scholarly journals Síntese de evidências para políticas de saúde: enfrentamento da sífilis congênita no âmbito da atenção primária à saúde

2021 ◽  
Vol 20 (2) ◽  
pp. 89-95
Author(s):  
Mariana de Sales Dias ◽  
Emiliana Maria Gaiotto ◽  
Marcia Regina Cunha ◽  
Lúcia Izumi Yasuko Nichiata
Keyword(s):  
Health Systems ◽  
Cochrane Library

Introdução: O controle da sífilis congênita (SC) é um desafio pa-ra profissionais e gestores da Atenção Primária à Saúde (APS). Objetivo: Apresentar os resultados da síntese de evidências cien-tíficas pela qual foram identificadas opções para enfrentamento da SC que apoiam a APS. Método: Utilizou-se a ferramenta SUPPORT sugerida pela Rede para Políticas Informadas por Evidências (EVIP-Net) para a busca de revisões sistemáticas e elaboração das opções para enfrentar o problema. As buscas foram realizadas em Biblioteca Virtual de Saúde, Cochrane Library, Embase, Health Evidence, Health Systems Evidence, Nice Evidence, Pubmed, Scopus. Resultados: Foram encontrados 310 estudos. Após seleção, analisaram-se 20 revisões sistemáticas que resultaram nas seguintes opções: 1) Am-pliar a oferta de teste de triagem para todas as gestantes e parceiros sexuais; 2) Realizar tratamento com penicilina benzatina para ges-tantes e parceiros sexuais com teste de triagem positivo para sífilis; 3) Elaborar estratégias para notificar parceiros sexuais de pacien-tes com diagnóstico de infecção sexualmente transmissível (IST); 4) Realizar campanhas de saúde para informar sobre as medidas de prevenção da sífilis congênita; promover intervenções educacionais sobre o uso de preservativos, prevenção de IST e gravidez na ado-lescência. Conclusão: As evidências científicas apresentadas neste artigo têm potencial para apoiar gestores e profissionais da APS na construção de políticas de saúde para enfrentamento da SC.

scholarly journals Structural stigma and its impact on healthcare for consumers with borderline personality disorder: protocol for a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Pauline Klein ◽  
Alicia Kate Fairweather ◽  
Sharon Lawn ◽  
Helen Margaret Stallman ◽  
Paul Cammell
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Health Services ◽  
Health Systems ◽  
Scoping Review ◽  
Borderline Personality ◽  
Cochrane Library ◽  
Cultural Norms ◽  
International Literature ◽  
Institutional Policies

Abstract Background Structural stigma in health systems experienced by consumers diagnosed with Borderline Personality Disorder (BPD) is a widespread phenomenon that causes major health inequities and harm for this population. Structural stigma in this context relates to institutional policies, cultural norms, and organizational practices that limit consumers’ access to health services, quality of care, and capacity to achieve optimal health and well-being. BPD is a serious mental illness with high morbidity and mortality, characterized by instability in interpersonal relationships, self-image, and emotional and behavioral deregulation, which stem from significant traumatic childhood/life events, and/or biological etiologies. The objectives of this scoping review are to explore the international literature on structural stigma in healthcare systems specific to BPD, and to provide an overview of the impact of structural stigma on health services for BPD consumers and their carers/families. Methods This scoping review will follow the Joanna Briggs Institute (JBI) scoping review guidelines. We will search the following electronic databases (from inception onwards): MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI-Evidence databases. Grey literature will be identified through the Google search engine. We will include all types of literature in English, published and unpublished, including any study design, reviews, clinical practice guidelines, policy reports, and other documents. No restrictions on publication date of sources of evidence will be applied. International literature should examine structural stigma associated with BPD in any healthcare setting such as, outpatients, inpatients, primary health care, or community-based facilities. Two reviewers will independently screen all titles, abstracts, and full-text citations. Quality appraisal of the included sources of evidence will be assessed using the Mixed Methods Appraisal Tool (MMAT) 2018 version. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., thematic analysis) methods. Discussion This review is anticipated to enhance both identification and understanding of those structures in health systems (i.e., institutional policies, cultural norms, and practices) that manifest and perpetuate stigma experienced by consumers with BPD and their carers/families. The findings can be used to inform future research, policy, and practice relating to stigma reduction strategies that can be adopted to improve the provision of BPD-responsive services and care for this population. Systematic review registration Open Science Framework (https://osf.io/bhpg4).

scholarly journals Preparedness components of health systems in the Eastern Mediterranean Region for effective responses to dust and sand storms: a systematic review

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 146
Author(s):  
Kiyoumars Allahbakhshi ◽  
Davoud Khorasani-Zavareh ◽  
Reza Khani Jazani ◽  
Zohreh Ghomian
Keyword(s):  
Systematic Review ◽  
Health Effects ◽  
Health Systems ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Hazard Identification ◽  
Cochrane Library ◽  
Potential Health ◽  
Sand Storm

Background: Dust and Sand Storm (DSS), according to estimates by global reports, will increase dramatically in the Eastern Mediterranean Region (EMR). Numerous health problems caused by DSS will be severely affected regions and vulnerable groups. This study aimed to identify the components of the preparedness of health systems for the DSS phenomenon in EMR. Methods: In this systematic review, the peer-reviewed papers in four electronic databases, including Medline through PubMed, Scopus, ISI Web of Science and the Cochrane library, as well as available grey literature, were searched and selected. The research process was carried out by including papers whose results were related to the potential health effects caused by desert dusts in EMR. Was used the combination of three groups of keywords: the exposure factor, health effects as outcomes, and the countries located in EMR. The focus was on the PRISMA checklist, with no time limitations until December 2017. Finally, through 520 related citations, 30 articles were included. Descriptive and thematic content analyses were evaluated. Results: The preparedness components were divided into three and ten main categories and subcategories, respectively. The three categories covered the areas of DSS hazard identification, planning and policy-making, and risk assessment. Conclusions: Recognition of the health system preparedness factors for DSS in EMR will help policy-makers and managers perform appropriate measures when dealing with this hazard. More studies should be conducted to understand these factors in other parts of the world. Registration: PROSPERO registration number CRD42018093325.

scholarly journals Determinants of Motivation among Healthcare Workers in the East African Community between 2009–2019: A Systematic Review

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 164 ◽  
Author(s):  
Rose Nabi Deborah Karimi Muthuri ◽  
Flavia Senkubuge ◽  
Charles Hongoro
Keyword(s):  
Systematic Review ◽  
Healthcare Worker ◽  
Health Systems ◽  
Health Workforce ◽  
Healthcare Workers ◽  
Essential Element ◽  
Cochrane Library ◽  
East African ◽  
East African Community ◽  
African Community

Healthcare workers are an essential element in the functionality of the health system. However, the health workforce impact on health systems tends to be overlooked. Countries within the Sub-Saharan region such as the six in the East African Community (EAC) have weak and sub-optimally functioning health systems. As countries globally aim to attain Universal Health Coverage and the Sustainable Development Goal 3, it is crucial that the significant role of the health workforce in this achievement is recognized. In this systematic review, we aimed to synthesise the determinants of motivation as reported by healthcare workers in the EAC between 2009 and 2019. A systematic search was performed using four databases, namely Cochrane library, EBSCOhost, ProQuest and PubMed. The eligible articles were selected and reviewed based on the authors’ selection criteria. A total of 30 studies were eligible for review. All six countries that are part of the EAC were represented in this systematic review. Determinants as reported by healthcare workers in six countries were synthesised. Individual-level-, organizational/structural- and societal-level determinants were reported, thus revealing the roles of the healthcare worker, health facilities and the government in terms of health systems and the community or society at large in promoting healthcare workers’ motivation. Monetary and non-monetary determinants of healthcare workers’ motivation reported are crucial for informing healthcare worker motivation policy and health workforce strengthening in East Africa.

scholarly journals The impacts of decentralization on health system equity, efficiency and resilience: a realist synthesis of the evidence

2019 ◽  
Vol 34 (8) ◽  
pp. 605-617 ◽  
Author(s):  
Seye Abimbola ◽  
Leonard Baatiema ◽  
Maryam Bigdeli
Keyword(s):  
Health System ◽  
Health Systems ◽  
Negative Impact ◽  
Contextual Factors ◽  
Evidence Synthesis ◽  
Implementation Strategies ◽  
Cochrane Library ◽  
Local Initiative ◽  
Middle Income ◽  
The Impact

Abstract One constant refrain in evaluations and reviews of decentralization is that the results are mixed. But given that decentralization is a complex intervention or phenomenon, what is more important is to generate evidence to inform implementation strategies. We therefore synthesized evidence from the literature to understand why, how and under what circumstances decentralization influences health system equity, efficiency and resilience. In doing this, we adopted the realist approach to evidence synthesis and included quantitative and qualitative studies in high-, low- and middle-income countries that assessed the the impact of decentralization on health systems. We searched the Medline and Embase databases via Ovid, and the Cochrane library of systematic reviews and included 51 studies with data from 25 countries. We identified three mechanisms through which decentralization impacts on health system equity, efficiency and resilience: ‘Voting with feet’ (reflecting how decentralization either exacerbates or assuages the existing patterns of inequities in the distribution of people, resources and outcomes in a jurisdiction); ‘Close to ground’ (reflecting how bringing governance closer to the people allows for use of local initiative, information, feedback, input and control); and ‘Watching the watchers’ (reflecting mutual accountability and support relations between multiple centres of governance which are multiplied by decentralization, involving governments at different levels and also community health committees and health boards). We also identified institutional, socio-economic and geographic contextual factors that influence each of these mechanisms. By moving beyond findings that the effects of decentralization on health systems and outcomes are mixed, this review presents mechanisms and contextual factors to which policymakers and implementers need to pay attention in their efforts to maximize the positive and minimize the negative impact of decentralized governance.

scholarly journals “An unnecessary cut?” multilevel health systems analysis of drivers of caesarean sections rates in Italy: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Valentina Laurita Longo ◽  
Emmanuel Nene Odjidja ◽  
Thierry Kamba Beia ◽  
Manuela Neri ◽  
Karina Kielmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Health Systems ◽  
Local Governments ◽  
Financial Burden ◽  
World Health ◽  
Cochrane Library ◽  
Medical Procedure ◽  
System Perspective ◽  
Increased Risk

Abstract Background Improvements in medical technologies have seen over-medicalization of childbirth. Caesarean section (CS) is a lifesaving procedure proven effective in reducing maternal and perinatal mortality across the globe. However, as with any medical procedure, the CS intrinsically carries some risk to its beneficiaries. In recent years, CS rates have risen alarmingly in high-income countries. Many exceeding the World Health Organisation (WHO) recommendation of a 10 to 15% annual CS rate. While this situation poses an increased risk to women and their children, it also represents an excess human and financial burden on health systems. Therefore, from a health system perspective this study systematically summarizes existing evidence relevant to the factors driving the phenomenon of increasing CS rates using Italy as a case study. Methods Employing the WHO Health System Framework (WHOHSF), this systematic review used the PRISMA guidelines to report findings. PubMed, SCOPUS, MEDLINE, Cochrane Library and Google Scholar databases were searched up until April 1, 2020. Findings were organised through the six dimensions of the WHOHSF framework: service delivery, health workforce, health system information; medical products vaccine and technologies, financing; and leadership and governance. Results CS rates in Italy are affected by complex interactions among several stakeholder groups and contextual factors such as the hyper-medicalisation of delivery, differences in policy and practice across units and the national context, issues pertaining to the legal and social environment, and women’s attitudes towards pregnancy and childbirth. Conclusion Mitigating the high rates of CS will require a synergistic multi-stakeholder intervention. Specifically, with processes able to attract the official endorsement of policy makers, encourage concensus between regional authorities and local governments and guide the systematic compliance of delivery units with its clinical guidelines.

scholarly journals Structural stigma and its impact on healthcare for consumers with Borderline Personality Disorder: protocol for a scoping review

2021 ◽  
Author(s):  
Pauline Klein ◽  
A. Kate Fairweather ◽  
Sharon Lawn ◽  
Helen Stallman ◽  
Paul Cammell
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Health Services ◽  
Health Systems ◽  
Scoping Review ◽  
Borderline Personality ◽  
Cochrane Library ◽  
Cultural Norms ◽  
International Literature ◽  
Institutional Policies

Abstract BackgroundStructural stigma in health systems experienced by consumers diagnosed with Borderline Personality Disorder (BPD), is a widespread phenomenon that causes major health inequities and harm for this population. Structural stigma in this context relates to institutional policies, cultural norms, and organizational practices that limits consumers’ access to health services, quality of care, and capacity to achieve optimal health and well-being. BPD is a serious mental illness with high morbidity and mortality, characterized by instability in interpersonal relationships, self-image, and emotional and behavioral deregulation, which stem from significant traumatic childhood/life events, and/or biological aetiologies. The objectives of this scoping review are to explore the international literature on structural stigma in healthcare systems specific to BPD, and to provide an overview of the impact of structural stigma on health services for BPD consumers, and their carers/families.MethodsThis scoping review will follow the Joanna Briggs Institute (JBI) scoping review guidelines. We will search the following electronic databases (from inception onwards): MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI-Evidence databases. Grey literature will be identified through the Google search engine. We will include all types of literature in English, published and unpublished, including any study design, reviews, clinical practice guidelines, policy reports, and other documents. No restrictions on publication date of sources of evidence will be applied. International literature should examine structural stigma associated with BPD in any healthcare setting such as, outpatients, inpatients, primary health care, or community-based facilities. Two reviewers will independently screen all titles, abstracts and full-text citations. Quality appraisal of the included sources of evidence will be assessed using the Mixed Methods Appraisal Tool (MMAT) 2018 version. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., thematic analysis) methods. DiscussionThis review is anticipated to enhance both identification and understanding of those structures in health systems (i.e., institutional policies, cultural norms, and practices), that manifest and perpetuate stigma experienced by consumers with BPD, and their carers/families. The findings can be used to inform future research, policy and practice relating to stigma reduction strategies that can be adopted to improve the provision of BPD-responsive services and care for this population. Systematic review registration: Open Science Framework (https://osf.io/bhpg4).

scholarly journals Intervenções farmacêuticas e seus desfechos em portadores de HIV/AIDS em atendimento de média complexidade

2021 ◽  
Vol 13 (4) ◽  
pp. e4390
Author(s):  
Jorgete Carneiro Chaves ◽  
Ana Cristina Lo Prete ◽  
Orenzio Soler ◽  
Carolina Heitmann Mares Azevedo Ribeiro
Keyword(s):  
Pharmaceutical Care ◽  
Health Systems ◽  
Pharmaceutical Services ◽  
Google Scholar ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Subject Headings ◽  
Pharmaceutical Interventions ◽  
Hiv Aids

Objetivo: Investigar evidências sobre tipos de intervenções, dando ênfase às intervenções farmacêuticas, e seus respectivos desfechos clínicos, epidemiológicos, de acesso, humanístico e econômicos em portadores de HIV/Aids em atendimento de média complexidade. Métodos: Revisão sistemática com estratégia de busca nos estudos publicados nas bases Cochrane Library, Epistemonikos, Health Evidence, Health Systems Evidence, Biblioteca Virtual de Saúde e Google Scholar; incluindo Medical Subject Headings (MeSH) e Descritores em Ciências da Saúde (DeCS), incluindo os domínios “Pharmaceutical attention”, “Pharmaceutical Care”, “Pharmaceutical Interventions”, “Pharmaceutical Services”, “HIV/AIDS”, “Medium Complexity Attention” e “Medium Complexity Care”, sendo adaptada para as distintas bases eletrônicas, utilizando-se dos operadores booleanos OR e AND. Resultados: Há evidências de que as intervenções farmacêuticas profissionais, financeiras, governamentais e multifacetadas, melhoram os desfechos clínicos, epidemiológicos, de acesso e equidade, humanístico e econômicos em portadores de HIV/Aids em atendimento de média complexidade. Considerações finais: Diversas intervenções farmacêuticas ao portador de HIV/Aids se mostraram importantes na melhora de desfechos clínicos, epidemiológicos, humanísticos e de acesso e equidade, tendo assim o cuidado farmacêutico se mostrado importante para fortalecer as estratégias do uso racional de medicamentos e promovendo a melhoria da qualidade de vida do paciente.

scholarly journals Structural stigma and its impact on healthcare for consumers diagnosed with Borderline Personality Disorder: protocol for a scoping review

2020 ◽  
Author(s):  
Pauline Klein ◽  
A. Kate Fairweather-Schmidt ◽  
Sharon Lawn ◽  
Helen Stallman ◽  
Paul Cammell
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Health Systems ◽  
Scoping Review ◽  
Full Text ◽  
Borderline Personality ◽  
Cochrane Library ◽  
Cultural Norms ◽  
Google Search ◽  
The Impact

Abstract BackgroundStructural stigma in health systems experienced by consumers diagnosed with Borderline Personality Disorder (BPD), is a widespread phenomenon that causes health inequities and harm for this population. Structural stigma in this context relates to organisational practices, cultural norms, and institutional policies that limits consumers’ access to health services, quality of care, and health and well-being. BPD is a mental illness with high morbidity and mortality, characterised by instability in interpersonal relationships, self-image, and emotional and behavioral deregulation, which stem from significant traumatic childhood/life events, and/or biological etiologies. This scoping review aims to explore the literature on structural stigma in health systems specific to BPD, and to provide an overview of the impact of stigma on healthcare services for BPD consumers, and their carers/families.MethodsThis scoping review will follow the Joanna Briggs Institute (JBI) guidelines. The search strategy was developed and tested using PsycINFO. A comprehensive search will be conducted across PsycINFO, MEDLINE, CINAHL, Scopus, ProQuest, Cochrane library and JBI Evidence-Based databases; as well as a grey literature search using Google search engine. Studies will be screened by title, abstract and full text articles, by separate reviewers against the eligibility criteria. Selected full text articles will be accessed against the inclusion criteria. Quantitative and qualitative data will be extracted from the selected full text articles. A narrative summary of findings will then be conducted and presented in accordance with the JBI guidelines for scoping reviews, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 checklist. Quality appraisal of the included articles will be assessed using the Mixed Methods Appraisal Tool (MMAT) 2018 version.DiscussionThis review is anticipated to enhance both identification and understanding of those structures in health systems (i.e., policies, cultural norms, and practices), that manifest and perpetuate stigma experienced by consumers with BPD, and their carers/families. The findings can be used to inform future research, policy and practice relating to stigma reduction strategies that can be adopted to improve the provision of BPD-responsive services and care for this population.Scoping review registrationThis scoping review was submitted for registration in Open for Science Framework on 11th June 2020.

scholarly journals Implementation considerations for the WHO Essential Diagnostics List with insights from the Essential Medicines List: A scoping review protocol

2021 ◽  
Author(s):  
Moriasi Nyanchoka ◽  
Mercy Mulaku ◽  
Simon Kariuki ◽  
Feiko ter Kuile ◽  
Taryn Young ◽  
...  
Keyword(s):  
Health Systems ◽  
Scoping Review ◽  
Policy Development ◽  
Grey Literature ◽  
Relevant Literature ◽  
Essential Medicines ◽  
World Health ◽  
Cochrane Library ◽  
Essential Medicines List ◽  
Effective Implementation

Background: Access to medicines and technologies is a key building block of the WHO health systems framework. In 2018, the World Health Organization (WHO) published the first Essential Diagnostics List (EDL) to address the need for countries to make essential diagnostics more accessible and affordable to patients in low-and-middle-income countries and to complement the more established Essential Medicines List (EML). The effective implementation of the WHO EDL is vital to ensure its impact on improving health outcomes. This scoping review aims to map literature on the implementation, uptake and evaluation of the WHO essential lists in African nations in order to guide the effective implementation and evaluation of the WHO EDL. Methods: This review will map literature on the implementation and evaluation of the WHO’s essential diagnostic list (EDL) and essential medical list (EML), using the Joanna Briggs Institute guidelines for scoping review. The implementation considerations we will review include, study designs used in the evaluation of the WHO essential lists, and the outcome measures, findings, gaps and limitations highlighted in the included articles. We will review both primary and secondary quantitative and qualitative literature evaluating the WHO essential lists. A comprehensive search strategy, developed with an information scientist, will be used to identify relevant sources. The database to be searched include: MEDLINE (Pubmed), CINAHL, the Cochrane Library, the Health Technology Assessment database, EMBASE, Health systems evidence, African Index Medicus, Web of Science, Science Direct, Scopus and WHO library databases. Grey Literature will be accessed by searching for policy documents, diagnostic guidelines, and reports of ministry of health, health agencies through their websites and links published in the last three years from selected African countries. Searches, study selection and data extraction will be conducted using the covidence platform by two independent reviewers. The Mixed Method Appraisal Tool (MMAT) version 2018 will be used to assess the quality of included studies. The findings will be analysed using the thematic content analysis approach and the results presented narratively and graphically.Discussion: We anticipate finding relevant literature on the implementation considerations for WHO’s essential diagnostic and medicines list in Africa. This review is likely to reveal implementation considerations, challenges, gaps, which could guide future evaluation, implementation, policy development, and development of practice tools to support the wider adoption of the WHO essential diagnostic list in Africa. Dissemination: We plan to publish our findings in a peer-reviewed journal and develop useful and accessible summary of the results.

scholarly journals Fortalecimento das estratégias de segurança de pacientes: uma revisão integrativa quantos aos processos de segurança de medicamentos

2020 ◽  
Vol 9 (12) ◽  
pp. e129129564
Author(s):  
Alessandra Santos Ferreira ◽  
Orenzio Soler
Keyword(s):  
Health Systems ◽  
Cochrane Library

Objetivos: Identificar evidências quanto aos processos utilizados para a promoção da segurança do paciente relacionados à utilização de medicamentos em ambientes hospitalares e quais implicações dessas ações para a prática clínica e do cuidado farmacêutico. Métodos: Revisão integrativa realizada nas bases de dados, Cochrane Library, Epistemonikos, Health Evidence, Health Systems Evidence, e Biblioteca Virtual de Saúde, utilizando-se os domínios “idosos”, “segurança do paciente”, “polifarmácia” combinando-os com os operadores booleanos 'AND' e 'OR'. As publicações foram selecionadas de acordo com os critérios de inclusão e exclusão; a análise dos artigos se deu por pares; não houve restrição de idiomas. Resultados: A busca resultou em 73 artigos, dos quais: 42 foram excluídos por temática diversa à desta revisão, 4 revisões sistemáticas, e 3 duplicatas.  Restaram 24 artigos elegíveis divididos em 5 eixos temáticos: percepção dos profissionais e dos pacientes quanto à segurança no uso de medicamentos; sistemas de liberação e relação de medicamentos padronizados; dispensação de medicamentos realizada por farmacêuticos e técnicos de farmácia; teste de estabilidade; e, qualidade e gestão de processos assistenciais. Conclusão: Existem inúmeras estratégias empregadas para promover a segurança no uso de medicamentos e o farmacêutico, como consultor técnico e clínico dos cuidados farmacêuticos, pode atuar detectando potenciais falhas e traçando estratégias para promover a segurança do paciente com vistas a reduzir custos com tecnologias da saúde.

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