Igor Martín Ramos Herrera

La perspectiva de los sujetos enfermos. Reflexiones sobre pasado, presente y futuro de la experiencia del padecimiento crónico

La experiencia del padecimiento ocupa un papel relevante en el analisis y en las propuestas para incorporar el punto de vista de los sujetos sociales y la subjetividad en el campo de la salud. Este trabajo presenta la perspectiva que hemos adoptado y el proceso seguido en nuestra investigacion sobre la experiencia de vivir con un padecimiento cronico. El mismo se enmarca en la produccion generada en esta linea asi como en una discusion mas amplia sobre salud-enfermedad en Latinoamerica. La experiencia del padecimiento remite a los fenomenos subjetivos y existenciales, o sea fenomenologicos inmersos en los procesos en donde producen y se reproducen los sujetos enfermos. Trayectoria, carrera del padecimiento y manejo del tratamiento son dimensiones que hemos explorado. Tambien presentamos varias lineas para elaborar una agenda de trabajo y destacamos sus implicaciones en funcion de las propuestas existentes en torno a la reforma sanitaria en nuestros paises.

Development of the Health Atlas of Jalisco: A New Web-Based Service for the Ministry of Health and the Community in Mexico

Background Maps have been widely used to provide a visual representation of information of a geographic area. Health atlases are collections of maps related to conditions, infrastructure or services provided. Various countries have put resources towards producing health atlases that support health decision makers to enhance their services to the communities. Latin America, as well as Spain, have produced several atlases of importance such as the interactive mortality atlas of Andalucía, which is very similar to the one that is presented in this paper. In Mexico, the National Institute of Public Health produced the only health atlas found that is of relevance. It was published online in 2003 and is currently still active. Objective The objective of this work is to describe the methods used to develop the Health Atlas of Jalisco (HAJ), and show its characteristics and how it interactively works with the user as a Web-based service. Methods This work has an ecological design in which the analysis units are the 125 municipalities (counties) of the state of Jalisco, Mexico. We created and published online a geographic health atlas displaying a system based on input from official health database of the Health Ministry of Jalisco (HMJ), and some databases from the National Institute of Statistics and Geography (NISGI). The atlas displays 256 different variables as health-direct or health-related indicators. Instant Atlas software was used to generate the online application. The atlas was developed using these procedures: (1) datasheet processing and base maps generation, (2) software arrangements, and (3) website creation. Results The HAJ is a Web-based service that allows users to interact with health and general data, regions, and categories according to their information needs and generates thematic maps (eg, the total population of the state or of a single municipality grouped by age or sex). The atlas is capable of displaying more than 32,000 different maps by combining categories, indicators, municipalities, and regions. Users can select the entire province, one or several municipalities, and the indicator they require. The atlas then generates and displays the requested map. Conclusions This atlas is a Web-based service that interactively allows users to review health indicators such as structure, supplies, processes, and the impact on public health and related sectors in Jalisco, Mexico. One of the main interests is to reduce the number of information requests that the Ministry of Health receives every week from the general public, media reporters, and other government sectors. The atlas will support transparency, information diffusion, health decision-making, and the formulation of new public policies. Furthermore, the research team intends to promote research and education in public health.