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A healthy and safe public health environment is a fundamental responsibility of government; achieving it requires collaboration across multiple sectors. Public health services include, for example, vaccination and quarantine for infectious diseases; health promotion, such as anti-smoking campaigns for noncommunicable diseases; and health insurance for universal health coverage. All these services require intersectoral actions in which the government must play a fundamental role, either partially or totally. The Taiwanese outlook on governmental public health infrastructure and professionalization of public health is given in this paper. It also describes the national governmental public health measures that were employed during the Covid-19 pandemic and discusses the challenges ahead for the country's governmental public health. Governmental public health is essential and should not be affected by changes in political forms or socioeconomic development. Instead, effective governmental public health will promote these developments while protecting citizens' right to health. [ABSTRACT FROM AUTHOR]

This paper discusses the origins and content of the framework that guided the creation of the Center for Public Health Research in 1984 and the modernization of the School of Public of Health of Mexico, established in 1922. These two institutions eventually merged with the Center for Research in Infectious Disease to create, in 1987, the National Institute of Public Health of Mexico, one of the leading institutions of higher education and research in public health in the developing world. [ABSTRACT FROM AUTHOR]

Globally, tertiary education has been greatly affected by the Covid-19 crisis. In this essay we explore the impact of the pandemic on this educational sector in an Australian setting; specifically, we discuss how the Research School of Population Health at the Australian National University adjusted and adapted to the changing circumstances arising from the pandemic. In this respect, two adjustments (both described in detail in the text) in the way mental health education was delivered at the School were proposed to mitigate the impact of Covid-19 and enhance the university's capacity to provide quality public health education to students. Thus, this essay shows that it is possible to design educational interventions that surmount the challenges posed by the pandemic. In addition, educators may use the examples cited in this paper to guide them to respond appropriately to the challenges that have arisen in terms of health education due to Covid-19. [ABSTRACT FROM AUTHOR]

Complex interventions are needed to effectively tackle noncommunicable diseases. However, complex interventions can contain a mix of effective and ineffective actions. Process evaluation (PE) in public health research is of great value as it could clarify the mechanisms and contextual factors associated with variation in the outcomes, better identify effective components, and inform adaptation of the intervention. The aim of this paper is to demonstrate the value of PE through five case studies that span the research cycle. The interventions include using digital health, salt reduction strategies, use of fixed dose combinations, and task shifting. Insights of the methods used, and the implications of the PE findings to the project, were discussed. PE of complex interventions can refute or confirm the hypothesized mechanisms of action, thereby enabling intervention refinement, and identifying implementation strategies that can address local contextual needs, so as to improve service delivery and public health outcomes. [ABSTRACT FROM AUTHOR]

This paper describes the creation of the legal framework and the origin, growth and consolidation of the institutions and interventions (initiatives, programs and policies) that nourished public health in Mexico in the past century. It also discusses the recent efforts to guarantee universal social protection in health. This quest, which lasted a century, developed through three generations of reform that gave birth to a health system that offers protection against sanitary risks, protection of health care quality and financial protection to all the population in the country. [ABSTRACT FROM AUTHOR]

Earthquakes are probably the scariest among the natural disasters that teach us about the forces of nature and their unpredictability. Knowing that there is nothing we can do to prevent the occurrence of an earthquake, we are forced to learn from our own experience. This paper systematizes the environmental, medical and public health impacts of earthquakes. Each is presented in a structured way, highlighting its most important aspects. The relationship between them and the affected environment and population; as well as the connection between these are emphasized during earthquakes. The environment at the place of occurrence of an earthquake is important for the survival of victims and also defines the particular medical and public health needs arising from its specificity. Every country needs good disaster management with specific protocols for the expected type of disaster. These protocols must incorporate environmental, medical and public health aspects and their implementation must be very efficient; they must include educating the inhabitants; training teams involved in rescue, (eventual) migration/ evacuation, medical treatments and public health actions, and training and educating leaders. [ABSTRACT FROM AUTHOR]

Depression is an important public health problem. It is the fourth cause of disease in the world in terms of lost years of healthy life. In Mexico, it ranks first in terms disability for women and ninth for men. There is a high comorbidity between depression and other mental disorders such as anxiety and substance abuse, as well as other serious and chronic physical conditions (e.g. diabetes, and heart disease). Despite the impact of depressive disorders in the quality of life of the population, there is a large proportion of people who don't get treatment, delaying seeking help and thus don't receive adequate assistance. The aim of this paper is to present an analysis of depression status in the Mexican population from a public health perspective; it includes prevalence and associated factors, gaps in care, characteristics of the use of services and treatments available. The paper concludes with a presentation of the implications for research and mental health policy in Mexico. [ABSTRACT FROM AUTHOR]

This paper describes the health system of Argentina. This system has three sectors: public, social security and private. The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS) covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll contributions of employers and employees. Finally, the private sector includes all those private providers offering services to individuals, OS beneficiaries and all those with private health insurance. This sector also includes private insurance agencies called Prepaid Medicine Enterprises, financed mostly through premiums paid by families and/or employers. This paper also discusses some of the recent innovations implemented in Argentina, including the program Remediar. [ABSTRACT FROM AUTHOR]

This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans. The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde. [ABSTRACT FROM AUTHOR]

This paper describes the Mexican health system. In part one, the health conditions of the Mexican population are discussed, with emphasis in those emerging diseases that are now the main causes of death, both in men and women: diabetes, ischaemic heart disease, cerebrovascular diseases and cancer . Part two is devoted to the description of the basic structure of the system: its main institutions, the population coverage, the health benefits of those affiliated to the different heath institutions, its financial sources, the levels of financial protection in health, the availability of physical, material and human resources for health, and the stewardship functions displayed by the Ministry of Health and other actors. This part also discusses the role of citizens in the monitorization and evaluation of the health system, as well as the levels of satisfaction with the rendered health services. In part three the most recent innovations and its impact on the performance of the health system are discussed. Salient among them are the System of Social Protection in Health and the Popular Health Insurance. The paper concludes with a brief analysis of the short- and middle-term challenges faced by the Mexican health system. [ABSTRACT FROM AUTHOR]

This paper describes the health conditions in Guatemala and, in more detail, the characteristics of the Guatemalan health system, including its structure en coverage, its financial sources, the stewardship functions developed by the Ministry of Health, as well as the generation of health information and the development of research activities. It also discusses the recent efforts to extend coverage of essential health services, mostly to poor rural areas. The most recent innovations also discussed in this paper include the Program for the Expansion of Coverage of Essential Services, the Program to Expand Access to Essential Drugs and the agreements between the Ministry of Health and several non-governmental organizations to provide essential services in rural settings. [ABSTRACT FROM AUTHOR]

This paper describes the health conditions in Cuba and the general characteristics of the Cuban health system, including its structure and coverage, its financial sources, its health expenditure, its physical, material and human resources, and its stewardship functions. It also discusses the increasing importance of its research institutions and the role played by its users in the operation and evaluation of the system. Salient among the social actors involved in the health sector are the Cuban Women Federation and the Committees for the Defense of the Revolution. The paper concludes with the discussion of the most recent innovations implemented in the Cuban health system, including the cardiology networks, the Miracle Mission (Misión Milagro) and the Battle of Ideas (Batalla de Ideas). [ABSTRACT FROM AUTHOR]

Objective. This paper critically examines recent work on qualitative health research (QHR) in Mexico. Material and Methods. A review was conducted of 128 articles published between 2000 and 2009. A literature search was done drawing together a verse of indexes, search engine, data bases and citations, as well as interviewing researchers. A frequency and content analysis was carried out. Results. QHR has expanded significantly, both nationally and internationally, and papers published in public health and social medicine journals. However, several factors impede its consolidation: the institutional, territorial and thematic concentration of studies, the dependency on grounded theory, the selective nature of the research topics and populations; and its marginal scientific impact. Conclusions. QHR has grown in México, but its consolidation faces serious challenges. Several proposals are discussed that could strengthen the field. [ABSTRACT FROM AUTHOR]

Listeriosis is caused by Listeria monocytogenes, an important food-borne disease due to its clinical forms, high mortality rate, and the economic impact in both clinical and food production industries. In Mexico, the lack of epidemiological surveillance systems leads to the need of accurate data on the incidence of listeriosis and its association with food-borne disease. In this paper, we present data about the presence of this bacterium in food, reports related to clinical cases of listeriosis, and information of diseases in which L. monocytogenes may be involved. However, in most of these cases the etiology was not established. Given this, there's a need to inform and warn the appropriate entities, to define strategies for the mandatory search of L. monocytogenes through the whole food production chain and clinical suspects, for the epidemiological importance and control of listeriosis in Mexico. [ABSTRACT FROM AUTHOR]

This commentary addresses some of the diverse questions of current interest with regard to the health effects of air pollution, including exposure-response relationships, toxicity of inhaled particles and risks to health, multipollutant mixtures, traffic-related pollution, accountability research, and issues with susceptibility and vulnerability. It considers the challenges posed to researchers as they attempt to provide useful evidence for policy-makers relevant to these issues. This commentary accompanies papers giving the results from the ESCALA project, a multi-city study in Latin America that has an overall goal of providing policy-relevant results. While progress has been made in improving air quality, driven by epidemiological evidence that air pollution is adversely affecting public health, the research questions have become more subtle and challenging as levels of air pollution dropped. More research is still needed, but also novel methods and approaches to address these new questions. [ABSTRACT FROM AUTHOR]

Objective. This paper aims at assessing the contribution of Chile's Health Care Integrating Councils (CIRA, Spanish acronym) to strengthening governance in health. Materials and methods. A literature review on the official documents related to the process of creation and development of CIRA was carried out; an ad hoc questionnaire was applied to all 29 health services of the country; finally, 35 semi-structure in-depth interviews were carried on a sample of six CIRA. Results. The CIRAs have become a tool for functional integration and a valuable space for dialogue, cooperation and learning for all of the actors of the Chilean public health network. Conclusions. In this study, we conclude that there is room for improvements of CIRA's role regarding governance of the health care network as long as CIRA is authorized to deal with strategic topics, such as investment in infrastructure, technology and human resources, and budgeting. [ABSTRACT FROM AUTHOR]

Unlike many other Latin American countries Mexico has no coherent and explicit national pharmaceutical policy (NPP). Other national challenges are: high out-of-pocket expenditure on medicines despite the implementation of universal health care coverage through Seguro Popular, high prices of medicines in the private sector in comparison to other countries when adjusted for income level, and the lack of clear strategies to improve safety and efficiency in the use of medicines, in particular interventions aimed at private physicians, pharmacies and consumers. The aim of this paper is to describe the challenges and opportunities to (1) consolidate the processes of formulating, implementing and evaluating NPP, and (2) define the policy content with regard to access and use of medicines. [ABSTRACT FROM AUTHOR]

This paper describes a plan for the attention of addictions from a public health perspective; it defines strengths of this perspective and its limitations to face the special challenges that the problem represents for social policies; adopts a wider perspective that includes the integration of health and social issues in measuring policy results having as a main aim the benefit of the person and of the communities with a perspective of the populations well being. It describes the challenge the country faces as producer, route of traffic and rates of consumption, analyzes briefly the evidence of public policies and makes a series of recommendations. [ABSTRACT FROM AUTHOR]

Since the Salud Mesoamerica 2015 initiative (SM-2015) aim is to improve health and nutrition conditions of those most vulnerable in Mesoamerica, the goal of the evaluation is to generate evidence of the joint effectiveness of a package of interventions designed to improve the health conditions. We propose a mix design for the evaluation, which will allow to know the magnitude of changes attributable to the interventions, as well as the meanings of these changes for the target population, taking into account the speciicities of each country. The main axis of this design is a locality panel where information about individuals, households, and health facilities (irst and second level) will also be collected. The evaluation design described in this paper was developed between June and December, 2009, and it was integrated during workshops in Cuernavaca (Mexico), Managua (Nicaragua), and San Jose (Costa Rica). The proposed design will allow to generate evidence about the joint effectiveness of the package of interventions proposed for the SM-2015. The success of this design rests on the political commitment of countries and donors. [ABSTRACT FROM AUTHOR]

This paper describes the Chilean health system, including its structure, financing, beneficiaries, and its physical, material and human resources. This system has two sectors, public and private. The public sector comprises all the organisms that constitute the National System of Health Services, which covers 70% of the population, including the rural and urban poor , the low middle-class, the retired, and the self-employed professionals and technicians. The private sector covers 17.5% of the population, mostly the upper middle-class and the high-income population. A small proportion of the population uses private health services and pays for them out-of-pocket. Around 10% of the population is covered by other public agencies, basically the Health Services for the Armed Forces. The system was recently reformed with the establishment of a Universal System of Explicit Entitlements, which operates through a Universal Plan of Explicit Entitlements (AUGE), which guarantees timely access to treatment for 56 health problems, including cancer in children, breast cancer , ischaemic heart disease, HIV/AIDS and diabetes. [ABSTRACT FROM AUTHOR]

This paper describes the Bolivian health system, including its structure and organization, its financing sources, its health expenditure, its physical, material and humans resources, its stewardship activities and the its health research institutions. It also discusses the most recent policy innovations developed in Bolivia: the Maternal and Child Universal Insurance, the Program for the Extension of Coverage to Rural Areas, the Family, Community and Inter-Cultural Health Model and the cash-transfer program Juana Azurduy intended to strengthen maternal and child care. [ABSTRACT FROM AUTHOR]

This paper describes the Venezuelan health system, including its structure and coverage, financial sources, human and material resources and its stewardship functions. This system comprises a public and a private sector . The public sector includes the Ministry of Popular Power for Health (MS) and several social security institutions, salient among them the Venezuelan Institute for Social Security (IVSS). The MH is financed with federal, state and county contributions. The IVSS is financed with employer , employee and government contributions. These two agencies provide services in their own facilities. The private sector includes providers offering services on an out-of-pocket basis and private insurance companies. The Venezuelan health system is undergoing a process of reform since the adoption of the 1999 Constitution which calls for the establishment of a national public health system. The reform process is now headed by the Barrio Adentro program. [ABSTRACT FROM AUTHOR]

This paper describes the Uruguayan health system, including its structure and coverage, its financial sources, the level and distribution of its health expenditure, the physical, material and human resources available, its stewardship functions, the institutions in charge of information and research, and the level and type of citizen's participation in the operation and evaluation of the system. The most recent policy innovations are also discussed, including the creation of the National Comprehensive Health System, the National Health Insurance, the National Health Fund and the Comprehensive Health Care Program. Finally, the impact of these innovations in health expenditure, fairness of health financing, coverage levels and main health indicators is analyzed. [ABSTRACT FROM AUTHOR]

This paper describes the health conditions in Dominican Republic and the characteristics of the Dominican health system, including its structure and coverage, its financial sources, the health expenditure, the physical, material and human resources available, the stewardship functions developed by the Ministry of Public Health and the generation of health information. The participation of health care users in the operation and evaluation of the system and the most recent policy innovations, including the new General Health Law, the new Social Security Law and the Decennial Health Plan are also discussed. [ABSTRACT FROM AUTHOR]

This paper describes the health conditions in Peru and, with greater detail, the Peruvian health system, including its structure and coverage, its financial sources, its physical, material and human resources, and its stewardship functions. It also discusses the activities developed in the information and research areas, as well as the participation of citizens in the operation and evaluation of the health system. The article concludes with a discussion of the most recent innovations, including the Comprehensive Health Insurance, the Health Care Enterprises system, the decentralization process and the Local Committees for Health Administration. The main challenge confronted by the Peruvian health system is the extension of coverage to more than 10% of the population presently lacking access to basic health care. [ABSTRACT FROM AUTHOR]

This paper describes the health conditions in Nicaragua and discusses the characteristics of its national health system including its structure and coverage, its financial sources its physical, material and human resources the stewardship functions developed by the Ministry of Health the participation of citizens in the operation and evaluation of the system and the level of satisfaction of health care users. It also discusses the most recent policy innovations, including the new General Health Law, the decentralization of the regulation of health facilities and the design and implementation of a new health care model known as Family and Community Health Model. [ABSTRACT FROM AUTHOR]

This paper describes the health system of Honduras, including its challenges, structure coverage, sources of financing, resources and stewardship activities. This system counts with a public and a private sector . The public sector includes the Ministry of Health (MH) and the Honduran Social Security Institute (HSSI). The private sector is dominated by a set of providers offering services payed mostly out-of-pocket . The National Health Plan 2010-2014 includes a set of reforms oriented towards the creation of an integrated and plural system headed by the MH in its stewardship role. It also anticipates the creation of a public health insurance for the poor population and the transformation of the HSSI into a public insurance agency which contracts services for its affiliates with public and private providers under a family medicine model. [ABSTRACT FROM AUTHOR]

This paper describes the health conditions in El Salvador and the main characteristics of the Salvadoran health system, including its structure and coverage, its financial sources, the physical, material and human resources available, the stewardship functions developed by the Ministry of Public Health, and the participation of health care users in the evaluation of the system. It also discusses the most recent policy innovations including the approval of the Law for the Creation of the National Health System, which intends to expand coverage, reduce health inequalities and improve the coordination of public health institutions. [ABSTRACT FROM AUTHOR]

This paper describes the Costa Rican health system which provides health, water and sanitation services. The health component of the system includes a public and a private sector . The public sector is dominated by the Caja Costarricense de Seguro Social (CCSS), an autonomous institution in charge of financing, purchasing and delivering most of the personal health services in Costa Rica. CCSS is financed with contributions of the affiliates, employers and the state, and manages three regimes: maternity and illness insurance, disability, old age and death insurance, and a non-contributive regime. CCSS provides services in its own facilities but also contracts with private providers. The private sector includes a broad set of services offering ambulatory and hospital care. These services are financed mostly out-of-pocket, but also with private insurance premiums. The Ministry of Health is the steward of the system, in charge of strategic planning, sanitary regulation, and research and technology development. Among the recent policy innovations we can mention the establishment of the basic teams for comprehensive health care (EBAIS), the de-concentration of hospitals and public clinics, the introduction of management agreements and the creation of the Health Boards. [ABSTRACT FROM AUTHOR]

Currently, the challenge is to analyze and synthesize as much information as possible in order to make quick, correct decisions. Systematic reviews and meta-analysis have quickly arisen in the health field because they allow researchers to congregate studies of similar characteristics to generate estimators that describe the risk or benefit of practices related to health problems. To understand and attach the appropriate importance to meta-analyses, it is necessary to consider the rationale of the theoretical framework, the methodological criteria, and the possible causal relationship between exposure and outcome, besides contextualizing the information. This paper briefly explores scientific rationality and its application in causal theory within an epidemiological framework, to set the basis that allows decision-makers and health professionals to evaluate the appropriateness and validity of conclusions derived from this type of analyses. [ABSTRACT FROM AUTHOR]

This paper reviews data regarding the effects of the legislation banning smoking in enclosed public places, including workplaces, restaurants and bars which entered into force in several countries of Europe starting with the year 2004. The source of data is represented by articles and short information published in peer reviewed journals or in electronic format between the years 2005 and 2008. Highlights include a consideration of the effects of these laws on the attitudes of the population regarding their implementation, exposure to passive smoking in public places as well as the scientific evidence on the public health and economic impact of these laws. The results of smoking ban in public places observed in several parts of Europe support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution. [ABSTRACT FROM AUTHOR]

This paper provides an overview of strategies that have been used to promote physical activity in individuals with intellectual disability. Several different approaches are discussed and the strengths and limitations of each are presented. Some determinants of physical activity for individuals with intellectual disability are also reported in an effort to better understand the factors that influence participation that could be targeted in future interventions. Recommendations for programming are provided. [ABSTRACT FROM AUTHOR]

Physical activity is a personal and societal investment in health. In Latin America, rates of non-communicable diseases are growing and there is burgeoning interest in physical activity as a preventative health measure. This paper describes physical activity among adults with intellectual disability from a public health perspective; and provides recommendations related to the need for, and measurement of, physical activity among persons with intellectual disability in Latin America. [ABSTRACT FROM AUTHOR]

Violence is currently considered to be both an epidemic problem and a public health problem among youth and adolescents, who represent 31.6% and 20.3% of the overall population of the Americas region, respectively. This paper analyzes the scientific literature on violence prevention as it relates to successful interventions among these populations. Some of the most successful interventions are those related to active engagement of adults with children and adolescents and programs oriented toward early child development and adequate educational practices among parents. The latter is one of the most cost-effective violence prevention interventions for children and adolescents. Efforts to disarm civilian populations during critical periods have also been shown to be effective. [ABSTRACT FROM AUTHOR]

Objective. To show the prevalence of diabetes mellitus (DM) and its associated factors in adults, using data derived from the 2000 National Health Survey (NHS). Material and Methods. The 2000 NHS was conducted between November 1999 and June 2000. An adult questionnaire was administered to 45 294 subjects 20 years of age and older. Capillary glucose levels, weight, height and blood pressure were obtained. Individual weighted factors were considered in the statistical analysis, as was the survey's complex sampling design to obtain variances using SUDAAN 7.5.6. Results. The national prevalence of DM in adults ages 20 years and older was 7.5% (95% CI: 7.1-7.9). The prevalence was 7.8% in women and 7.2% in men. It was higher according to age: 2.3% in adults 40 years or younger and 21.2% in those older than 60 years of age. In the urban population, prevalence was 8.1% and in the rural population it was 6.5%. The disease was more frequent in the northern region of the country (8.4%) and in the Mexico City metropolitan area (8.1%). DM was more frequent in the population with the least amount of schooling (9.9%), the lowest income (8.1%), high blood pressure (13.7%), hypercholesterolemia (23.3%) microalbuminuria (15.5%) and renal disease (12.3%). Using multivariate logistic regression, stratified by gender, variables associated with DM were identified: age, little schooling, family history of DM, high blood pressure, renal disease or hypercholesterolemia in both genders. Abdominal obesity was associated with DM in women only and living in an urban area was associated with DM only in men. The highest associations were observed with age, family history of DM, and microalbuminuria. Conclusion. Results from the 2000 NHS show that DM represents a serious public health problem in Mexico. The impact increases when DM affects populations with social or economic factors that limit access to treatment. Data reported in this paper are useful to the implementation of screening and prevention programs. These results confirm that DM should be screened in first-degree family members and everyone who has one or more metabolic syndrome components (high blood pressure, dyslipidemia, obesity and microalbuminuria) [ABSTRACT FROM AUTHOR]