL relations ,AT-risk people ,VETERANS ,PAY for performance ,JUDGMENT sampling ,STATISTICAL sampling ,DATA analysis software ,MILITARY personnel - Abstract
With the Peace Agreement between Fuerzas Armadas Revolucionarias de Colombia (FARC), Colombia promised healthcare to 13,000 'reincorporating' FARC ex-combatants. Shortages of healthcare workers in reincorporation camps means this promise is in danger of going unfulfilled. More information is needed to determine incentives, disincentives, and recruitment of healthcare providers to address this shortage. Semi-structured interviews were conducted with healthcare providers across FARC reincorporation camps, and a multidisciplinary team conducted analysis in NVivo12 using a team-based coding method. Twenty-four healthcare professionals from 15 camps participated, of which 75% were female. Incentives to work with FARC included improved clinical skills, professional advancement, increased comfort with FARC, and contributing to the peace process. Disincentives included poor living conditions, lack of support, biases, familial commitments, and sacrificing career opportunities. Three-fourths of the sample recommended working with FARC, and 92% reported a shortage of healthcare workers. Recruitment strategies included improved resources and specialised career development for healthcare workers, facilitating interactions between FARC and healthcare professionals outside clinical scenarios, and integrating medicine for vulnerable populations into health education. This study shows the impact that working with FARC ex-combatants can have on healthcare providers and tangible suggestions for increasing provider participation to address the healthcare worker shortage. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
39. The evolution of Vaccination Week in the Americas.
- Author
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Ropero Alvarez, Alba Maria, Kurtis, Hannah Jane, Vulanovic, Lauren, Hasan, Hayatee, Ruiz, Cuauhtémoc, and Thrush, Elizabeth
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- *
EPIDEMICS , *HEALTH services accessibility , *IMMUNIZATION , *MEASLES , *MEDICAL protocols , *NEGOTIATION , *POLIOMYELITIS vaccines , *PREVENTIVE health services , *SPECIAL days - Abstract
This report covers the background and evolution of Vaccination Week in the Americas (VWA), an initiative that started as a coordinated response to a 2002 measles outbreak in Colombia and Venezuela, and evolved into the model for other regions and World Immunization Week (WIW). VWA focuses on the work of national immunization programs, with special efforts to reach the unreached. This paper offers examples of how countries have leveraged VWA to implement a diverse array of vaccination activities, strengthening overall health services by integrating with other preventive health interventions, and bolstering "Pan-Americanism" and health diplomacy. The opportunities offered by this global initiative were clearly demonstrated in April 2016 when the successful global switch from the trivalent oral polio vaccine to the bivalent vaccine was synchronized with WIW. Going forward, VWA and WIW can help close the gaps in access to immunization and other health services, contributing to achieve universal health coverage. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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40. A qualitative study of employment, working and health conditions among Venezuelan migrants in Colombia.
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Agudelo‐Suárez, Andrés A., Vargas‐Valencia, Mary Y., Vahos‐Arias, Jonny, Ariza‐Sosa, Gladys, Rojas‐Gutiérrez, Wilder J., and Ronda‐Pérez, Elena
- Subjects
WORK environment ,NOMADS ,HEALTH services accessibility ,RESEARCH methodology ,INTERVIEWING ,MENTAL health ,QUALITATIVE research ,EMPLOYMENT ,SOCIAL classes ,QUALITY of life ,CONTENT analysis ,DATA analysis software - Abstract
This study aims to explore the perceptions of the Venezuelan immigrant population in Medellín, Colombia, regarding their employment, working and health conditions (physical, mental and psychosocial). A qualitative study was conducted (focused ethnography perspective). Semi‐structured interviews were carried out with 31 Venezuelans and 12 key informants from different social organisations that work with the immigrant population. A narrative content analysis was carried out (Atlas.Ti 8.0 software). The migratory process for Venezuelans is caused for political, economical and social aspects in Venezuela and Colombia is offered as the first destination for labour establishing. Access to the labour market is limited to certain occupations, in many cases in the informal economy. Participants referring low salaries, working long hours and reduced social benefits. Occupational risks are evidenced by low experience in the labour market. Some health problems are perceived, and a good part of the interviewed population referred to signs and symptoms related to mental health problems. Barriers to access health and social protection services were found. Finally, future expectations depend on their adaptation to Colombia, the improvement of social conditions in Venezuela or having chances of improving their social and living conditions in another country. A high labour and social vulnerability were found in Venezuelan participants that impact on physical and mental health. Political and strategies from a public health perspective are required and the implementation of systems for monitoring and evaluating the labour and health situation in the working immigrant population. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
41. Burden of skin cancer in Colombia.
- Author
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Meijs, Martijn, Herrera, Astrid, Acosta, Alvaro, and de Vries, Esther
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SKIN cancer ,GREY literature ,DATA warehousing ,DELAYED diagnosis ,DEATH rate ,HEALTH services accessibility - Abstract
Background: Levels of incidence and mortality of skin cancer in Colombia and Latin America are largely unknown. Objectives: Present the available information from official and gray literature and governmental databases to grasp the magnitude and characteristics of skin cancer in Colombia (middle‐income Latin American country). Methods: Narrative review based on a literature search (2005–2020), gray literature and cancer registry and governmental warehouse data, calculation of proportions and age‐standardized incidence (ASIR) and mortality rates (ASMR), expressed per 100,000 person‐years. Results: ASIR of cutaneous melanoma in Colombia is around 3, corresponding ASMR between 0.7 and 0.8. Distinctive features are the high proportion and rates for acral melanomas, and the advanced stage at diagnosis in the general population but not in private clinics. For non‐melanoma skin cancer, ASIR is at least around 35–40, ASMR 0.8. Conclusions: Among the wealthy Colombians, melanoma features are similar to those of high incidence countries (but of lower magnitude), whereas the majority of the population present distinct features with a much higher proportion of acral melanomas, very late stages at diagnosis, and poor prognosis. More advanced melanomas seem to have a relation with lower socioeconomic status. Non‐melanoma skin cancer is common, with very high mortality rates at levels even above those of predominantly fair‐skinned populations, implying high fatality rates for non‐melanoma skin cancers. This could indicate a late diagnosis or difficulties in access to treatment, illustrating the need for primary and secondary prevention to reduce the burden of disease and improve the prognosis of this common cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
42. Access to health care for Venezuelan irregular migrants in Colombia: between constitutional adjudication and human rights law.
- Author
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Angeleri, Stefano
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HUMAN rights ,HEALTH services accessibility ,MIDDLE-income countries ,PRIMARY health care ,INTERNAL migration ,IMMIGRANTS ,VENEZUELANS ,CONSTITUTIONAL courts - Abstract
In the last six years, Colombia has received an exceptionally high number of incoming people on the move, fleeing from neighbouring Venezuela, including around 1 million Venezuelan nationals in an irregular situation.
1 Against this unique and challenging background, this article aims to ascertain the extent to which the jurisprudence of the Constitutional Court of Colombia and that of United Nations' human rights treaty bodies and InterAmerican institutions are synergetic and supportive of the idea that the right to health must be equitably accessible for irregular migrants and subgroups of the same. The case law of this Court provides useful insights into both the difficulties of implementing 'beyond minimalist' approaches to the rights of irregular migrants in a middle-income country and the unusually influential but selective role of international human rights law and the comments of treaty bodies in its findings. For this case study, I also systematise applicable arguments of UN and InterAmerican human rights law and demonstrate that they are normative frameworks capable of pitching the right to health of irregular migrants beyond access to urgent treatment by integrating arguments based on core rights and vulnerability into a primary health care approach to public health that 'brings promotion and prevention, cure and care together'.2 [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
43. Striking a Balance: Conscientious Objection and Reproductive Health Care from the Colombian Perspective.
- Author
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CABAL, LUISA, ARANGO OLAYA, MONICA, and MONTOYA ROBLEDO, VALENTINA
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ABORTION laws ,HEALTH care reform ,COURTS ,HEALTH services accessibility ,HEALTH insurance ,HEALTH policy ,REPRODUCTIVE health ,REFUSAL to treat - Abstract
Conscientious Objection or conscientious refusal (CO) in access to reproductive health care is at the center of current legal debates worldwide. In countries such as the US and the UK, constitutional dilemmas surrounding CO in the context of reproductive health services reveal inadequate policy frameworks for balancing CO rights with women's rights to access contraception and abortion. The Colombian Constitutional Court's holistic jurisprudence regarding CO standards has applied international human rights norms so as to not only protect women's reproductive rights as fundamental rights, but to also introduce clear limits for the exercise of CO in health care settings. This paper reviews Latin American lines of regulation in Argentina, Uruguay, and Mexico City to argue that the Colombian Court's jurisprudence offers a strong guidance for future comprehensive policy approaches that aim to effectively balance tensions between CO and women's reproductive rights. [ABSTRACT FROM AUTHOR]
- Published
- 2014
44. Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil.
- Author
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Garcia-Subirats, Irene, Vargas, Ingrid, Mogollón-Pérez, Amparo Susana, De Paepe, Pierre, da Silva, Maria Rejane Ferreira, Unger, Jean Pierre, and Vázquez, María Luisa
- Subjects
- *
HEALTH services accessibility , *STATISTICAL sampling , *SURVEYS , *CROSS-sectional method , *DESCRIPTIVE statistics - Abstract
Abstract: There are few comprehensive studies available on barriers encountered from the initial seeking of healthcare through to the resolution of the health problem; in other words, on access in its broad domain. For Colombia and Brazil, countries with different healthcare systems but common stated principles, there have been no such analyses to date. This paper compares factors that influence access in its broad domain in two municipalities of each country, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had had at least one health problem within the last three months (2163 in Colombia and 2155 in Brazil). The results reveal important barriers to healthcare access in both samples, with notable differences between and within countries, once differences in sociodemographic characteristics and health needs are accounted for. In the Colombian study areas, the greatest barriers were encountered in initial access to healthcare and in resolving the problem, and similarly when entering the health service in the Brazilian study areas. Differences can also be detected in the use of services: in Colombia greater geographical and economic barriers and the need for authorization from insurers are more relevant, whereas in Brazil, it is the limited availability of health centres, doctors and drugs that leads to longer waiting times. There are also differences according to enrolment status and insurance scheme in Colombia, and between areas in Brazil. The barriers appear to be related to the Colombian system's segmented, non-universal nature, and to the involvement of insurance companies, and to chronic underfunding of the public system in Brazil. Further research is required, but the results obtained reveal critical points to be tackled by health policies in both countries. [Copyright &y& Elsevier]
- Published
- 2014
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45. Higher pharmaceutical public expenditure after direct price control: improved access or induced demand? The Colombian case.
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Prada, Sergio I., Soto, Victoria E., Andia, Tatiana S., Vaca, Claudia P., Morales, Álvaro A., Márquez, Sergio R., and Gaviria, Alejandro
- Subjects
PHARMACEUTICAL industry & economics ,HEALTH services accessibility ,MARKETING ,MEDICAL needs assessment ,UNNECESSARY surgery ,PHARMACY ,ECONOMICS - Abstract
Background: High pharmaceutical expenditure is one of the main concerns for policymakers worldwide. In Colombia, a middle-income country, outpatient prescription represents over 10% of total health expenditure in the mandatory benefits package (POS), and close to 90% in the complementary government fund (No POS). In order to control expenditure, since 2011, the Ministry of Health introduced price caps on inpatient drugs reimbursements by active ingredient. By 2013, more than 400 different products, covering 80% of public pharmaceutical expenditure were controlled. This paper investigates the effects of the Colombian policy efforts to control expenditure by controlling prices. Methods: Using SISMED data, the official database for prices and quantities sold in the domestic market, we estimate a Laspeyres price index for 90 relevant markets in the period 2011–2015, and, then, we estimate real pharmaceutical expenditure. Results: Results show that, after direct price controls were enacted, price inflation decreased almost − 43%, but real pharmaceutical expenditure almost doubled due mainly to an increase in units sold. Such disproportionate increase in units sold maybe attributable to better access to drugs due to lower prices, and/or to an increase in marketing efforts by the pharmaceutical industry to maintain profits. Conclusions: We conclude that pricing interventions should be implemented along with a strong market monitoring to prevent market distortions such as inappropriate and unnecessary drug use. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
46. Social Participation in Health: A Community-Based Participatory Research Approach to Capacity Building in Two Colombian Communities.
- Author
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Ramírez, Alexandra Agudelo
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SOCIAL participation ,COMMUNITY-based participatory research ,COMMUNITY involvement ,HEALTH services accessibility ,PARTICIPANT observation - Abstract
Background: In Latin America, community participation in health issues is subject to corrupt and self-serving interest. Research recommends strengthening communities' abilities to develop actions that involve them in the coproduction of their health. Objectives: This study aims (1) to understand social participation in health based on the discourse of community leaders and institutional representatives and (2) to design and implement an educational strategy for capacity building within two communities in Colombia. Methods: The study used a community-based participatory research partnership between researchers, community leaders, and institutional representatives. To understand social participation in health, 17 interviews were conducted with leaders and institutional representatives. Based on this assessment, an educational strategy was designed and implemented with residents of two communities, which resulted in 28 people taking part in 14 pedagogical workshops. The strategy was evaluated through focus groups and the results of the project were validated by all the interested parties. Results: Interviewees' perception of participation is reduced to access to health care services. They identified that the agencies and institutions promote participation only to comply with the law. The communities stated that they had few tools to resolve situations that violate their right to health. Therefore, leaders and researchers developed an educational strategy custom tailored, so the community could acquire the capacities to confront injustices and bureaucracy in the health system and public services. Conclusions: This participatory research empowered communities to defend their right to health. The findings are a reference for social participation in health initiatives in similar contexts. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
47. Time, space and health: using the life history calendar methodology applied to mobility in a medical-humanitarian organisation.
- Author
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Cubides, Juan-Carlos, Jorgensen, Nuni, and Peiter, Paulo Cesar
- Subjects
PROFESSIONAL practice ,NOMADS ,HUMANITARIANISM ,SOCIAL determinants of health ,HEALTH services accessibility ,RESEARCH methodology ,EVIDENCE-based medicine ,INTERVIEWING ,REFUGEES ,MEDICAL societies - Abstract
In the medical humanitarian context, the challenging task of collecting health information from people on the move constitutes a key element to identifying critical health care needs and gaps. Médecins Sans Frontières (MSF), during its long history of working with migrants, refugees and mobile populations in different contexts, has acknowledged how crucial it is to generate detailed context-related data on migrant and refugee populations in order to adapt the response interventions to their needs and circumstances. In 2019, the Brazilian Medical Unit/MSF developed the Migration History Tool (MHT), an application based on the life history method which was created in close dialogue with field teams in order to respond to information needs emerging from medical operations in mobile populations. The tool was piloted in two different contexts: firstly, among mobile populations transiting and living in Beitbridge and Musina, at the Zimbabwe-South Africa border; and, secondly, among Venezuelan migrants and refugees in Colombia. This article describes the implementation of this innovative method for collecting quantitative retrospective data on mobility and health in the context of two humanitarian interventions. The results have proven the flexibility of the methodology, which generated detailed information on mobility trajectories and on the temporalities of migration in two different contexts. It also revealed how health outcomes are not only associated with the spatial dimensions of movement, but also with the temporalities of mobility trajectories. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
48. Teoría Crítica, riesgo y justicia en salud pública.
- Author
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Rueda-Barrera, Eduardo Alfonso
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- *
PUBLIC health & society , *HEALTH services accessibility , *SOCIAL justice , *CRITICAL theory , *FRANKFURT school of sociology , *HEALTH risk assessment , *PUBLIC health , *METHODOLOGY - Abstract
In this paper I discuss the relevance of the program of social critical theory to examine the demands for justice in public health from a non-reductionist perspective —that is, a not sectorial one— that accounts for the intimate relationship between health and social arrangements and allows further exploration of the fundamental question about the necessary conditions for human self-realization. [ABSTRACT FROM AUTHOR]
- Published
- 2012
49. Geomarketing en salud para ubicar oferta de servicios médicos de valor: Caso: Proyecto de investigación para ubicar una nueva oferta hospitalaria.
- Author
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Romero, Luis Alfonso Pérez
- Subjects
MEDICAL care marketing ,MEDICAL geography ,HEALTH policy ,PREVENTION of epidemics ,PANDEMICS ,EPIDEMIOLOGICAL research ,HEALTH planning ,HEALTH services accessibility ,MANAGEMENT - Abstract
Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2008
50. Roadblocks in Chagas disease care in endemic and nonendemic countries: Argentina, Colombia, Spain, and the United States. The NET-Heart project.
- Author
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Miranda-Arboleda, Andrés F., Zaidel, Ezequiel José, Marcus, Rachel, Pinazo, María Jesús, Echeverría, Luis Eduardo, Saldarriaga, Clara, Sosa Liprandi, Álvaro, and Baranchuk, Adrián
- Subjects
CHAGAS' disease ,NON-communicable diseases ,ENDEMIC diseases ,HEALTH services accessibility ,DRUG accessibility ,GLOBAL burden of disease - Abstract
Background: Chagas disease (CD) is endemic in Latin America; however, its spread to nontropical areas has raised global interest in this condition. Barriers in access to early diagnosis and treatment of both acute and chronic infection and their complications have led to an increasing disease burden outside of Latin America. Our goal was to identify those barriers and to perform an additional analysis of them based on the Inter American Society of Cardiology (SIAC) and the World Heart Federation (WHF) Chagas Roadmap, at a country level in Argentina, Colombia, Spain, and the United States, which serve as representatives of endemic and nonendemic countries. Methodology and principal findings: This is a nonsystematic review of articles published in indexed journals from 1955 to 2021 and of gray literature (local health organizations guidelines, local policies, blogs, and media). We classified barriers to access care as (i) existing difficulties limiting healthcare access; (ii) lack of awareness about CD and its complications; (iii) poor transmission control (vectorial and nonvectorial); (iv) scarce availability of antitrypanosomal drugs; and (v) cultural beliefs and stigma. Region-specific barriers may limit the implementation of roadmaps and require the application of tailored strategies to improve access to appropriate care. Conclusions: Multiple barriers negatively impact the prognosis of CD. Identification of these roadblocks both nationally and globally is important to guide development of appropriate policies and public health programs to reduce the global burden of this disease. Author summary: Chagas disease (CD) has been described as an epidemic in Latin America, but its geographical influence is global. One of the biggest challenges in providing care for patients with CD is to improve access to early diagnosis and treatment in order to avoid chronic cardiovascular and gastrointestinal complications. However, different roadblocks interfere with the optimal care of these patients, which facilitates disease progression. While some barriers to care are global in scope, there are additionally national and even local obstacles for patients with CD. Appropriate delineation of these barriers will allow for the development of targeted interventions to improve the outlook for CD patients in both endemic and nonendemic countries alike. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
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