Improving access to long-term contraceptives in rural Guatemala through the Ministry of Health

The purpose of this study was to test a model to train nurse auxiliaries at health centers and posts in Guatemala and to determine whether these providers could deliver adequate, cost-effective services. The training model consisted of: a) selection of nurse auxiliaries; b) two-day group training; c) on-the-job training, including work with actual clients at the trainees’ work centers; and d) certification of trainees who had conducted at least five quality insertions under supervision. This study has shown that nonprofessional health providers can effectively provide quality IUD services in Guatemala. The main recommendation derived from the project is to scale up the strategy nationally

Caracterización y comparación del modelo termodinámico Otto y cima para la predicción de torque, potencia y consumo de un motor de combustión interna S.I y validación experimental.

Este trabajo se realizó basado en la necesidad de evaluar resultados que estiman dos modelos termodinámicos mediante la comparación con datos experimentales; el objetivo de este trabajo es analizar la eficacia que poseen estos modelos para predecir parámetros como; potencia, torque y consumo de combustible de un M.C.I. Para lo cual se utilizó un vehículo para realizar pruebas experimentales de los parámetros mencionados en un dinamómetro automotriz; además se ejecutaron pruebas de emisión de gases con el fin de obtener las proporciones de aire/combustible que se desarrollan en el motor. Se desarrollaron los cálculos con los modelos mencionados, para elaborar las respectivas comparaciones. Finalmente se obtuvieron resultados de correlatividad que indican que los modelos matemáticos poseen buena capacidad para predecir parámetros de desempeño mecánico, en relación a los obtenidos en las pruebas experimentales. Por lo tanto, se concluye que no es necesario aplicar ningún factor de corrección en estos modelos

Acumulación De Restos Lignino-Celulósicos (Necromasa) En Un Bosque Templado De Antiguo Crecimiento Dominado Por Nothofagus En El Centro- Sur De Chile

Coarse woody debris (CWD) are the necromass in wooded environments and comply with various ecosystems functions, such as seedling nursery, habitat other organisms, store carbon (C) and nutrients, etc.. Volume, necromass, and decay states of CWD dead in an old-growth temperate (OGTF) forest in Puyehue National Park, South-Central Chile were evaluated. In 10 plots of 900 m2 CWD was quantified (≥ 10 cm diameter), whose necromass classified using a scale of five categories/stages of decay, necromass (1 = lowest and 5 = highest degradation). The average forest density was 299 trees ha-1, 112 m2 ha-1 of basal area, and 2.395 m3 of stem volume. The upper arboreal stratum was dominated by N. betuloides. The greatest amount of CWD belonged to N. betuloides (95,2%), where logs (52,7%) and branches (35%), plant structures were present in greater numbers. The bulk of necromass found in advanced states of decomposition (level 4 and 5) with 56,5% and 34,1%, respectively. It was determined that the CWD volume was 632 m3 ha-1, representing a necromass of 321.5 Mg ha- 1. These results demonstrate that the old-growth temperate forests of southern Chile are significant reserves of coarse woody debris, which contributes to the biogeochemistry of these complex and remote ecosystems

Service adaptation and IPC measures.

BackgroundAvailability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs.MethodsData were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE.ResultsThere were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not.ConclusionAfter more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.</div

Response rate to the health facility phone survey for the round of the study.

Response rate to the health facility phone survey for the round of the study.</p

Availability at the health facility level for each piece of PPE by country by facility type.

Availability at the health facility level for each piece of PPE by country by facility type.</p

Availability at the HF level and to all HCWs for each piece of PPE by country.

The gap in availability is shown by the distance between the availability of the PPE barrier at the health facility and the availability to all HCWs points.</p

PPE use: Barriers used when examining COVID-19 suspected patients and correct use of the equipment.

PPE use: Barriers used when examining COVID-19 suspected patients and correct use of the equipment.</p

Sampling strategy for each country.

BackgroundAvailability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs.MethodsData were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE.ResultsThere were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not.ConclusionAfter more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.</div

Facility characteristics.

BackgroundAvailability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs.MethodsData were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE.ResultsThere were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not.ConclusionAfter more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.</div