1
|
Augusto PDS, da Silva CPG, Santos TCF, Ennes LD, Paiva CF, de Almeida AJ. Health Management of an HIV Testing and Counseling Center: Nursing Contributions. Rev Bras Enferm 2024; 77:e20230217. [PMID: 38511789 PMCID: PMC10941675 DOI: 10.1590/0034-7167-2023-0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/17/2023] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES to analyze the role of nursing in the establishment of an HIV/AIDS Testing and Counseling Center in a Brazilian municipality. METHODS a historical study utilizing primary sources, including documents and oral accounts, involving a total of ten participants. The study encompasses the years 1997 and 1998. The research took place at the Testing and Counseling Center in São João de Meriti. Data was collected from March to May 2022. RESULTS nursing made significant contributions through the development of training initiatives led by nurses, who were also responsible for individual and group counseling, as well as HIV testing requests. FINAL CONSIDERATIONS nursing played a crucial role in the center and in the management of Sexually Transmitted Infections, being involved in all stages of treatment in accordance with current public health policy.
Collapse
Affiliation(s)
| | | | | | - Lilian Dias Ennes
- Universidade Federal do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | |
Collapse
|
2
|
Ribeiro KSQS, Saldanha JHS, Zanela ÂK, Ferrari FP, Freitas GKF, Barroso RB, Silva SLAD, Chaves SCL, Aquino VDS, Schmitt ACB, Fernandes TG. [Evaluation of the implementation of the Care Network for People with Disabilities in the Brazilian Unified National Health System: a multiple case study]. CAD SAUDE PUBLICA 2023; 39:e00186122. [PMID: 37162117 PMCID: PMC10549978 DOI: 10.1590/0102-311xpt186122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 05/11/2023] Open
Abstract
The Care Network for People with Disabilities (RCPCD) was implemented in 2012 as a consequence of the actions of the Viver sem Limite (Living without Limits) plan and has been the research object of recent studies. However, no published studies address the degree of implementation of this network. This study aimed to evaluate the degree of implementation of the RCPCD in eight states in the five regions of Brazil. This multiple case study performed evaluative research of the degree of implementation of the RCPCD in the states of Amazonas, Bahia, Espírito Santo, Mato Grosso do Sul, Minas Gerais, Paraíba, Rio Grande do Sul, and São Paulo. A logical model of the policy and a measurement matrix were developed. The degree of implementation of seven states was moderate, but Amazonas had an incipient degree of implementation. The evaluation of each stage of the process showed important differences, as the regional diagnosis and network adhesion stages presented moderate to advanced degrees of implementation in most states. In the service contracting stage, no state had an advanced degree of implementation, and the stage of follow-up and monitoring of the RCPCD was not even reached. The measurement matrix helps evaluate the degree of implementation of the RCPCD, and, by recognizing its results, the state steering groups and technical area recommend its use. Actions to improve this implementation, such as strengthening regionalization, establishing regional steering groups, ensuring contracting mechanisms, and defining criteria for certification of the care points, are necessary.
Collapse
|
3
|
de Melo RC, da Silva LALB, Toma TS, de Araújo BC, Luquine CD, Milhomens LDM, Melo DS, de Bortoli MC, Barreto JOM. Telessaúde no consumo e comportamento alimentar em adultos: uma revisão rápida de revisões sistemáticas. Rev Panam Salud Publica 2023; 47:e47. [PMID: 37008677 PMCID: PMC10065307 DOI: 10.26633/rpsp.2023.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/05/2022] [Indexed: 04/03/2023] Open
Abstract
Objetivo. Sintetizar as evidências sobre os efeitos de intervenções de telessaúde oferecidas por meio de aplicativos de celular e de mensagens de texto no comportamento de adultos com vistas à alimentação saudável. Métodos. Foi realizada uma revisão rápida por meio de buscas em nove bases eletrônicas da literatura para identificar revisões sistemáticas publicadas em inglês, português e espanhol que avaliassem estratégias de telessaúde comparadas a atendimento presencial para melhoria da alimentação na população adulta (18 a 59 anos). As buscas foram realizadas em novembro de 2020 e atualizadas em abril de 2022. As revisões sistemáticas incluídas foram avaliadas quanto à qualidade metodológica com a ferramenta AMSTAR 2. Resultados. Cinco revisões sistemáticas foram incluídas, sendo uma com avaliação de confiança moderada e as demais com confiança criticamente baixa. Verificou-se uma escassez de estudos comparando o uso de estratégias de telessaúde com o atendimento presencial para a promoção da alimentação saudável em adultos. Os resultados mais consistentes referem-se ao aumento no consumo de frutas e vegetais com o uso de aplicativo ou mensagens de texto, além de melhoria do padrão alimentar de pessoas com diabetes ou intolerância à glicose com o uso de mensagens de texto. Conclusão. A maioria das análises de intervenções utilizando aplicativos de celular ou mensagens de texto mostrou efeitos positivos nos desfechos de alimentação saudável. No entanto, esses achados se referem aos poucos ensaios clínicos com amostras pequenas de participantes incluídos nas revisões sistemáticas da presente revisão rápida, a maioria de baixa qualidade metodológica. Conclui-se que há uma lacuna no conhecimento, sendo importante a realização de estudos metodologicamente mais robustos.
Collapse
Affiliation(s)
- Roberta Crevelário de Melo
- Secretaria de Estado de SaúdeInstituto de SaúdeNúcleo de EvidênciasSão Paulo (SP)BrasilSecretaria de Estado de Saúde, Instituto de Saúde, Núcleo de Evidências, São Paulo (SP), Brasil.
| | - Letícia Aparecida Lopes Bezerra da Silva
- Secretaria de Estado de SaúdeInstituto de SaúdeNúcleo de EvidênciasSão Paulo (SP)BrasilSecretaria de Estado de Saúde, Instituto de Saúde, Núcleo de Evidências, São Paulo (SP), Brasil.
| | - Tereza Setsuko Toma
- Secretaria de Estado de SaúdeInstituto de SaúdeNúcleo de EvidênciasSão Paulo (SP)BrasilSecretaria de Estado de Saúde, Instituto de Saúde, Núcleo de Evidências, São Paulo (SP), Brasil.
| | - Bruna Carolina de Araújo
- Secretaria de Estado de SaúdeInstituto de SaúdeNúcleo de EvidênciasSão Paulo (SP)BrasilSecretaria de Estado de Saúde, Instituto de Saúde, Núcleo de Evidências, São Paulo (SP), Brasil.
| | - Cézar Donizetti Luquine
- Secretaria de Estado de SaúdeInstituto de SaúdeNúcleo de EvidênciasSão Paulo (SP)BrasilSecretaria de Estado de Saúde, Instituto de Saúde, Núcleo de Evidências, São Paulo (SP), Brasil.
| | - Lais de Moura Milhomens
- Secretaria de Estado de SaúdeInstituto de SaúdeNúcleo de EvidênciasSão Paulo (SP)BrasilSecretaria de Estado de Saúde, Instituto de Saúde, Núcleo de Evidências, São Paulo (SP), Brasil.
| | - Daiane Sousa Melo
- Secretaria de Estado de SaúdeInstituto de SaúdeNúcleo de EvidênciasSão Paulo (SP)BrasilSecretaria de Estado de Saúde, Instituto de Saúde, Núcleo de Evidências, São Paulo (SP), Brasil.
| | - Maritsa Carla de Bortoli
- Secretaria de Estado de SaúdeInstituto de SaúdeNúcleo de EvidênciasSão Paulo (SP)BrasilSecretaria de Estado de Saúde, Instituto de Saúde, Núcleo de Evidências, São Paulo (SP), Brasil.
| | | |
Collapse
|
4
|
Hancco Saavedra J, Pérez Jiménez V. La voluntad política y la gobernanza: claves en la implementación de HEARTS en el Perú. Rev Panam Salud Publica 2022; 46:e85. [PMCID: PMC9642826 DOI: 10.26633/rpsp.2022.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/09/2022] [Indexed: 11/11/2022] Open
Abstract
El objetivo del artículo es describir cómo la gobernanza y la voluntad política han influido en la implementación de la Iniciativa HEARTS para la prevención y el control de la hipertensión arterial en el sistema de salud de Perú. Se describe el proceso de gobernanza y se realiza un análisis secundario de datos que compara los niveles basales al inicio de la fase 1 de HEARTS con los primeros seis meses de seguimiento en 34 establecimientos de salud. Se realizó la planificación y organización de la implementación de HEARTS desde el nivel nacional a través de la Dirección de Enfermedades No Transmisibles, contando con la voluntad política de la Alta dirección del Ministerio de Salud y el acompañamiento técnico de la Organización Panamericana de la Salud. La gobernanza se estructuró en 3 niveles: nacional, regional y local; la implementación se apoyó en actores claves de la academia, las sociedades científicas y las Direcciones Regionales de Salud y de las Redes Integrales. Los resultados encontrados tras los primeros meses de seguimiento evidenciaron un incremento de la cobertura y el control de la hipertensión arterial en la mayoría de los establecimientos intervenidos. El análisis de los factores claves relacionados con la voluntad política y la gobernanza en la implementación de la Iniciativa HEARTS para la prevención y el control de la hipertensión arterial demostró que las funciones de la Alta dirección, para alinear las políticas públicas y priorizar las enfermedades no trasmisibles, en coordinación estrecha y permanente entre los formuladores de política y el Ministro de Salud, tuvieron un efecto positivo en la implementación de la Iniciativa HEARTS en el Perú.
Collapse
Affiliation(s)
| | - Vivian Pérez Jiménez
- Organización Panamericana de la SaludLimaPerúOrganización Panamericana de la Salud, Lima, Perú
| |
Collapse
|
5
|
Migliori GB, Thong PM, Alffenaar JW, Denholm J, Tadolini M, Alyaquobi F, Al-Abri S, Blanc FX, Buonsenso D, Chakaya J, Cho JG, Codecasa LR, Danila E, Duarte R, Dukpa R, García-García JM, Gualano G, Kurhasani X, Manika K, Mello FCDQ, Pahl K, Rendon A, Sotgiu G, Souleymane MB, Thomas TA, Tiberi S, Kunst H, Udwadia ZF, Goletti D, Centis R, D’Ambrosio L, Silva DR. Country-specific lockdown measures in response to the COVID-19 pandemic and its impact on tuberculosis control: a global study. J Bras Pneumol 2022; 48:e20220087. [PMID: 35475873 PMCID: PMC9064628 DOI: 10.36416/1806-3756/e20220087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/13/2022] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to describe country-specific lockdown measures and tuberculosis indicators collected during the first year of the COVID-19 pandemic. Data on lockdown/social restrictions (compulsory face masks and hand hygiene; international and local travel restrictions; restrictions to family visits, and school closures) were collected from 24 countries spanning five continents. The majority of the countries implemented multiple lockdowns with partial or full reopening. There was an overall decrease in active tuberculosis, drug-resistant tuberculosis, and latent tuberculosis cases. Although national lockdowns were effective in containing COVID-19 cases, several indicators of tuberculosis were affected during the pandemic.
Collapse
Affiliation(s)
| | - Pei Min Thong
- . National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Jan-Willem Alffenaar
- . The University of Sydney, Pharmacy School, Sydney (NSW) Australia
- . The University of Sidney at Westmead Hospital, Sydney (NSW) Australia
- . Sydney Institute for Infectious Diseases, The University of Sydney, Sydney (NSW) Australia
| | - Justin Denholm
- . Melbourne Health Victorian Tuberculosis Program, Melbourne (VIC) Australia
- . Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne (VIC) Australia
| | - Marina Tadolini
- . Infectious Diseases Unit, Istituti Clinici Scientifici Maugeri - IRCCS - Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italia
- . Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Fatma Alyaquobi
- . TB and Acute Respiratory Diseases Section, Department of Communicable Diseases, Directorate General of Disease Surveillance and Control, National TB Programme, MoH Oman, Muscat, Sultanate of Oman
| | - Seif Al-Abri
- . Directorate General for Disease Surveillance and Control, MoH Oman, Muscat, Sultanate of Oman
| | - François-Xavier Blanc
- . Nantes Université, CHU Nantes, Service de Pneumologie, L’Institut du Thorax, Nantes, France
| | - Danilo Buonsenso
- . Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli - IRCCS - Roma, Italia
| | - Jeremiah Chakaya
- . Department of Medicine, Dermatology and Therapeutics, Kenyatta University, Nairobi, Kenya
- . Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jin-Gun Cho
- . The University of Sidney at Westmead Hospital, Sydney (NSW) Australia
- . Parramatta Chest Clinic, Parramatta (NSW) Australia
| | - Luigi Ruffo Codecasa
- . TB Reference Centre of Villa Marelli Institute, Niguarda Hospital, Milano, Italia
| | - Edvardas Danila
- . Vilnius University Hospital Santaros Kilinkos, Vilinius, Lithuania
| | - Raquel Duarte
- . National Reference Centre for MDR-TB, Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal e Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Rada Dukpa
- . National TB Control Program, Ministry of Health, Timbu, Bhutan
| | - José-María García-García
- . Programa Integrado de Investigación en Tuberculosis - PII-TB - Sociedad Española de Neumología y Cirugía Torácica - SEPAR - Barcelona, España
| | - Gina Gualano
- . Istituto Nazionale per le Malattie Infettive “Lazzaro Spallanzani” - INMI - IRCCS, Roma, Italia
| | - Xhevat Kurhasani
- . UBT - Higher Education Institution, Prishtina, Kosovo
- . NGO KeA, Prishtina, Kosovo
| | - Katerina Manika
- . Pulmonary Department, Aristotle University of Thessaloniki, “G. Papanikolaou” Hospital, Thessaloniki, Greece
| | | | - Kristin Pahl
- . Clinton Health Access Initiative, Phnom Penh, Cambodia
| | - Adrian Rendon
- . Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias -CIPTIR - Hospital Universitario de Monterrey, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Giovanni Sotgiu
- . Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | - Tania A. Thomas
- . Division of Infectious Diseases and International Health, University of Virginia, Charlottesville (VA) USA
| | - Simon Tiberi
- . Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- . Royal London Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | - Heinke Kunst
- . Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- . Royal London Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | - Zarir F. Udwadia
- . P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | - Delia Goletti
- . Istituto Nazionale per le Malattie Infettive “Lazzaro Spallanzani” - INMI - IRCCS, Roma, Italia
| | - Rosella Centis
- . Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia
| | | | - Denise Rossato Silva
- . Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS- Porto Alegre, Brasil
| |
Collapse
|
6
|
Abstract
Global health matters to every nurse everywhere. In this article we outline why. We highlight some important health issues confronting the world today; explore how these issues are being tackled; and consider the implications for nursing. We describe how nurses are making a difference in the challenging contexts, range and complexity of nursing work round the globe, and we conclude with a call to action. Nurses can influence, and become, policy-makers and politicians, and explain to them why the Sustainable Development Goals cannot be reached without strengthening nursing. In this International Year of the Nurse and Midwife, the window of opportunity is open, but it will not stay open for long. Nurses and midwives globally and locally must be ready to jump through it. We ask you to join hands, and join us.
Collapse
Affiliation(s)
- Jane Salvage
- International Council of Nurses, Global Nursing Leadership Institute, Geneva, Switzerland
| | - Jill White
- The University of Sydney, Susan Wakil School of Nursing and Midwifery, Sydney, Australia
| |
Collapse
|
7
|
O'Dwyer G, Konder MT, Reciputti LP, Lopes MGM, Agostinho DF, Alves GF. The process of implementation of emergency care units in Brazil. Rev Saude Publica 2017; 51:125. [PMID: 29236876 PMCID: PMC5718113 DOI: 10.11606/s1518-8787.2017051000072] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 01/16/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To analyze the process of implementation of emergency care units in Brazil. METHODS We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. RESULTS Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. CONCLUSIONS The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the urgency network.
Collapse
Affiliation(s)
- Gisele O'Dwyer
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil
| | - Mariana Teixeira Konder
- Universidade Estadual do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Clínica Médica. Rio de Janeiro, RJ, Brasil
| | - Luciano Pereira Reciputti
- Fundação Oswaldo Cruz. Iniciação Científica. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil
| | - Mônica Guimarães Macau Lopes
- Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas e Estratégicas. Brasília, DF, Brasil
| | - Danielle Fernandes Agostinho
- Fundação Oswaldo Cruz. Iniciação Científica. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil
| | - Gabriel Farias Alves
- Fundação de Apoio à Pesquisa do Estado do Rio de Janeiro Iniciação Científica. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil
| |
Collapse
|
8
|
Mansilla C, Herrera CA, Basagoitia A, Pantoja T. The Evidence-Informed Policy Network (EVIPNet) in Chile: lessons learned from a year of coordinated efforts. Rev Panam Salud Publica 2017; 43:e36. [PMID: 31363358 PMCID: PMC6612728 DOI: 10.26633/rpsp.2017.36] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 09/20/2016] [Indexed: 11/24/2022] Open
Abstract
Informing the health policymaking process with the best available scientific evidence has become relevant to health systems globally. Knowledge Translation Platforms (KTP), such as the World Health Organization's Evidence Informed Policy Networks (EVIPNet), are a recognized strategy for linking research to action. This report describes the experience of implementing EVIPNet in Chile, from its objectives, organizational structure, strategy, activities, and main outputs, to its evolution over the course of its first year. Lessons learned are also covered. Of the activities initiated by EVIPNet-Chile, the Rapid Response Service proved to be a good starting point for engaging policymakers. Capacity building workshops and policy dialogues with relevant stakeholders were also successful. Additionally, EVIPNet-Chile developed a model for engaging academic institutions in policymaking through a network focused on preparing evidence briefs. A number of challenges, such as changing methods for producing rapid evidence syntheses, were also identified. This KTP implementation model located in a Ministry of Health could contribute to the development of similar initiatives in other health systems.
Collapse
Affiliation(s)
- Cristián Mansilla
- Ministry of Health of ChileMinistry of Health of ChileMinistry of Health of Chile
| | - Cristian A Herrera
- Ministry of Health of ChileMinistry of Health of ChileMinistry of Health of Chile
| | - Andrea Basagoitia
- Ministry of Health of ChileMinistry of Health of ChileMinistry of Health of Chile
| | | |
Collapse
|
9
|
Abstract
Objectives. To describe, analyze, and compare the opinions of decisionmakers involved in the health technology assessment (HTA) process in Brazil in 2011. Methods. A cross-sectional study was conducted using a structured questionnaire to evaluate the opinions of a convenience sample of health care professionals from both the public and private health care systems (HCS). The survey collected demographic data for each respondent along with their input on national regulations. Data analysis included descriptive statistics, including chi-square tests to compare groups. Results. Of the 200 completed questionnaires, 65% of the respondents were 31–50 years of age; 36% were HCS managers, 49.3% from the public and 50.7% from the private system. The majority of respondents (85%) considered the time permitted for submission of new technology to be inadequate; 88% also stated that the composition of the evaluation committee needed improvement. Respondents from the private health system more frequently stated that submission times were inappropriate (P = 0.019) and that the deadline for a decision by the committee should be defined (P = 0.021), with a maximum of no more than 180 days / 6 months (P < 0.001). Conclusions. Respondents indicated that the HTA process should be improved to meet their expectations. Given that new legislation has been enacted to continuously accept submissions, to make decisions within 180 days, and to expand the committee to represent more stakeholders, most of the respondents concerns have been addressed. This study is valuable as an historical analysis of HTA process improvement. Further surveys are needed to track the new HTA process, its application, and its contribution to health care needs in Brazil.
Collapse
Affiliation(s)
- Fernanda Lessa
- Division of Health Economics and Healthcare ManagementDepartment of Medicine, Universidade Federal de São PauloSão PauloBrazilDivision of Health Economics and Healthcare Management, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.,Send correspondence to Fernanda Lessa,
| | - Marcos Bosi Ferraz
- Division of Health Economics and Healthcare ManagementDepartment of Medicine, Universidade Federal de São PauloSão PauloBrazilDivision of Health Economics and Healthcare Management, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
| |
Collapse
|
10
|
Santos VCD, Ferraz MB. Quantitative and qualitative analysis on the legislative production relating to healthcare in passage in the National Congress in the years 2007 and 2008. SAO PAULO MED J 2013; 131:389-97. [PMID: 24346778 PMCID: PMC10871825 DOI: 10.1590/1516-3180.2013.1316576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 02/24/2013] [Accepted: 03/06/2013] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVES The Federal Constitution of 1988 allowed the National Congress to contribute towards formulation of new public policies. The objective of this study was to analyze the legislative production that dealt with health issues that was in passage in the National Congress between January 2007 and December 2008. DESIGN AND SETTING Descriptive-exploratory cross-sectional study with quantitative and qualitative approaches, conducted in a federal university. METHODS The analysis material for the study comprised 144 draft bills that were classified and subsequently randomly evaluated by 155 professionals working within the healthcare system. RESULTS The analysis showed that the Workers' Party (PT) and Brazilian Democratic Movement Party (PMDB) were the parties that presented the largest proportions of the draft bills (12.5% and 11.1%); 25.4% of the draft bills were presented by congress members with academic qualifications within healthcare and only 1.4% of the draft bills became transformed into legal regulations. In questionnaire responses, 51.5% of the evaluators did not consider the draft bills to be viable, 40.6% did not consider them to be relevant and 52.5% said that if the draft bills were not approved it would not be harmful to Brazilian society. CONCLUSION In analyzing the data from this study, it was noted that the legislative production relating to healthcare was low and the transformation rate from draft bill to legal regulation was negligible. The results from the evaluation showed that the quality of legislative production was impaired.
Collapse
Affiliation(s)
- Viviane Cristina dos Santos
- Center for Health Economics and Researcher, Health Economics Research Group, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Marcos Bosi Ferraz
- Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
11
|
de Paula AP, Giozza SP, Pereira MZ, Boaventura PS, Santos LMP, Sachetti CG, Tamayo COC, Kowalski CCG, Elias FTS, Serruya SJ, Guimarães R. Clinical investigations for SUS, the Brazilian public health system. SAO PAULO MED J 2012; 130:179-86. [PMID: 22790551 PMCID: PMC10876198 DOI: 10.1590/s1516-31802012000300008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 11/25/2011] [Indexed: 04/07/2023] Open
Abstract
CONTEXT AND OBJECTIVE Scientific and technological development is crucial for advancing the Brazilian health system and for promoting quality of life. The way in which the Brazilian Ministry of Health has supported clinical research to provide autonomy, self-sufficiency, competitiveness and innovation for the healthcare industrial production complex, in accordance with the National Policy on Science, Technology and Innovation in Healthcare, was analyzed. DESIGN AND SETTING Descriptive investigation, based on secondary data, conducted at the Department of Science and Technology, Ministry of Health. METHODS The Ministry of Health's research management database, PesquisaSaúde, was analyzed from 2002 to 2009, using the key word "clinical research" in the fields "primary sub-agenda" or "secondary sub-agenda". The 368 projects retrieved were sorted into six categories: basic biomedical research, preclinical studies, expanded clinical research, clinical trials, infrastructure support and health technology assessment. From a structured review on "clinical research funding", results from selected countries are presented and discussed. RESULTS The amount invested was R$ 140 million. The largest number of projects supported "basic biomedical research", while the highest amounts invested were in "clinical trials" and "infrastructure support". The southeastern region had the greatest proportion of projects and financial resources. In some respects, Brazil is ahead of other BRICS countries (Russia, India, China and South Africa), especially with regard to establishing a National Clinical Research Network. CONCLUSION The Ministry of Health ensured investments to encourage clinical research in Brazil and contributed towards promoting cohesion between investigators, health policies and the healthcare industrial production complex.
Collapse
Affiliation(s)
- Ana Patrícia de Paula
- MD, PhD. Coordinator, Postgraduate Program, Escola Superior de Ciências da Saúde, Fundação de Ensino e Pesquisa em Ciências da Saúde, Federal District Health Department, Brasília, Federal District, Brazil.
| | - Silvana Pereira Giozza
- DDS, PhD. Consultant, Department of Science and Technology, Ministry of Health, Brasília, Federal District, Brazil.
| | - Michelle Zanon Pereira
- MSc. Consultant Nutritionist, Department of Science and Technology, Ministry of Health, Brasília, Federal District, Brazil.
| | - Patrícia Souza Boaventura
- Consultant Specialist Pharmacist, Department of Science and Technology, Ministry of Health, Brasília, Federal District, Brazil.
| | - Leonor Maria Pacheco Santos
- PhD. Chemist and Professor, Department of Public Health, Universidade de Brasília (UnB), Brasília, Federal District, Brazil.
| | - Camile Giaretta Sachetti
- MSc. Consultant Pharmacist, Department of Science and Technology, Ministry of Health, Brasília, Federal District, Brazil.
| | - César Omar Carranza Tamayo
- MD, PhD. Consultant, Department of Science and Technology, Ministry of Health, Brasília, Federal District, Brazil.
| | | | - Flavia Tavares Silva Elias
- MSc. Nutritionist, General Coordinator, Department of Science and Technology, Ministry of Health, Brasília, Federal District, Brazil.
| | - Suzanne Jacob Serruya
- MD, PhD. Consultant, Latin American Centre for Perinatology and Women and Reproductive Health, Pan-American Health Organization, Montevideo, Uruguay.
| | - Reinaldo Guimarães
- MD, MSc. Professor, Universidade Estadual do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
| |
Collapse
|
12
|
Abstract
CONTEXT AND OBJECTIVE Healthcare investments should consider short and long-term demands. The objectives here were to compare the average tenures of ministers of health in Brazil and in another 22 countries and to evaluate the relationship between ministers' tenures and a number of indicators. DESIGN AND SETTING Descriptive study conducted at Centro Paulista de Economia da Saúde (CPES). METHODS Twenty-two countries with the highest Human Development Indices (HDIs) and Brazil were included. The number of ministers over the past 20 years was investigated through each country's Ministry of Health website. Pearson's correlation coefficient was used to compare the number of ministers in each country with that country's indicators. The Mann-Whitney test was used to compare ministers' tenures in Brazil and other countries. RESULTS The mean tenure (standard deviation, SD) of Brazilian ministers of health was 15 (12) months, a period that is statistically significantly shorter than the mean tenure of 33 (18) months in the other 22 countries (P < 0.05). There was a moderate and statistically significant positive correlation between the number of ministers and mortality rates for several conditions. The number of ministers also presented moderate and statistically significant negative correlations with per capita total healthcare expenditure (r = -0.567) and with per capita government healthcare expenditure (r = -0.530). CONCLUSION On average, ministers of health have extremely short tenures. There is an urgent need to think and plan healthcare systems from a long-term perspective.
Collapse
Affiliation(s)
- Marcos Bosi Ferraz
- Centro Paulista de Economia da Saúde, Universidade Federal de São Paulo, Brazil.
| | | |
Collapse
|