scholarly journals Enfermedades importadas en España: dificultades en la atención sanitaria

2019 ◽  
Vol 18 (1) ◽  
pp. 582-607 ◽  
Author(s):  
Adela Gómez Luque ◽  
Lorena Breña Díaz ◽  
Sebastián Sanz Martos ◽  
Laura Bermejo Sánchez ◽  
Argeme Serradilla Fernández ◽  
...  

Introducción: En España, desde el 2000 hasta el 2010, existían medidas que fomentaban la igualdad en salud y acceso a los servicios sanitarios de la población inmigrante. Con el inicio de la crisis y las reducciones del gasto público en salud, se instauraron medidas, que no solo tienen consecuencias negativas para este colectivo sino también para la salud pública en general, viéndose en aumento el número de casos de enfermedades importadas, también relacionadas con el aumento de viajes internacionales.Objetivos: Evaluar la presencia de enfermedades importadas en España y conocer la problemática del inmigrante en el Sistema Sanitario. Método: Revisión bibliográfica de estudios en lengua inglesa y castellana publicados entre 2007 y 2017 recogidos varias bases de datos y en informes de instituciones y organizaciones científicas.Resultados: Se obtuvo un total de 173 artículos indexados en las bases de datos. De estos, 32 se ajustaron a los criterios de inclusión, de los que se seleccionaron 15 para responder a los objetivos.15 producciones se adaptaron al objetivo del presente estudio. Los estudios afirman que los movimientos poblacionales como migraciones o a viajes internacionales, elevan la presencia de enfermedad importada en España. Esto junto con las medidas legislativas impuestas por el gobierno en materia de sanidad, dificultan al inmigrante irregular la posibilidad de acceder al Sistema Sanitario español. Destacan además otras dificultades para el inmigrante como son el idioma y el desconocimiento del correcto acceso y uso de las prestaciones sanitarias.Conclusión: Todo esto, crea desconfianza en el inmigrante, el cual aplaza el contacto con el servicio sanitario, pudiendo llegar a ocasionar un grave problema en la salud pública, principalmente por el retraso en el diagnóstico, tratamiento y seguimiento de enfermedades infecciosas importadas. Introduction: In Spain, from 2000 to 2010, there were measures that promoted equality in health and permitted access to health services for the immigrant population. Because of the economic crisis and the reductions in public expenditure on health, security measures were put in place, which not only had negative consequences for this group, also for public health in general. Therefore, the number of imported diseases cases have increased in direct relation to international travels.Objectives: To evaluate the presence of imported diseases in Spain and to know the problem of the immigrant in the Health System.Method: the literature review of studies in English and Spanish published between 2007 and 2017, including several databases and reports from institutions and scientific organizations.Results: A total of 173 articles indexed in the databases were obtained. 32 of these articles were adjusted to the inclusion criteria, of which 15 were selected to respond to the objectives. The studies affirm that population movements such as migrations or international trips, increase the presence of imported diseases in Spain. In addition, legislative measures imposed by the government on health matters, complicate access to the Spanish Health System for irregular immigrants. They also highlight other difficulties for the immigrant, such as the language and the lack of knowledge of the correct access and use of health services.Conclusion: The sum of all the above mentioned, creates lack of confidence in the immigrant, which postpones contact with the health service, and may lead to a serious problem in public health, mainly due to the delay in the diagnosis, treatment, and monitoring of imported infectious diseases.

2019 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Alfreda Dinayu Purbantari ◽  
Roesdiyanto Roesdiyanto ◽  
Nurnaningsih Herya Ulfah

Abstract: Tuberculosis (TB) is a contagious disease that is still the world's attention, Until now, there is not a single country that is free of TB (Kemenkes 2011). Public Health Center (puskesmas) Janti is a puskesmas where the number of TB BTA+ sufferers increases every year while the number of treatment success rate at Puskesmas Janti decreases every year. In 2013 is 96%, in 2014 is 87,50% and in 2015 is 85,37%. Increasing the number of patients and decreasing the number of success rates of treatment indicates that the utilization of health services is less. This study aims to find out the relationship of Education, Health Service Access and Family Support with Health Service Utilization of BTA+ Pulmonary TB Patients at Public Health Center (puskesmas) Janti Malang. The design of this study is quantitative correlation with samples of all patients with TB Paru + BTA who are still doing treatment at Puskesmas Janti in September 2016 until April 2017. The analysis used correlation test and logistic regression test with cross sectional approach. The results of the research analysis found that there is a significant relationship between education, access to health services and family support together with the utilization of health services of patients Tb Paru BTA+. Based on the results of determination coefficient R2 (Nagelkerke) of 0.619, this means that education (X1), access to health services (X2), and family support (X3) has contributed 61.9% to the utilization of health services of patients with TB Paru BTA+ at Puskesmas Janti.Keywords: education, access, family support, health service utilizationAbstrak: Tuberkulosis (TB) adalah penyakit menular yang masih menjadi perhatian dunia, hingga saat ini, belum ada satu negara pun yang bebas TB (Kemenkes 2011). Puskesmas Janti adalah satu puskesmas yang berada di Kota Malang dengan jumlah pasien TB Paru BTA+ yang paling tinggi dan meningkat setiap tahun diantara puskesmas yang lain di Kota Malang, sedangkan jumlah angka keberhasilan pengobatan di Puskesmas Janti mengalami penurunan setiap tahun. Tahun 2013 sebesar 96%, pada tahun 2014 sebesar 87,50% dan pada tahun 2015 sebesar 85,37%. Peningkatan jumlah penderita dan penurunan jumlah angka keberhasilan pengobatan menunjukkan bahwa pemanfaatan pelayanan kesehatan kurang. Penelitian ini bertujuan untuk mengetahui Hubungan Pendidikan, Akses Pelayanan Kesehatan dan Dukungan Keluarga dengan Pemanfaatan Pelayanan Kesehatan Penderita TB Paru BTA+ di Puskesmas Janti Kota Malang. Rancangan penelitian ini adalah kuantitatif korelasional dengan sampel seluruh penderita TB Paru BTA+ yang masih melakukan pengobatan di Puskesmas Janti pada bulan September 2016 sampai dengan April 2017. Analisis menggunakan uji korelasi dan uji regresi logistik dengan pendekatan cross sectional. Hasil analisis penelitian di dapatkan ada hubungan yang dignifikan antara pendidikan, akses pelayanan kesehatan dan dukungan keluarga secara bersama-sama dengan pemanfaatan pelayanan kesehatan penderita Tb Paru BTA+. Berdasarkan hasil koefisien determinasi R2 (Nagelkerke) sebesar 0,619, hal ini berarti bahwa pendidikan (X1), akses pelayanan kesehatan (X2), dan dukungan keluarga (X3) memiliki kontribusi sebesar 61,9% terhadap pemanfaatan pelayanan kesehatan penderita TB Paru BTA+ di Puskesmas Janti.Kata Kunci:    pendidikan, akses pelayanan kesehatan, dukungan keluarga, pemanfaatan pelayanan kesehatan penderita TB Paru BTA+


2020 ◽  
Author(s):  
Shirin Shahbazi Sighaldeh ◽  
Fatemeh Zarghami ◽  
Ali Shahryari ◽  
Ali Mohammadinia ◽  
Mohsen Ebrahimi ◽  
...  

Abstract Background: Crystal (methamphetamine) is a strong stimulant of addictive substances that affects the central nervous system. The consumption of this substance is increasing among teenagers and adult young people in the country. In this matter, one of the practical and important ways to its control is to identify the factors leading to its first use. Thus this paper, explores the factors related to the first crystal use in Golestan province, Iran.Methods: In a qualitative study, 19 crystal users were recruited in the study conducted in Golestan province by snowball sampling from DIC (Drop-In Center) in addiction treatment centers. The interviews were mostly carried out individually with the participants; only one interview was conducted in an addiction treatment camp in the form of a group-focused discussion. Data analysis was implemented through content analysis in MAXQDA 10 software.Results: The mean age of the participants was 35.05± 6.06 years with a range of 23-46 years. Meanwhile, the mean of crystal use period was 7.42 (SD:3.61) and a range of 1-14 years. Based on the obtained data, the reasons for first crystal use could be categorized in six; 1: "crystal use to other drugs rehabilitation"; 2: "Lack of awareness of the addictive nature of crystal"; 3: “stimulating curiosity in public with crystal-use friends” , 4: affordable and convenient use”, 5: "anti-sleeping effects and increasing work efficiency", and 6: "therapeutic and other misconceptions”".Conclusions: The results indicated that crystal is mostly abused to opium rehabilitation. The lack of awareness and misconceptions about this substance can lead people to crystal use. Therefore, designing public health interventions to increase awareness about negative consequences of crystal use is fundamental to prevent people from abusing it. We suggest designing public health program to promote awareness about health risks of crystal and modifying related misconceptions. Finally, the government can establish policies to mandate sale tax for crystal producers and reduce easy access to crystal especially among youth.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
F Sesti ◽  
A Rosano ◽  
D Ingleby ◽  
G Baglio ◽  
R Bell ◽  
...  

Abstract Issue With increasing of numbers of people moving in Europe and around the world, the health of migrants has become a key global public-health issue. Migrants in an irregular situation (MIS) represent an important part of the migration phenomenon, whether they have become irregular by entering a country without authorisation or by overstaying a visa, including whose applied unsuccessfully for asylum. Description of the problem Overstaying of visas is not unusual in EU countries and during 2015 and 2016 in particular, many countries experienced a large number of unauthorised entrants. Health policies for MIS are increasingly a matter of concern. Using the 2015 Migrant Integration Policy Index Health strand (MIPEX HS) it is possible to conduct an analysis of health policies, focusing on access to health services by MIS. Results Among the 34 European countries covered by the MIPEX HS, Italy’s overall score of 65 is exceeded only by Switzerland (70) and Norway (67). Averaging the indicators of access for MIS, Italy obtains the highest score (83), followed by Denmark, France, the Netherlands, Romania, Spain, Sweden and Switzerland with 67. Its score for legal entitlements to health care is 75 (the same as Sweden), while reporting of MIS to the immigration authorities is prohibited and there are no sanctions against helping them. However, legislation introduced by the new government in 2018 has restricted some of their rights. Lessons Current migration to Europe requires dealing with short-term health needs as well as strengthening public health and health systems in the long term. This presentation will discuss the lessons that can be learned from the comparative analysis of health policies for MIS using the MIPEX HS. Key messages Affordable health care is a human right, which should not be denied to any migrant. Policy analysis plays a key role in identifying interventions for promoting health equity.


2019 ◽  
Vol 13 (2) ◽  
pp. 195-210 ◽  
Author(s):  
Taniya Sah ◽  
Rituparna Kaushik ◽  
Neha Bailwal ◽  
Neisetuonuo Tep

The Government of Delhi introduced the policy of Mohalla Clinics in 2015 in order to improve its health care system. It was aimed at providing primary health care to people in their neighbourhood, with a particular focus on people residing in poor localities of Delhi. This article seeks to assess the role of Mohalla Clinics in the urban health care system. Based on a primary survey conducted in various areas of Delhi, we find that these clinics have helped in easing the pressure on tertiary care hospitals by providing treatment of minor ailments within the vicinity of neighbourhood. Overall, people positively endorse this initiative which contributed to a decline in out-of-pocket expenditure on medicines and tests. We find that Mohalla Clinics are ensuring better geographical access to health services by reducing time in commuting and waiting. Their scope, however, can be further broadened by introducing provisions for pregnant and lactating women, who constitute a major section of the patients visiting these clinics.


2015 ◽  
Vol 49 (4) ◽  
pp. 0589-0595 ◽  
Author(s):  
Ana Carla Borghi ◽  
Angela Maria Alvarez ◽  
Sonia Silva Marcon ◽  
Lígia Carreira

OBJECTIVEDescribing how Kaingang seniors and their primary caregivers experience access to public health services.METHODA qualitative study guided by ethnography, conducted with 28 elderly and 19 caregivers. Data were collected between November 2010 and February 2013 through interviews and participative observation analyzed by ethnography.RESULTSThe study revealed the benefits and difficulties of the elderly access to health services, the facility to obtain health care resources such as appointments, medications and routine procedures, and the difficulties such as special assistance service problems and delays in the dispatching process between reference services.CONCLUSIONThe importance of knowing and understanding the cultural specificities of the group in order to offer greater opportunities for the elderly access to health services was reinforced.


2021 ◽  
Author(s):  
George William Lutwama ◽  
Maryse Kok ◽  
Eelco Jacobs

Abstract Background: Community health workers (CHWs) are crucial for increasing access to health services to communities. Due to decades of conflict and under-funding, access to health care in South Sudan remains severely limited. To improve equitable access to healthcare, the government has introduced “the Boma Health Initiative (BHI)”, a strategy to harmonise community health programmes across the country. In order to scale up the BHI, it is necessary to assess the recent CHW programmes and draw lessons for future implementation. This study aimed to explore the characteristics, barriers, and facilitators to the implementation of CHW interventions in South Sudan between 2011 and 2019.Methods: The study used a qualitative approach drawing from 26 key informant interviews and a scoping review of 21 Health Pooled Fund (HPF) programme reports from October 2016 to June 2018 and policy documents from 2011 to 2019. The results were thematically analysed based on a conceptual framework on factors influencing the performance of CHWs.Results: Funding of CHW programmes has come from international donors, channelled through non-governmental organisations (NGOs) that have implemented a variety of CHW programmes. Communities have been participating in the selection of voluntary CHWs, intervention areas, and occasionally in the supervision of activities performed by CHWs. The coordination mechanisms among stakeholders have been weak, leading to wastage and duplication of resources. Although training of CHWs is done, training duration was short, and refresher-trainings were rare. There were and still are disparities in the type of incentives provided to CHWs. Monitoring and supportive supervision activities have been insufficient; drug misuse and stock-outs were common. Conclusion: Despite their challenges, CHW programmes can be implemented in conflict-affected South Sudan if the local human capital is leveraged and engaged by NGOs as implementing partners. Robust coordination efforts are required to build synergies among stakeholders for the effective implementation of the BHI strategy.


2020 ◽  
Vol 5 (1) ◽  
pp. 119
Author(s):  
Fairus Dwi Putri ◽  
Khaerul Umam Noer

This paper focuses on the lives of women scavengers heads of households and how the state guarantees the fulfillment of the right to health. Women are relatively more vulnerable to various risks related to their life cycle and role in the family; thus, their access to health insurance is an obligation that must be met by the government. This paper has two objectives: to map social life and, at the same time, analyze the accessibility of the Healthy Indonesia National Health Insurance Card for female head of household scavengers in TPA Cipayung, Depok City. Using qualitative methods, and focusing on five dimensions of accessibility: availability, accessibility, accommodation, affordability, and acceptance, this study found that all health insurance arrangements are still very problematic. Even though these women scavengers are protected by JKN-KIS PBI, in reality, they are still challenging to get access to health services, ranging from the availability of doctors, the scarcity of drugs, to the discrimination of health services. This shows that they have not yet received full health insurance, which has a direct impact on the social and economic lives of the scavengers.


2020 ◽  
pp. e1-e6
Author(s):  
Mark A. Hall ◽  
Lilli Mann-Jackson ◽  
Scott D. Rhodes

States have enacted a wave of statutes over the past several years preempting local government law and policies that potentially promote public health in various ways. Among these local preemption measures are statutes in at least 9 states that outlaw municipal policies providing some form of “sanctuary” to immigrants. Such policies, and their preemption, have importance both for direct access to health services and for broader social determinants of health. This article gauges the coverage and potential impact of these state preemption laws based on key informant interviews nationally and a close legal analysis of relevant laws and policy documents. It distinguishes between preemption laws focused on law enforcement cooperation and those that also encompass a wider array of “welcoming” policies and initiatives. It also distinguishes between more passive forms of preemption that prohibit barring cooperation with federal immigration enforcement, and those statutes that more affirmatively require active measures to assist federal enforcement. Drawing these distinctions can help municipalities determine which immigrant-supportive measures are still permitted, and how best to mitigate the adverse public health effects of these preemption laws. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e6. doi: https://doi.org/10.2105/AJPH.2020.306018 )


Author(s):  
Veneta Krasteva

The article examines the consequences of prolonged unemployment experienced in the beginning of the career in Bulgaria from a subjective point of view. The analysis is based on information obtained from in-depth interviews with people from three age groups who have entered the labor market in periods with high levels of unemployment. The negative consequences pointed out by the interviewed people include material deprivation, limited access to health services, low self-esteem, interruption of social contacts, postponement of creating a family and living in a home of one’s own, loss of hope for a better future. Along with the negative consequences, some positive ones were also identified, such as strengthening family ties, people’s enhanced motivation to deal with the arising difficulties and their striving for personal development.


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