Activity

This study analyzes the conditions and possibilities of sustainability of the Salud al Paso program of the Metropolitan Health Secretariat of the Municipality of Quito, Ecuador, as an example for similar initiatives, in the context of the changes made by the new administration in May 2019. C75 trans price The analysis of the implementation of this initiative, focused on the prevention of noncommunicable diseases (NCDs), was based on the program’s user database, the information gathered on the perspectives of operational staff, knowledge of the program, and the opinion of local leaders and opinion leaders of the Quito Metropolitan District, as well as official information. Based on this data, the study identified factors that could have facilitated or hindered its sustainability and documented the rationale to suspend the on-demand activities included in the program and limit activities to the care of populations under municipal responsibility (day-care centers, schools and colleges, markets, elder care programs, and employees) and patients with identified cardiometabolic risk. The insufficient institutionalization of the program, conceived as a project with an insufficient vision of its sustainability in time, was mentioned as a possible obstacle by leaders and operational staff. The growing prevalence of NCDs requires initiatives for their prevention, which must be institutionalized to ensure their continuity and overcome eventual changes of government. In addition, future interventions similar to Salud al Paso should establish better sectoral coordination articulation, especially with the Ministry of Public Health and other service networks.About 1/4th of adults have high blood pressure which is the single most important risk for death (including heart disease and stroke).There are effective policies that could facilitate people making healthy choices to prevent raised blood pressure, and if fully implemented, could largely prevent hypertension from occurring.Hypertension is easy to screen and treat for BUT only about 50% of adults with hypertension are aware of their condition and only about 1 in 7 is adequately treated.Preventing and controlling high blood pressure is the major mechanism for NCD prevention and control and a model for other NCD risks.Effective lifestyle and drug treatments could prevent and control hypertension in most individuals if systematically applied to the population, simple interventions are feasible in all settings, and can be used to enhance primary care.Urgent sustained action is needed is needed for effective public policies and health system changes to prevent and control hypertension.In 2018, the Colombian Ministry of Health and Social Protection, in collaboration with the National Health Institute and the Pan American Health Organization, convened all actors associated with the National Tuberculosis Prevention and Control Program (PNPCT) and the National Science, Technology, and Innovation System to form a national network to coordinate operations research on tuberculosis (TB) in the country. Seven workshops were held and a consensus was reached to establish the National Network for Knowledge Management, Research, and Innovation in Tuberculosis in Colombia (TB Colombia Network). With more than 180 participants, a central node, and five regional nodes that bring together the country’s 37 territorial entities, the TB Colombia Network conducted four days of training in operations research in 2019, defining 65 priority research topics aligned with the strategic lines in the PNPCT prevention and comprehensive care, with a focus on people affected by TB (41 topics in three modules); and political commitment, social protection, and support systems (24 topics in four modules). The peer comparison method was used for prioritization. The TB Colombia Network remains active and contributes to knowledge management aimed at eliminating TB in Colombia. It has helped make progress in building plans and implementing local operations research projects that generate scientifically validated results to strengthen the PNPCT and improve the care of TB patients.

Construct and evaluate the care cascade for pulmonary tuberculosis in the indigenous population of the department of Cauca (Colombia) and identify existing gaps.

Mixed-methods sequential explanatory design. In the first phase, the pulmonary tuberculosis care cascade for the indigenous population of Cauca was evaluated. Data were obtained from secondary sources and all cases diagnosed from 1 January 2016 to 31 December 2017 were included. In the second phase, semi-structured interviews were done with nine program coordinators and 11 nursing auxiliaries to explain identified gaps. Absolute and percentage values were estimated for each of the steps and gaps in the care cascade. Quantitative and qualitative results were triangulated.

In 2016 and 2017, an estimated 202 patients with respiratory symptoms were expected to be positive and 106 cases of pulmonary tuberculosis were reported among the indigenous population of the department of Cauca. A gap of 47.5% was found for diagnosis, since only 52.5% of subjects were diagnosed in health services. This gap was explained by poor quality of samples and flawed smear techniques; flaws in correct identification of patients with respiratory symptoms; limited access to diagnostic methods, such as culture and molecular tests; and limited training and high turnover of personnel in health service provider institutions.

The tuberculosis control program should focus actions on bridging the gap in case detection in the indigenous population.

The tuberculosis control program should focus actions on bridging the gap in case detection in the indigenous population.This article describes the main models for embedding research and the successful experiences and challenges faced in joint work by researchers and decisionmakers who participated in the Embedding Research for the Sustainable Development Goals (ER-SDG) initiative, and the experience of the Technical Support Center. In June 2018, funding was granted to 13 pre-selected research projects from 11 middle- and low-income countries in Latin America and the Caribbean (Argentina, Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, Guatemala, Guyana, Haiti, Paraguay, and Peru). The projects focused on the system-, policy-, or program-level changes required to improve health and build on the joint work of researchers and decisionmakers, with a view to bringing together evidence production and decision-making in health systems and services. The Technical Support Center supported and guided the production of quality results useful for decision-making. This experience confirmed the value of initiatives such as ER-SDG in consolidating bridges between research on the implementation of health policies, programs, and systems, and the officials responsible for operating health-related programs, services, and interventions.