Mónica Ruoti

Atención Primaria en Salud en Paraguay: panorámica y perspectiva

This paper presents an overview of Primary Health Care (PHC) in Paraguay, as part of a multicentric study, seeking to identify the possibilities of PHC as a factor for reorganizing the health system. The methodology adopts the comprehensive PHC concept, and takes into consideration the systems segmentation, formed by the public sector of the Ministry of Health and Welfare, Social Security, a not-for-profit private sector, a private for-profit sector and a mixed sector. The study analyzes 5 dimensions: stewardship, financing, resources, integration/continuity, intersectorality/participation, through reviewing data from the literature and official documents, and key informant interviews (experts, decision-makers, professionals and civil society). Advances in health policy legislation since the 1990, with gratuity for all age groups, have been observed. Public spending on health is among the lowest in Latin America. PHC is provided through different vertical programs, with poor coordination and articulation, though a recent political shift prioritizes the progressive implementation of Family Health teams. In conclusion, PHC can contribute to improve health, equity and participation.

Evaluación de la Atención Primaria de Salud en un contexto urbano: percepción de actores involucrados - Bañado Sur - Paraguay, 2011

En Paraguay, desde 2008 se procesa la reforma de la Atencion Primaria de Salud, buscando reducir inequidades. Con el objetivo de conocer el rol de la Atencion Primaria de Salud en la reordenacion del sistema de salud, se utilizo la herramienta Primary Care Assessment Tool para estudiar los Equipos de Salud Familiar en Asuncion. Fueron entrevistados 360 usuarios y 36 profesionales. Los resultados cubren las dimensiones acceso, puerta de entrada, vinculo, integralidad, coordinacion, enfoque familiar, orientacion a la comunidad, y formacion profesional. Se observa que usuarios y profesionales tienen percepciones diferentes, pero convergen que el acceso es un punto debil y la formacion profesional uno fuerte. Se concluye que hay una importante inversion en la Atencion Primaria de Salud, pero la poblacion aun no se esta apropiando de toda su potencialidad.

Knowledge, attitudes, and practices regarding the leishmaniases among inhabitants from a Paraguayan district in the border area between Argentina, Brazil, and Paraguay

AbstractAimsLeishmaniasis is caused by parasites of the genus Leishmania sp. that differ in their geographical distribution, hosts, and vectors. Knowledge, attitudes, and practices (KAP) of the population are important to understand their relation to the disease. The aim of this study was to characterize KAP with regard to the leishmaniases in inhabitants of the triple border area Argentina–Brazil–Paraguay in specific neighborhoods where infected dogs were found and phlebotomine were captured, identifying a transmission focus.MethodsThis is an observational, descriptive design based on a quantitative transversal survey. Sixty-two surveys were applied in homes located in areas at risk. Surveys were carried out in households in the San Francisco and Santa Rosa neighborhoods where the presence of infected reservoirs (dogs) was confirmed and Lu. longipalpis had been previously identified and captured.ResultsSeventy-one percent of respondents stated that they had heard about the disease. Knowledge about types, mode of transmission, and symptoms of the disease was rare. Attitudes and practices were closely related to pet dogs, and confusion between human and canine cases was noticed. There was a major flaw in the public services responsible for the transfer of knowledge to the population.ConclusionThese results suggest the necessity of conducting an educational intervention in these vulnerable populations, to improve conditions for prevention and control of leishmaniasis in the triple border where the flux of people is very intense and the chances of outbreaks are currently very high. Graphical abstractᅟ

Población escolarizada de estudiantes con intento de suicidio

Depression is the leading cause of morbidity and disability among adolescents and suicide is the third cause of death in the world. To describe characteristics of a population of school adolescents with suicide attempt. Cross-sectional descriptive and retrospective study with probabilistic sampling. Data base of adolescents from 56 public and private schools. Three-staged probabilistic sampling. A self-administered structured and anonymous questionnaire was applied with previous authorization. To know their level of satisfaction with aspects of their lives, the Plan of Action on Health and Development of Adolescents and Youth in the Americas of WHO/PAHO was used. The information was loaded in Excel and analyzed by SPSS. Total population (661), 16.6% (110) stated that they tried to kill themselves, 46.4% (51) were men and 53.6% (59) women. 20.2% (22) of the students were between 12 and 14 years old, 61.7% (68) between 15 and 17, 17.2% (19) were 18 years old or more. 59.1% (54) were in Middle School and 50% (55) in High School. 51.8% (68) were in public schools and 30.9% (34) in private ones. 67.3% (74) lived with their parents, 23.6% (26) worked at the time of the study and 39.1% (43) had a relative with suicide attempt. 11.8% (13) referred that they suffered sexual abuse 38.2% (42) the first time they were asked and 38.2% when the question was repeated. 19.1% (21) ever consulted for emotional problems. There’s a significant correlation between having suffered sexual abuse and suicide attempt (p=0,000). Severe situations of mental health disorders were evidenced without being detected institutionally as an opportunity to intervene and avoid adolescent deaths.