Revista Panamericana De Salud Publica-pan American Journal of Public Health最新文献

{"title":"The Global Matrix of Physical Activity in Children and Adolescents in Latin America: trends, successes and challenges in practice and surveillance.","authors":"Bruno Bizzozero-Peroni, Mark S Tremblay, Salomé Aubert, Silvia A González, Diego Augusto Santos Silva, Juan López-Taylor, Pablo Lobo, Gabriela De Roia, Olga L Sarmiento, Nicolas Aguilar-Farias, Susana Andrade Tenesaca, Karla I Galaviz, Javier Brazo-Sayavera","doi":"10.26633/RPSP.2025.87","DOIUrl":"10.26633/RPSP.2025.87","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize the grades of physical activity (PA) indicators for children and adolescents (5-17 years) in Latin American countries; explore the social determinants of health (SDoH) for PA indicators; and identify strengths, weaknesses, opportunities, and threats to improve PA levels.</p><p><strong>Method: </strong>Participating Latin American countries graded a set of common PA indicators following the harmonized methodology established by the Global Matrix initiative. Cross-sectional (2014, 2016, 2018, 2022) and time trend (2018-2022) data were synthesized within and between countries for each PA indicator. PA data were also synthesized according to their SDoH. Report card team leaders completed a questionnaire to identify strengths, weaknesses, opportunities, and threats (SWOT) to improve PA grades.</p><p><strong>Results: </strong>Eight Latin American countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Uruguay, and Venezuela) participated in at least one of the four editions of the Global Matrix initiative. Across all PA indicator grades in the region (<i>n</i> = 193), 35.2% received a \"D\" (20%-39% success rate), the most frequent grade. Incomplete information was reported in 27.5% of the indicators. A 9.3% improvement was observed in the regional average score of all PA indicators analyzed over time. While source-of-influence indicators improved by 28.1%, behavioral indicators declined by 6.2%. The need for further analyses disaggregated by SDoH, such as sex, was identified.</p><p><strong>Conclusion: </strong>Latin American countries reported poor grades on PA indicators for children and adolescents. Contrasted progress was observed between the behavioral and source of influence indicator groups. Improved surveillance systems and greater country-level investment in PA data collection are urgently needed to enhance comparability and guide regional action.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e87"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who are the women having non-institutional deliveries in Brazil and who attends them? An analysis of 13.7 million births, 2018-2022.","authors":"Larissa Adna Neves Silva, Cauane Blumenberg, Aluísio J D Barros","doi":"10.26633/RPSP.2025.86","DOIUrl":"10.26633/RPSP.2025.86","url":null,"abstract":"<p><strong>Objective: </strong>To identify groups of women in Brazil more likely to have deliveries outside health facilities and the types of professionals attending these deliveries, and to assess related social determinants.</p><p><strong>Methods: </strong>Data from Brazil's Live Birth Information System from 2018 to 2022 were used to investigate non-institutional deliveries by region of residence, ethnicity/skin color, schooling, and maternal age at delivery. Associations between these factors were also assessed. The proportion of births attended by doctors, nurses/midwives, traditional birth attendants, and others was also analyzed, comparing institutional and non-institutional deliveries.</p><p><strong>Results: </strong>The overall prevalence of non-institutional deliveries was 1.0%. Higher proportions were observed in the North region (4.0%), and among Indigenous women (26.3%), adolescent mothers (1.4%), and women with fewer than 4 years of schooling (8.3%). The proportion of non-institutional deliveries was 67.6% among, Indigenous women from the North region with little education. Indigenous women with fewer than 4 years of schooling and who had a non-institutional delivery had the highest proportion of deliveries without a qualified professional (95.2%).</p><p><strong>Conclusions: </strong>Cultural norms and barriers to accessing maternity services, combined with broader social inequalities and organizational challenges faced by Indigenous populations, may contribute to the high proportion of non-institutional deliveries without a skilled attendant observed among these women. Culturally sensitive strategies to expand access to maternity care for and empower Indigenous women are crucial to ensure their and their children's survival.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e86"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Trans fatty acids in nutrition labeling and ingredient listing of prepackaged products in Costa Rica, 2022Ácidos graxos <i>trans</i> na rotulagem nutricional e na lista de ingredientes de produtos pré-embalados na Costa Rica, 2022].","authors":"Hilda Patricia Núñez-Rivas, Marlene Roselló-Araya, Adriana Blanco-Metzler, Luis Ernesto Galicia-Cano, Jorge Ernesto Victoria-Restrepo, Víctor Eduardo Villalobos-Daniel, Fabio da Silva Gomes","doi":"10.26633/RPSP.2025.72","DOIUrl":"10.26633/RPSP.2025.72","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the content of industrially produced trans fatty acids stated in the nutrition labeling and ingredients list of prepackaged products marketed in Costa Rica.</p><p><strong>Methods: </strong>Descriptive, cross-sectional study analyzing the presence and content of industrially produced trans fatty acids stated in the nutritional labeling and ingredients list of 7,402 prepackaged foods in two supermarket chains in Costa Rica. The analysis was based on the current policy of the Pan American Health Organization (PAHO) on this subject.</p><p><strong>Results: </strong>Of the 7,402 prepackaged products studied, 40.8% made a statement on industrially produced trans fatty acids. Of these, 95.5% declared 0 grams and the rest stated more than 0 and less than 8 grams per 100 grams of product. Most of the collected products that reported fatty acids contained an excessive amount of energy, according to the PAHO nutrient profiling model. Forty-nine percent of the products exceeded 2 grams of industrially produced trans fats per 100 grams of total fat; less than 0.7% (n = 52) reported hydrogenated fatty acids; 0.4% (n = 29) reported partially hydrogenated oils; and only one product reported both.</p><p><strong>Conclusions: </strong>The presence of trans fatty acids persists in a considerable proportion of marketed products, especially in cakes, cookies, and breads. Nutrition labeling should be mandatory in Costa Rica and regulations should be established to prohibit the presence of hydrogenated and partially hydrogenated fatty acids in industrialized products.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e72"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-informed policy for monitoring SDG 3 in the Legal Amazon region: A rapid review.","authors":"Renata Cristina Ferreira Rola, Livia Fernandes Probst, Tereza Setsuko Toma, Jorge Otávio Maia Barreto","doi":"10.26633/RPSP.2025.88","DOIUrl":"10.26633/RPSP.2025.88","url":null,"abstract":"<p><strong>Objective: </strong>To systematically identify and critically assess indicators used globally and in Brazil to monitor health outcomes related to Sustainable Development Goal (SDG) 3, with an emphasis on identifying those most suitable for the Legal Amazon region.</p><p><strong>Methods: </strong>This rapid review examined global initiatives to achieve SDG 3 and their applicability to the Legal Amazon. Systematic reviews and overviews were included, with no language restrictions, considering studies published from 2015 onwards. Searches were conducted across several databases using both controlled vocabulary and free-text terms. Study selection, data extraction, and quality assessment followed standardized procedures, with independent reviewers ensuring rigor and resolving discrepancies through consensus.</p><p><strong>Results: </strong>The identified indicators covered health coverage, quality of care, environmental health, epidemiology, financial aspects, and governance, although none provided calculation formulas. Studies highlighted positive impacts of health service integration and conditional cash transfer programs, improving treatment adherence, disease detection, and child health outcomes. None of the included articles described specific indicators tailored to the Amazon region.</p><p><strong>Conclusions: </strong>The Legal Amazon faces challenges such as limited healthcare access and threats from deforestation and illegal mining. This review found no systematic reviews addressing these needs, making the findings suggestive rather than definitive. Despite this gap, preliminary efforts made it possible to propose indicators tailored to the region, covering areas such as Indigenous health, environmental risks, and healthcare accessibility. These indicators require validation by regional stakeholders to ensure their relevance and effectiveness in policy development.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e88"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Health system and hospital utilization in Chile, 1952-2020: trends, reforms, and inflection pointsSistema de saúde e utilização de serviços hospitalares no Chile, 1952-2020: tendências, reformas e pontos de inflexão].","authors":"Mauricio Matus-López","doi":"10.26633/RPSP.2025.84","DOIUrl":"10.26633/RPSP.2025.84","url":null,"abstract":"<p><strong>Objective: </strong>To collect and analyze longitudinal data on hospital discharges in Chile between 1952 and 2020, both at the national level and within the public subsystem. Patterns of change were identified in relation to the following key institutional milestones: the Curative Medicine Act of 1968, the creation of the National Health Services System in 1979, and the implementation of the Universal and Guaranteed Access Reform in 2005.</p><p><strong>Methods: </strong>A first-of-its-kind time series was constructed using official sources from the Ministry of Health and institutional documents. Indicators were calculated for the total number of discharges, discharge rates per thousand population, and comparisons with the United States. The analysis included exploratory graphics and construction of segmented regression models.</p><p><strong>Results: </strong>Hospital discharges rose steadily, with two periods mirroring robust expansion of the private sector: between 1982 and 1987 and between 2006 and 2019. Public provision of hospital services slowed or decreased with the 1979 reform and with the 2005 reform, although not with the 1968 reform.</p><p><strong>Conclusion: </strong>This study provides empirical evidence on the long-term trajectory of Chilean hospital services and confirms a structural contrast between the country's major health system models and the differences in their reforms. It also underscores the need for long-term information to analyze the impact of health reforms.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e84"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital transformation of mortality reporting using an ICD-11 integrated death certificate system in Suriname.","authors":"Jerry Toelsie, Richard Mendes, Ritesh Dhanpat, Radjesh Ori, Rosmond Adams, Coen van Gool, Carine Alsokhn, Katri Kontio, Yafflo Ouattara","doi":"10.26633/RPSP.2025.85","DOIUrl":"10.26633/RPSP.2025.85","url":null,"abstract":"<p><p>The Ministry of Health of Suriname has replaced the outdated 1958 paper-based death certificate with an adapted digital version based on the World Health Organization international form of Medical Certificate of Cause of Death, integrated with the International Classification of Diseases 11th Revision (ICD-11) coding tool. This digital system, which comprises a mobile application and a web-based platform, enables direct selection of diagnoses using the ICD-11 codes, including post-coordination (code combinations) and the use of extension codes. Acting as a centralized hub, it allows the Ministry of Health to efficiently extract and analyze mortality data. Training programs have been provided for all medical doctors to ensure effective adoption. This initiative aligns with the Pan American Health Organization's Information Systems for Health 2024-2030 strategy, which emphasizes digital transformation to strengthen health systems in the Americas. It also reflects Suriname's commitment to the 2019 World Health Assembly resolution to adopt ICD-11 as the global standard for cause-of-death reporting. By improving data quality, flow, and accessibility, the system supports timely reporting and reduces workload. Furthermore, it addresses a critical gap, as limited published research exists on the implementation of electronic Medical Certificate of Cause of Death (eMCCD) in the Americas. The system will undergo evaluation after one year to assess its impact and guide further improvements.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e85"},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[ReAnímate: a pilot study to teach cardiopulmonary resuscitation and choking first aid to schoolchildrenReAnímate: estudo-piloto para o ensino de reanimação cardiopulmonar e desobstrução das vias aéreas para escolares].","authors":"Antonieta Valderrama, Arturo Zumaeta, Valeria Epulef, María Francisca Elgueta, Macarena Monsalve, Paulo Carrasco, Macarena Ávila","doi":"10.26633/RPSP.2025.81","DOIUrl":"10.26633/RPSP.2025.81","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate a pilot program designed to teach cardiopulmonary resuscitation (CPR) to schoolchildren in Chile.</p><p><strong>Materials and methods: </strong>An educational pilot program consisting of a workshop for seventh-graders, including pre-workshop and post-workshop evaluations, was implemented in five public schools in the Metropolitana and Magallanes regions of Chile.</p><p><strong>Results: </strong>A total of 379 seventh-graders enrolled in the first 19 months of the pilot program and who consented to data analysis were included. In the pre-workshop evaluation, only 58.7% knew the right number to call for an ambulance; this increased to 99.5% at the end of the workshop. In the initial evaluation, 58.7% stated that chest compressions should be initiated in an unresponsive person who is not breathing normally, and only 14.8% stated that the proper rate of chest compressions for CPR is 100 to 120 per minute. After the workshop, these percentages increased to 77.6% and 76.5%, respectively. Overall, 98% of participants reported that they had found the workshop useful, and 97% said they had enjoyed participating. After the workshop, 87% stated that they would intervene if faced with one of these emergencies. In a survey of parents or guardians, 93% stated that CPR classes should be mandatory in schools.</p><p><strong>Conclusions: </strong>The structured plan pilot-tested in this study can be used to teach resuscitation to schoolchildren in Chile, with good theoretical results and excellent feedback from participants.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e81"},"PeriodicalIF":2.2,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess mortality associated with extreme heat in Rio de Janeiro, Brazil, 2023.","authors":"Rita Daniela Fernandez-Medina, Eduardo Mesquita Peixoto, Denis Rodrigues, Rodrigo Said, Cleonice Andrade Holanda, Cristina da Silva Freire, Aline Maria de Almeida, Silvia Cristina de Carvalho Cardoso, Mário Sergio Ribeiro, Claudia Maria Braga de Mello, Alex Rosewell, Luciane Velasque","doi":"10.26633/RPSP.2025.76","DOIUrl":"10.26633/RPSP.2025.76","url":null,"abstract":"<p><strong>Objective: </strong>To determine the excess mortality associated with the November 2023 extreme heat wave in Rio de Janeiro, Brazil, with temperatures reaching 42°C.</p><p><strong>Methods: </strong>Using the excess heat factor (EHF) to characterize the heat wave, this study identified elevated excess mortality across various disease categories, including symptoms and abnormal clinical findings, nervous system disorders, mental health conditions, and genitourinary diseases, diverging from typical heat-related mortality patterns.</p><p><strong>Results: </strong>This event resulted in an estimated excess mortality of 1 392 individuals in a short period, disproportionately affecting older adults and women, with a significant number of deaths occurring at home. The findings underscore the complexity of heat wave impacts and highlight gaps in health care access, risk perception, and clinical management.</p><p><strong>Conclusions: </strong>Heat waves are increasingly recognized as a significant public health threat, exacerbated by climate change, with profound impacts on morbidity and mortality. The study emphasizes the urgent need for comprehensive heat alert and response systems, intersectoral action plans, and public education to mitigate the effects of extreme heat. Furthermore, it calls for adaptive strategies in urban planning, housing, and public health policies to address the growing frequency and intensity of heat waves in the context of climate change. As Brazil faces escalating challenges from rising temperatures, particularly in urban centers, coordinated multisectoral efforts are essential to protect vulnerable populations and reduce heat-related mortality in the future.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e76"},"PeriodicalIF":2.2,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Energy and sodium content of foods reported in the National Household Income and Expenditure Survey 2018-2019, Costa Rica, according to the NOVA classificationAporte energético e teor de sódio dos alimentos informados na Pesquisa Nacional de Renda e Despesa Domiciliar 2018-2019 da Costa Rica, de acordo a classificação NOVA.]","authors":"Marlene Roselló-Araya, Hilda P Núñez-Rivas, Adriana Blanco-Metzler, Luis Galicia Cano, Rafael Claro, Jorge Ernesto Victoria-Restrepo, Víctor Eduardo Villalobos-Daniel, Fabio Da Silva Gomes","doi":"10.26633/RPSP.2025.73","DOIUrl":"10.26633/RPSP.2025.73","url":null,"abstract":"<p><strong>Objective: </strong>To describe the energy and sodium content of foods reported in the 2018-2019 National Household Income and Expenditure Survey of Costa Rica, classified using the NOVA system, by urban/rural residence and income quintiles.</p><p><strong>Methods: </strong>Descriptive study in which records of food purchases from the 2018-2019 National Household Income and Expenditure Survey were converted to energy and sodium content by means of food composition tables. Foods were classified into the four NOVA groups and analyzed according to urban/rural residence and income quintiles.</p><p><strong>Results: </strong>Of the 737 foods analyzed, 52% were processed or ultra-processed (14% in group 3 and 38% in group 4). The remaining 48% corresponded to unprocessed or minimally processed foods and processed culinary ingredients (groups 1 and 2). Of the total energy consumed (2 302 kcal per person per day [kcal/p/d]), approximately 26% came from groups 3 and 4. Overall energy consumption was higher in urban areas (2252 kcal/p/d versus 2422 kcal/p/d in rural areas). Group 4 food consumption was higher in urban areas (21.3% versus 14.0%, respectively). Group 2 contributed 2.53 g/p/d of sodium, followed by group 4 with 0.84 g/p/d.</p><p><strong>Conclusions: </strong>Processed culinary ingredients and ultra-processed foods are the main sources of dietary sodium in Costa Rica, indicating the need for public policies to prevent chronic noncommunicable diseases associated with excessive sodium consumption. The pattern of energy consumption in Costa Rica is stable, the main source being unprocessed and minimally processed foods, led by cereals, grains, and pastas. However, processed and ultra-processed foods contribute at least a quarter of caloric intake.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e73"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Social protection strategies for people with tuberculosis in Latin America: (re)thinking policies and practicesEstrategias de protección social para las personas con tuberculosis en América Latina: (re)pensar las políticas y las prácticas].","authors":"Gabriel Pavinati, Lucas Vinícius de Lima, Kleydson Bonfim Andrade Alves, Miguel Angel Aragón López, Gabriela Tavares Magnabosco","doi":"10.26633/RPSP.2025.78","DOIUrl":"10.26633/RPSP.2025.78","url":null,"abstract":"<p><p>This study critically analyzes the effects of social protection policies on tuberculosis treatment and discusses perspectives for the implementation of comprehensive, sustainable care in Latin America. Based on the theory of social determinants of health, this article offers theory and reflection on the effects of social inequalities on adherence to treatment, showing that financial support, food security, and access to transportation are fundamental elements in reducing the impact of the disease on individuals and communities. In addition, the worsening of tuberculosis control indicators due to the COVID-19 pandemic is contextualized, highlighting the interruption of essential services, increased underreporting, and compromised treatment coverage. Latin American countries show progress in the implementation of social protection programs, but structural challenges such as poor intersectoral integration, unstable funding for public policies, and bureaucratic barriers to implementation limit their effectiveness in controlling tuberculosis. Furthermore, dependence on external government resources sometimes reveals the fragility of policies in contexts of political and economic instability. It follows that social protection must be a key pillar in the response to tuberculosis in Latin America, through permanent, intersectoral, sustainable actions. This proposal could help to support the goals of the End TB Strategy and those of the 2030 Agenda for Sustainable Development. The elimination of tuberculosis in the region depends on strengthening primary care, political and social commitment, and the adoption of strategies aligned with global targets for equity and sustainable development.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e78"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}