Introduction of quality of care and a gender perspective in reproductive health service organizations in Latin America and the Caribbean

In 2005 and with the technical assistance of the Frontiers in Reproductive Health (FRONTIERS) Program, the Integrated Health Coordination Program (PROCOSI), a Bolivian network of 33 nongovernmental organizations, designed and tested a set of four guidelines to help organizations deliver high-quality reproductive health services with a gender perspective. The guidelines were: 1) to present a strategy to certify organizations as “gender sensitive” healthcare providers; 2) to present the knowledge staff members should know to be certified; 3) to describe procedures to collect and analyze the data to evaluate implementation of the strategy; and 4) to describe how to assess strategy implementation costs. In PROCOSI’s experience, a large proportion of participating clinics were able to improve the quality of services. During the follow-up period, FRONTIERS staff provided technical assistance to the Bolivian Ministry of Health and Sports, the Salvadoran Social Security Institute, the IPPF-affiliate in Peru, Instituto Peruano de Paternidad Responsable, and the Honduran Women and Family Association in order to present the strategy to managers, conduct baseline studies, prepare work plans, and select achievement indicators

Factores determinantes de la estrategia de diversificación relacionada: una aplicación a las empresas industriales españolas

El objetivo de este artículo es analizar los factores determinantes de la estrategia de diversificación relacionada. Para ello, se ha realizado una revisión de la literatura especializada descubriendo que son dos las teorías que con mayor potencial justifican dicha estrategia: la Economía Industrial y la Teoría de Recursos y Capacidades. A partir de estas teorías se diseña el modelo teórico de análisis. Para contrastar el modelo se utiliza la base de datos de la Encuesta sobre Estrategias Empresariales (ESEE), para el periodo 1991-2002. Se aplica la regresión logística binomial a un panel incompleto y completo de observaciones de empresas diversificadas. Los resultados del estudio sugieren que la concentración industrial, la rentabilidad industrial, los activos físicos e intangibles y el tamaño de las empresas son factores que determinan que la empresa siga una estrategia de diversificación relacionada.diversificación, diversificación relacionada, diversificación no relacionada.

Use of systematic screening to increase the provision of reproductive health services in Bolivia

The objective of this study was to determine if the use of a checklist to screen for unmet service needs could increase the number of services per visit provided to clients using rural Bolivian health facilities. Measurement included changes in services per visit before and after the introduction of the intervention, and a comparison of services received at screened and non-screened visits. Findings show that, to the degree that provider compliance can be secured, systematic screening of clients appears to be an effective method for reducing unmet health service needs. The findings of this study replicate those of other studies conducted in Africa, Asia, and Latin America. The Bolivia Ministry of Health plans to scale-up the intervention

Epidemiología de lesiones por presión en un hospital público de Santiago de Chile

Tesis (Magíster en Enfermería)Introducción: Las Lesiones por Presión(LPP)son consideradas un problema importante de salud a nivel mundial con consecuenciasinterdimensionales que consideran ámbitos sociosanitarios yeconómicosque afectanla calidad de vida de los usuarios del sistema de salud y sus familias además dela recarga laboral en el personal de salud. En España entre un 3-11% de los pacientes que ingresan a servicios hospitalariosdesarrollan LPP, afirmando quecerca del 70% de estas se producen durante las primeras dos semanas de hospitalización. La literatura nacional al respecto es escasa, por lo que se dificulta su comparación con datos mencionados. Objetivo: Definir el perfil epidemiológico de las Lesiones por Presión de un hospital público de Santiago de Chile.Metodología:Consiste en un análisis secundario de los datos recolectados en el proyecto “Factoresde riesgo para el desarrollo de LPP, estudio multicéntrico” que realizó la identificación de aquellos factores predisponentes que permitieran la comparación entrediferentes instituciones y contrarrestar resultados.Estudiocuantitativo, observacional, descriptivo de base de datos secundaria, realizado en un solo centro de saludbuscando identificar su perfil epidemiológico relacionado a la problemática de LPP. Resultados:Se obtuvo una prevalencia de 26,24 por 100 pacientes que presentan LPP durante el proceso de hospitalización.Se evidenció mayor número de casos con LPP en la población masculina con un 57,53%.Se encuentra mayor incidencia de LPP en la Unidad de Paciente Crítico. Existe una mayor prevalencia en sitios anatómicos a nivel sacro y talones.ntroduction: Pressure ulcers(PU) are considered a major global health problem with interdimensional consequences that consider socio-health and economic areas that affect the quality of life of users of the health system and their families in addition to work recharge in health staff. In Spain, between 3-11% of patients who enter hospital services develop PU, stating that about 70% of these occur during the first two weeks of hospitalization. The national literature in this regard is scarce, so it is difficult to compare it.Objective: Define the epidemiological profile of Pressure Ulcersof a public hospital in Santiago, Chile.Methodology: Secondary analysis of the data collected in the project “Risk factors for the development of PU, multicenter study” that made the identification of those predisposing factors that allowed the comparison between different institutions and counteract results. Quantitative, observational, descriptive study conducted in a single health center seeking to identify its epidemiological profile related to the problem of PU. Results: A prevalence of 26.24 per 100 patients who presented PUduring the hospitalization process was obtained. There was a greater number of cases with PUin the male population with 57.53%. A higher incidence of PUis found in the Critical Patient Unit. There is a higher prevalence in anatomical sites at the sacral level and heels

Consolidating a gender perspective in the PROCOSI network

The Integral Health Coordination Program (Programa de Coordinación en Salud Integral, or PROCOSI) in Bolivia developed a program to certify service delivery and management support NGOs as gender-sensitive. The certification system is based on an initial self-assessment by teams consisting of staff from service delivery (clinical) or management support (administrative) NGOs, followed by the development and implementation of activities to improve the gaps found until a minimum of 80 percent of the designated quality and gender standards are met. At the project’s end, 14 of the 15 participating NGOs had reached compliance with at least 80 percent of the proposed standards, and their achievement was recognized in a public certification ceremony. The project succeeded in developing a cost-effective strategy to incorporate a gender perspective. Drawing from the lessons learned by implementing and evaluating this strategy, the report offers a number of recommendations concerning the program’s future utilization including ways to ensure the continuity of certification processes

Reference Guides for Health Care Organizations Seeking Accreditation for High-quality, Gender-sensitive Reproductive Health Services—Appendixes

Bolivia’s Integral Health Coordination Program (PROCOSI), a network of 33 nongovernmental organizations (NGOs) providing reproductive health care, has long promoted gender sensitivity as a necessary component of high-quality health care. PROCOSI encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their reproductive health programs. Included in this document are the Appendixes to “The Reference Guides for Health Care Organizations Seeking Accreditation for High-Quality, Gender-Sensitive Reproductive Health Services,” which provide guidance to help health-care organizations and NGOs implement high-quality, gender-sensitive standards to achieve certification for their member clinics and administrative centers. The procedures and standards are based on the process developed by PROCOSI, but the approach and standards can be modified to fit local needs and conditions. The reference guides focus on a formal certification process, but this guidance can also be used by NGOs that are not aiming for certification but that wish to evaluate and improve the quality and gender sensitivity of their services

Reference Guides for Health Care Organizations Seeking Accreditation for High-quality, Gender-sensitive Reproductive Health Services

Bolivia’s Integral Health Coordination Program (PROCOSI), a network of 33 nongovernmental organizations (NGOs) providing reproductive health care, has long promoted gender sensitivity as a necessary component of high-quality health care. PROCOSI encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their reproductive health programs. The Reference Guides in this publication provide guidance to help health-care organizations and NGOs implement high-quality, gender-sensitive standards to achieve certification for their member clinics and administrative centers. The procedures and standards included here are based on the process developed by PROCOSI, but the approach and standards can be modified to fit local needs and conditions. The Reference Guides focus on a formal certification process, but this guidance can also be used by NGOs that are not aiming for certification but that wish to evaluate and improve the quality and gender sensitivity of their services. The publication includes a Procedures Guide, Self-Training Guide, Assessment Guide, and Costing Guide

Cognitive Impairment and Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a frequent sleep disorder characterized by repetitive interruption of ventilation caused by partial or complete collapse of the upper airway during sleep. OSA is highly prevalent in the world and it has been associated with cardiovascular disease and cognitive impairment in children and adults. The cognitive impairment in individuals with OSA includes deficiencies in attention and constructional abilities, delayed long-term visual and verbal memory, and executive functions. Although, the pathogenesis of cognitive impairment in patients with OSA is complex and remains incompletely understood, several mechanisms, such as hypoxia, inflammation and sleep fragmentation have been proposed. The aim of this chapter is to describe some findings reported in the literature to explain the association between OSA and cognitive impairment