Ximena Sanchez

The motherhood experience in the context of social vulnerability: A comprehensive approach to social phenomenology

Articulo parte de la disertacion de maestria “Vivencia de una madre e hijo en situacion de vulnerabilidad. Un abordaje Fenomenologico Social” presentada a Facultad de Enfermeria, Universidad Andres Bello, Santiago, Chile. Apoyo financiero de la Universidad Andres Bello, Vicerrectoria de Investigacion y Doctorado, proceso no DI-21-10/R.

Effectiveness of the Comprehensive Childhood Protection System for vulnerable mothers and children

OBJETIVO: estabelecer a efetividade da oferta publica de beneficios e/ou de prestacoes do Programa Chile Cresce Contigo e a Rede Protege, em criancas e mulheres socialmente vulneraveis de um bairro da Regiao Metropolitana do Chile. METODO: estudo descritivo, com a utilizacao de um questionario. A amostra foi constituida por 132 maes de 133 criancas e estratificada segundo grupos de vulnerabilidade social. A informacao primaria foi coletada atraves de uma entrevista estruturada as maes e complementada com dados das fontes secundarias institucionais. Realizaram-se analises descritiva e de associacao. RESULTADOS: houve baixa percepcao de vulnerabilidade social pelos profissionais quando do ingresso do controle. A efetividade dos beneficios universais e especificos foi baixa, com melhores resultados nas criancas e nas maes, contudo, nao foram observadas diferencas significativas, segundo a vulnerabilidade. Outro resultado foi o baixo acesso aos beneficios especificos nas criancas com risco psicossocial e atraso psicomotor, especialmente no grupo mais vulneravel. CONCLUSAO: os resultados mostram uma lacuna no acesso aos beneficios garantidos por lei. Para superar essa situacao, as enfermeiras/os necessitam fortalecer competencias nas praticas sanitarias contextualizadas e de gestao integrada nas redes interdisciplinares e intersetoriais.

Efectividad del Sistema de Proteccion Integral de la Infancia en madres y ninos vulnerables

OBJETIVO: estabelecer a efetividade da oferta publica de beneficios e/ou de prestacoes do Programa Chile Cresce Contigo e a Rede Protege, em criancas e mulheres socialmente vulneraveis de um bairro da Regiao Metropolitana do Chile. METODO: estudo descritivo, com a utilizacao de um questionario. A amostra foi constituida por 132 maes de 133 criancas e estratificada segundo grupos de vulnerabilidade social. A informacao primaria foi coletada atraves de uma entrevista estruturada as maes e complementada com dados das fontes secundarias institucionais. Realizaram-se analises descritiva e de associacao. RESULTADOS: houve baixa percepcao de vulnerabilidade social pelos profissionais quando do ingresso do controle. A efetividade dos beneficios universais e especificos foi baixa, com melhores resultados nas criancas e nas maes, contudo, nao foram observadas diferencas significativas, segundo a vulnerabilidade. Outro resultado foi o baixo acesso aos beneficios especificos nas criancas com risco psicossocial e atraso psicomotor, especialmente no grupo mais vulneravel. CONCLUSAO: os resultados mostram uma lacuna no acesso aos beneficios garantidos por lei. Para superar essa situacao, as enfermeiras/os necessitam fortalecer competencias nas praticas sanitarias contextualizadas e de gestao integrada nas redes interdisciplinares e intersetoriais.

Vivenciando la maternidad en contextos de vulnerabilidad social: un enfoque comprensivo de la fenomenología social

Articulo parte de la disertacion de maestria “Vivencia de una madre e hijo en situacion de vulnerabilidad. Un abordaje Fenomenologico Social” presentada a Facultad de Enfermeria, Universidad Andres Bello, Santiago, Chile. Apoyo financiero de la Universidad Andres Bello, Vicerrectoria de Investigacion y Doctorado, proceso no DI-21-10/R.

In)visibilidade da vulnerabilidade social e do direito ao cuidado integral da saúde no Chile

Objetivo: estimar a magnitude da percepcao da invisibilidade da vulnerabilidade social e suas consequencias no acesso aos servicos universais e especificos do Sistema de Protecao Integral a Infância no Chile. Metodo: estudo transversal em 50 diades vulneraveis, registrados em um centro de saude familiar (Regiao Metropolitana, Chile; 2012). Depois do consentimento informado, as maes foram entrevistadas usando um questionario estruturado. Um modelo de analise de correspondencia foi aplicado. Resultados: a invisibilidade da vulnerabilidade social foi estimada para maes (92.0%) e filhos (86.0%), observando-se um melhor acesso aos servicos universais pelas criancas e aos especificos pelas maes. Conclusao: a invisibilidade da vulnerabilidade limita as oportunidades de protecao social a grupos em desvantagem. Consequentemente, a politica publica nao corrige as desigualdades sociais, que merecem a atencao dos gestores da saude publica chilena.Objective: To estimate the magnitude of perception of invisibility of social vulnerability and its impact on the access to universal and specific services of the Comprehensive Childhood Protection System in Chile. Method: Cross-sectional study in 50 vulnerable dyads, who were registered in a family health care center (Metropolitan Region, Chile; 2012). After the informed consent, mothers were interviewed using a structured questionnaire. A correspondence analysis model was applied. Results: The invisibility of social vulnerability estimated for mothers (92.0%) and children (86.0%), and a better access was observed to universal services by children and to specific services by mothers. Conclusion: The invisibility of vulnerability limits the opportunities of social protection for disadvantaged groups. Therefore, public policy does not correct social inequalities, which deserve attention by the public health managers in Chile. DESCRIPTORS: Social vulnerability. Public policy. Risk groups. Health inequalities. Comprehensive health care. http://dx.doi.org/10.1590/0104-07072016006150015Objetivo: estimar la magnitud de la percepcion de la in-visibilidad de la vulnerabilidad social y sus consecuencias en el acceso a servicios universales y especificos del Sistema de Proteccion Integral de la Infancia en Chile. Metodo: estudio transversal en 50 diadas vulnerables, registradas en un centro de salud familiar (Region Metropolitana, Chile; 2012). Despues de la firma de consentimiento informado, las madres fueran entrevistadas usando un cuestionario estructurado. Se aplico un modelo de analisis de correspondencias. Resultados: la in-visibilidad de la vulnerabilidad social fue estimada para madres (92.0%) y hijos (86.0%), observandose un mejor acceso a los servicios universales a los infantes y especificos a las madres. Conclusion: la in-visibilidad de la vulnerabilidad limita las oportunidades de proteccion social a grupos desventajados. Como consecuencia, la politica publica no corrige las desigualdades sociales, que merecen atencion de los gestores de la salud publica chilena.

Social protection systems in vulnerable families: their importance for the public health

OBJECTIVE To analyze the effectiveness of the Chilean System of Childhood Welfare in transferring benefits to socially vulnerable families. METHODS A cross-sectional study with a sample of 132 families from the Metropolitan Region, Chile, stratified according to degree of social vulnerability, between September 2011 and January 2012. Semi-structured interviews were conducted with mothers of the studied families in public health facilities or their households. The variables studied were family structure, psychosocial risk in the family context and integrated benefits from the welfare system in families that fulfill the necessary requirements for transfer of benefits. Descriptive statistics to measure location and dispersion were calculated. A binary logistic regression, which accounts for the sample size of the study, was carried out. RESULTS The groups were homogenous regarding family size, the presence of biological father in the household, the number of relatives living in the same dwelling, income generation capacity and the rate of dependency and psychosocial risk (p ≥ 0.05). The transfer of benefits was low in all three groups of the sample (≤ 23.0%). The benefit with the best coverage in the system was the Single Family Subsidy, whose transfer was associated with the size of the family, the presence of relatives in the dwelling, the absence of the father in the household, a high rate of dependency and a high income generation capacity (p ≤ 0.10). CONCLUSIONS The effectiveness of benefit transfer was poor, especially in families that were extremely socially vulnerable. Further explanatory studies of benefit transfers to the vulnerable population, of differing intensity and duration, are required in order to reduce health disparities and inequalities.

Vivenciando a maternidade em contextos de vulnerabilidade social: uma abordagem compreensiva da fenomenologia social

Articulo parte de la disertacion de maestria “Vivencia de una madre e hijo en situacion de vulnerabilidad. Un abordaje Fenomenologico Social” presentada a Facultad de Enfermeria, Universidad Andres Bello, Santiago, Chile. Apoyo financiero de la Universidad Andres Bello, Vicerrectoria de Investigacion y Doctorado, proceso no DI-21-10/R.

Motherhood inmigrant women in chile: a qualitative study

BACKGROUND The adverse impact of poverty and migration in pregnant women is expressed in diverse results in reproductive, mental and child health, all of which are related to lack of documentation to reside in the country, absence of health insurance and no economic resources to pay private services, or either not understanding the administrative procedures. OBJECTIVE To understand the experience of immigrant women in the process of motherhood and rearing infants under 6 months, in the context of social vulnerability in an urban area of Santiago de Chile. DESIGN Qualitative research design, with descriptive analysis data and interpretation gradually given to explicity the findings relevant the study with women from a healthcare center in the urban region of Chile. PARTICIPANTS The sample was deliberate by criterion, the participants were thirteen immigrant women between the ages of 18 and 40 years old. Guided open-ended interview were performed after providing informed consent. In the analysis of information, the following criteria was applied: credibility, authenticity, possibility of confirmation, dependence and transferability. FINDINGS From immigrants women discourses, difficulties to access the health system could be observed, due to institutional and structural barriers that represented a limitation for social and cultural integration. In addition, feelings of mistrust, tension and insecurity about reaching for healthcare and social support for them and their family, produces a series of problems for the women and their children. CONCLUSION Immigrant women face cultural and institutional barriers, as well as social and personal adversities that conditions a complex process of social vulnerability to take responsibility for a safe motherhood and rearing. Living the phases of the migration process and an unwanted pregnancy - in most cases - made the women face the challenge of rearing in another country, in economic vulnerability, emotional instability with their partners and with social and cultural barriers with healthcare teams. IMPLICATIONS FOR PRACTICE It is necessary to mention the role of the midwifery and nursing from the point of view of assistance, due to their responsibility in accompanying the child-rearing period for both native and immigrant women for years. It is worth mentioning the theory of culturation, referring to the need for knowledge of the cultural and social structure of an individual, family and community, which provides an integrated, interdisciplinary and cross-cultural approach to care in contexts of vulnerability conditioned by migration.

Capital social de las mujeres mayores usuarias de la red pública de la Atención Primaria de Salud

Social capital is an economical idea that refers to connections between individuals and entities that can be economically valuable. Aim: To establish the relationship of social capital as a health care asset, with sociodemographic variables of older women attending public health care services. Material and Methods: Chen’s Personal Social Capital scale was applied to 113 women aged between 64 and 80 years during 2014. Cronbach’s alpha of the instrument was calculated. Results: The Cronbach’s alpha of the instrument was 0.86. The average score for social capital was 23.9 points of a maximum of 50. Bridging capital scores had the higher disparity, specifically in participation in community organizations and the representation of their interest in them. Bonding capital decreased along with a higher age of interviewed women (r = -0,43, p < 0,01). Higher territorial roots were associated with a lower perception of social community resource availability (r = -0,42, p < 0,01). Conclusions: The social capital scores in these women were low. Their better support networks were close relationships and relatives. The sensation of solitude increased with age

Efetividade do Sistema de Protecao Integral da Infancia em maes e criancas vulneraveis

OBJETIVO: estabelecer a efetividade da oferta publica de beneficios e/ou de prestacoes do Programa Chile Cresce Contigo e a Rede Protege, em criancas e mulheres socialmente vulneraveis de um bairro da Regiao Metropolitana do Chile. METODO: estudo descritivo, com a utilizacao de um questionario. A amostra foi constituida por 132 maes de 133 criancas e estratificada segundo grupos de vulnerabilidade social. A informacao primaria foi coletada atraves de uma entrevista estruturada as maes e complementada com dados das fontes secundarias institucionais. Realizaram-se analises descritiva e de associacao. RESULTADOS: houve baixa percepcao de vulnerabilidade social pelos profissionais quando do ingresso do controle. A efetividade dos beneficios universais e especificos foi baixa, com melhores resultados nas criancas e nas maes, contudo, nao foram observadas diferencas significativas, segundo a vulnerabilidade. Outro resultado foi o baixo acesso aos beneficios especificos nas criancas com risco psicossocial e atraso psicomotor, especialmente no grupo mais vulneravel. CONCLUSAO: os resultados mostram uma lacuna no acesso aos beneficios garantidos por lei. Para superar essa situacao, as enfermeiras/os necessitam fortalecer competencias nas praticas sanitarias contextualizadas e de gestao integrada nas redes interdisciplinares e intersetoriais.