protocol for a living systematic review

Funding Information: This study was funded by the Solidarity Fund, through a grant administered by the World Health Organization. Publisher Copyright: ©Ana Paula Cavalcante de Oliveira, Mariana Lopes Galante, Leila Senna Maia, Isabel Craveiro, Alessandra Pereira da Silva, Ines Fronteira, Raphael Chança, Paulo Ferrinho, Mario Dal Poz.Background: Countries and health systems have had to make challenging resource allocation and capacity-building decisions to promote proper patient care and ensure health and care workers’ safety and well-being, so that they can effectively address the present COVID-19 pandemic as well as upcoming public health problems and natural catastrophes. As innovations are already in place and updated evidence is published daily, more information is required to inform the development and implementation of policies and interventions to improve health and care workforce capacity to address the COVID-19 pandemic response. Objective: The objective of this protocol review is to identify countries’ range of experiences with policies and management interventions that can improve health and care workers’ capacity to address the COVID-19 pandemic response and synthesize evidence on the effectiveness of the interventions. Methods: We will conduct a living systematic review of quantitative, qualitative, and mixed methods studies and gray literature (technical and political documents) published in English, French, Hindi, Portuguese, Italian, and Spanish between January 1, 2000, and March 1, 2022. The databases to be searched are MEDLINE (PubMed), Embase, SCOPUS, and Latin American and Caribbean Health Sciences Literature. In addition, the World Health Organization’s COVID-19 Research Database and the websites of international organizations (International Labour Organization, Economic Co-operation and Development, and The Health System Response Monitor) will be searched for unpublished studies and gray literature. Data will be extracted from the selected documents using an electronic form adapted from the Joanna Briggs Institute quantitative and qualitative tools for data extraction. A convergent integrated approach to synthesis and integration will be used. The risk of bias will be assessed with Joanna Briggs Institute critical appraisal tools, and the certainty of the evidence in the presented outcomes will be assessed with the Grading of Recommendations, Assessment, Development and Evaluation. Results: The database and gray literature search retrieved 3378 documents. Data are being analyzed by 2 independent reviewers. The study is expected to be published by the end of 2023 in a peer-reviewed journal. Conclusions: This review will allow us to identify and describe the policies and strategies implemented by countries and their effectiveness, as well as identify gaps in the evidence.publishersversionpublishe

Desafios, políticas e estratégias determinantes para garantir a Disponibilidade e Acessibilidade da Enfermagem no Brasil: um protocolo de scoping review

The aim was to identify the existing challenges, determinants, policies, and strategies to ensure the availability and accessibility of nursing personnel by the population in Brazil. Scoping review of peer-reviewed papers and technical and political documents. Eight scientific databases will be searched (such as PubMed, BVS, and EMBASE). Sources of unpublished studies/ grey literature to be searched include websites from the Ministry of Health, councils, and institutions. No language or publication date restrictions will apply. The review will consider documents that contain information regarding nursing personnel in the Brazilian context and address: I. the challenge of availability and/or accessibility of nursing personnel; II. the causes of the challenge; or III: strategies to deal with the challenge: either (a) in a state of description of implemented interventions or (b) evaluation of the strategy in its implementation stage. The result will be described in a narrative way, descriptive statistics will be presented as necessary, and the information will be grouped, summarized, and compared. For the qualitative analysis of the documents, both inductive and deductive thematic content analysis will be used. The results can reveal information about gaps and imbalances in the workforce, enabling the implementation of strategies to address these challenges.Objetivou-se identificar os desafios, determinantes, políticas e estratégias existentes para garantir a disponibilidade e acessibilidade do pessoal de enfermagem pela população no Brasil. Revisão de escopo de artigos revisados por pares e documentos técnicos e políticos. Serão pesquisadas oito bases de dados científicas (como PubMed, BVS e EMBASE). As fontes de estudos não publicados/literatura cinzenta a serem pesquisadas incluem sites do Ministério da Saúde, conselhos e instituições. Nenhuma restrição de idioma ou data de publicação será aplicada. A revisão considerará documentos que contenham informações sobre o pessoal de enfermagem no contexto brasileiro e abordarão: I. o desafio da disponibilidade e/ou acessibilidade do pessoal de enfermagem; II. as causas do desafio; ou III: estratégias para lidar com o desafio: seja (a) em estado de descrição das intervenções implementadas ou (b) avaliação da estratégia em sua fase de implementação. O resultado será descrito de forma narrativa, estatísticas descritivas serão apresentadas conforme necessário e as informações serão agrupadas, resumidas e comparadas. Para a análise qualitativa dos documentos, será utilizada análise de conteúdo temática indutiva e dedutiva. Os resultados podem revelar informações sobre lacunas e desequilíbrios na força de trabalho, permitindo a implementação de estratégias para enfrentar estes desafios

Oral health policies and decision-making process in Brazil, Colombia and Chile

Abstract Public health policies are crucial for the well-being of the general population; however, the health systems of developed countries still do not include oral health in its system. Thus, it is necessary to understand the process of decision-making in oral health policies to create opportunities for countries to achieve an overall positive health outcome, including oral health. This study aimed to identify the factors influencing the inclusion of oral health on the political agenda in Brazil, Colombia, and Chile. The study sample involved decision-makers at political, technical, and academic levels. The extracted data were analyzed using the software Maxqda® and Kingdon´s theoretical model; defining interactive variables that produce a “window of opportunity” to define the agenda and the insertion of theme in formulating public policies. The decision-making process regarding oral health is influenced by many factors like the need to improve the overall oral health of the population, identified through national epidemiological studies, and the importance of individuals in positions involving political decision-making, who advocate for oral health. Strategies were developed in partnership with the academy that focused on the health rights of the population provided by law; territorial and national programs were also developed. The inclusion and creation of oral health policies depend on actors who advocate for thematic and scientific evidence to support decision-making. A close relationship between academia and stakeholders and knowledge translation is important for the development of public policies that can be effective for health systems

Teleodontologia e SUS: uma importante ferramenta para a retomada da Atenção Primária à Saúde no contexto da pandemia de COVID-19

This “short communication” describes the possibilities of using Teleodontology to expand and qualify health care in oral health care networks. WHO already recommended to its member countries, including Brazil, even before the pandemic, the use of Telehealth as a strategy to improve the quality of its services, especially in the context of universal health systems, as the Unified Health System In the current context, Teleodontology opens opportunities for oral health to resume the offer of various services, remotely, such as: 1. tracking, active search, monitoring users of priority groups, at risk and with systemic problems, monitoring of suspected cases of COVID-19 and its contacts, via telemonitoration; 2. initial listening, individual and collective educational activities, among others, through teleorientation; 3. discussion of clinical cases to define the opportune moment to perform operative procedures among professionals of different levels of care, matrix support, sharing and soluting doubts between professionals or between professionals and teaching and research institutions, through teleconsulting, among others . In addition to a literature review on Teleodontology in the context of the pandemic, an important contribution of this “short communication” is the conceptualization of the terms used and possibilities they offer to SUS professionals, in addition to specifying the possible protocols for recording these activities, in order to provide service managers with secure data for monitoring and evaluating the work process. In addition, we bring a brief discussion with some promising experiences, carried out in the pre- and trans-pandemic context, which can consolidate themselves as important strategies for the resumption of oral health in the post-pandemic scenario.Este “short communication” descreve as possibilidades de utilização da Teleodontologia para ampliação e qualificação do cuidado em saúde nas redes de atenção à saúde bucal. A OMS já recomendava aos seus países membros, mesmo antes da pandemia, o Telessaúde como estratégia para melhorar a qualidade dos serviços, especialmente nos sistemas universais, como é o caso do Sistema Único de Saúde. A Teleodontologia abre oportunidades para que a saúde bucal retome a oferta de diversos serviços, de forma remota, como: 1. rastreamento, busca ativa, monitoramento de usuários prioritários, de risco e com problemas sistêmicos, de suspeitas de COVID-19 e contactantes, através do Telemonitamento; 2. escuta inicial, atividades educativas individuais ou coletivas, através da Teleorientação; 3. discussão de casos clínicos para a definição da oportunidade/necessidade de procedimentos operatórios, matriciamento, compartilhamento, solução de dúvidas entre profissionais e entre estes e instituições de ensino e pesquisa, por Teleconsultorias, entre outros. Além de uma revisão sobre a Teleodontologia no contexto da pandemia, conceituamos os termos utilizados e possibilidades que oferecem aos profissionais do SUS, além de especificar os protocolos possíveis para registro dessas atividades, a fim de fornecer dados seguros para seu monitoramento e avaliação. Ademais, trazemos uma breve discussão com experiências promissoras, realizadas nos contextos pré e trans pandemia, que podem ser importantes estratégias para a retomada da saúde bucal no cenário pós pandemia

Understanding the implementation process of Oral Health Programs and Policies in Latin America

Introdução: As políticas em saúde pública são importantes para o bem-estar da população em geral, e a saúde bucal está inserida no contexto de saúde integral, desta forma os responsáveis por criarem as políticas e programas de saúde bucal são elementos chaves para a criação de políticas que visam melhorar a saúde da população de um país. Objetivos: Identificar como foi o processo de implementação das políticas de saúde bucal, no contexto do uso da evidência, agenda política e barreiras de implementação nos países envolvidos: Brasil, Colômbia e Chile. Métodos: Trata-se de um estudo qualitativo com entrevistas presenciais com atores-chaves no processo de implementação em cada país, foi realizada análise de conteúdo e os dados foram categorizados com uso do Maxqda®. Resultados: Apesar dos países apresentarem sistemas de saúde diferentes, observou-se que durante o processo de implementação das políticas de saúde, o uso da evidência científica ainda é restrito e a participação da academia mostrou-se necessária para a elaboração das políticas de saúde. Em relação ao processo de inclusão na agenda, os resultados de estudos epidemiológicos tiveram um papel indutor, além da necessidade de atores chaves que advoguem a favor do tema. A principal barreiras citada pelos países é a formação do dentista, que ainda é voltada para o atendimento clínico individual e privado. Conclusão: Os formuladores de políticas devem compreender a importância da odontologia no sistema de saúde, a academia deve se aproximar da gestão de modo a informar as políticas para ser elaborada com uso da evidência cientifica e estimular a sensibilização dos futuros profissionais para este tema.Introduction: Public health policies are important for the well-being of the population in general, and oral health is inserted in the context of comprehensive health, thus those responsible for creating oral health policies and programs are key elements for creating policies that improve the health of a country\'s population. Objectives: To identify how the oral health policy implementation process went, in the context of the use of evidence, political agenda and implementation barriers in the countries involved Brazil, Colombia and Chile. Methods: A qualitative study with face-to-face interviews with key actors in the implementation process in each country, content analysis was conducted and the data were categorized using the Maxqda®. Results: Although countries have different health systems, it was observed that while implementing health policies, the use of scientific evidence is still restricted and the participation of the academy was shown to be necessary for the elaboration of health policies. Regarding the process of inclusion in the agenda, the results of epidemiological studies played an inductive role, in addition to the need for key actors who advocate in favor of the theme. The main barriers cited by the countries are the training of the dentist, who is still focused on individual and private clinical care. Conclusion: Policy makers must understand the importance of dentistry in the health system, the academy must approach management to inform policies to be developed using scientific evidence and to stimulate the awareness of future professionals on this topic

Implementation of policy and management interventions to improve health and care workforce capacity to address the COVID-19 pandemic response: a systematic review

Abstract Background The COVID-19 pandemic highlighted pre-existing weaknesses in health and care systems and services and shortages of health and care workers (HCWs). As a result, policymakers needed to adopt measures to improve the health and care workforce (HCWF) capacity. This review aims to identify countries’ range of policies and management interventions implemented to improve HCWs’ capacity to address the COVID-19 pandemic response, synthesize their evidence on effectiveness, and identify gaps in the evidence. Methods The literature was searched in PubMed, Embase, Scopus, LILACS–BVS, WHO’s COVID-19 Research Database and the ILO, OECD and HSRM websites for literature and documents published between January 2020 and March 2022. Eligibility criteria were HCWs as participants and policy and management interventions aiming to improve HCWF capacity to address the COVID-19 pandemic response. Risk of bias was assessed with Joanna Briggs Institute (JBI) Critical Appraisal Tools (CAT) and certainty of the evidence in presented outcomes with GRADE. Results The searches retrieved 3378 documents. A total of 69 were included, but only 8 presented outcomes of interventions implemented. Most of the selected documents described at least one intervention implemented by countries at the organizational environment level to increase the flexibility and capacity of the HCWF to respond to the pandemic, followed by interventions to attract and retain HCWs in safe and decent working environments. There was a lack of studies addressing social protection, human resources for health information systems, and regarding the role of community health workers and other community-based providers. Regarding the risk of bias, most of documents were rated as medium or high quality (JBI’s CAT), while the evidence presented for the outcomes of interventions was classified as mostly low-certainty evidence (GRADE). Conclusions Countries have implemented various interventions, some innovative, in response to the pandemic, and others had their processes started earlier and accelerated by the pandemic. The evidence regarding the impact and efficacy of the strategies used by countries during the pandemic still requires further research

Teledentistry and the Unified Health System : an important tool for the resumption of Primary Health Care in the context of the COVID-19 pandemic

O preprint foi submetido para publicação em um periódico.Este “short communication” descreve as possibilidades de utilização da Teleodontologia para ampliação e qualificação do cuidado em saúde nas redes de atenção à saúde bucal. A OMS já recomendava aos seus países membros, mesmo antes da pandemia, o Telessaúde como estratégia para melhorar a qualidade dos serviços, especialmente nos sistemas universais, como é o caso do Sistema Único de Saúde. A Teleodontologia abre oportunidades para que a saúde bucal retome a oferta de diversos serviços, de forma remota, como: 1. rastreamento, busca ativa, monitoramento de usuários prioritários, de risco e com problemas sistêmicos, de suspeitas de COVID-19 e contactantes, através do Telemonitamento; 2. escuta inicial, atividades educativas individuais ou coletivas, através da Teleorientação; 3. discussão de casos clínicos para a definição da oportunidade/necessidade de procedimentos operatórios, matriciamento, compartilhamento, solução de dúvidas entre profissionais e entre estes e instituições de ensino e pesquisa, por Teleconsultorias, entre outros. Além de uma revisão sobre a Teleodontologia no contexto da pandemia, conceituamos os termos utilizados e possibilidades que oferecem aos profissionais do SUS, além de especificar os protocolos possíveis para registro dessas atividades, a fim de fornecer dados seguros para seu monitoramento e avaliação. Ademais, trazemos uma breve discussão com experiências promissoras, realizadas nos contextos pré e trans pandemia, que podem ser importantes estratégias para a retomada da saúde bucal no cenário pós pandemia.This “short communication” describes the possibilities of using Teleodontology to expand and qualify health care in oral health care networks. WHO already recommended to its member countries, including Brazil, even before the pandemic, the use of Telehealth as a strategy to improve the quality of its services, especially in the context of universal health systems, as the Unified Health System In the current context, Teleodontology opens opportunities for oral health to resume the offer of various services, remotely, such as: 1. tracking, active search, monitoring users of priority groups, at risk and with systemic problems, monitoring of suspected cases of COVID-19 and its contacts, via telemonitoration; 2. initial listening, individual and collective educational activities, among others, through teleorientation; 3. discussion of clinical cases to define the opportune moment to perform operative procedures among professionals of different levels of care, matrix support, sharing and soluting doubts between professionals or between professionals and teaching and research institutions, through teleconsulting, among others . In addition to a literature review on Teleodontology in the context of the pandemic, an important contribution of this “short communication” is the conceptualization of the terms used and possibilities they offer to SUS professionals, in addition to specifying the possible protocols for recording these activities, in order to provide service managers with secure data for monitoring and evaluating the work process. In addition, we bring a brief discussion with some promising experiences, carried out in the pre and transpandemic context, which can consolidate themselves as important strategies for the resumption of oral health in the post-pandemic scenario

Prioritization criteria in policies and management of human resources for health: a proposal for a validated methodology

Objective. To create and validate criteria for prioritizing problems related to policies and management of the health workforce. Methods. This methodological study was divided into three stages. First, the criteria were elaborated by means of a systematized literature review. Second, the criteria were evaluated online by a committee of judges comprised of eight specialists. In the third stage, an evaluation was carried out by the target audience in a hybrid workshop. The participants evaluated the material using the Suitability Assessment of Materials instrument, adapted for the research. Results. Three prioritization criteria (relevance, window of opportunity and acceptability) and a scoring scale were developed based on the literature review. In the evaluation by the committee of judges, the approval percentage of the criteria and prioritization method was 84%. Modifications were made based on suggestions in relation to the material presented to the specialists. In the pre-test stage, the approval percentage varied by item, with six of them reaching a maximum approval of 100% (corresponding to approximately 46% of the items), four reaching 92% and three achieving 83% each, indicating positive results. Conclusions. The developed criteria were considered valid for use in the context of policies and management in the area of human resources for health