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

{"title":"[Evidence Map of Interventions to Reduce Alcohol ConsumptionMapa de la evidencia sobre intervenciones para reducir el consumo de alcohol].","authors":"Paula Aballo Nunes Machado, Gabriela Vasconcellos de Barros Vianna, Luciana Grucci Maya Moreira, Maria Eduarda Leão Diogenes, Fabio Fortunato Brasil de Carvalho, Carmen Verônica Mendes Abdala, Camila Belo Tavares Ferreira, Mayara Rodrigues Batista, Raphael Duarte Chança, Thainá Alves Malhão","doi":"10.26633/RPSP.2024.124","DOIUrl":"https://doi.org/10.26633/RPSP.2024.124","url":null,"abstract":"<p><strong>Objective: </strong>Systematize evidence on the effect of global interventions to reduce the consumption and/or sale of alcoholic beverages.</p><p><strong>Method: </strong>Evidence map based on searches in nine bibliographic databases, including 182 studies of systematic reviews with or without meta-analysis, reviews of interventions, and reviews of reviews. The studies evaluated the effect of interventions grouped into comprehensive sets of actions: communication for behavior change; health-promoting environments; and systemic changes. Two outcomes of interest were considered: reduction in alcohol consumption and reduction in its purchase/sale.</p><p><strong>Results: </strong>A total of 207 associations between different interventions and outcomes were recorded, with emphasis on communication for behavior change (81.64%) and reduction of consumption (98.55%). Most of the associations showed a positive (40.58%), inconclusive (28.99%), or potentially positive (26.57%) effect. The main interventions with positive or potentially positive results were: a government monopoly on the sale of alcoholic beverages, control of the density of points of sale, charging a minimum price per unit, health warnings on alcoholic beverage labels, and multiple integrated interventions.</p><p><strong>Conclusion: </strong>It is hoped that this map will help public policy makers and healthcare professionals adapt experiences to their own contexts, stimulating intersectoral actions to reduce alcohol consumption.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e124"},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626330","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":"[Building Health Capacities Through the HEARTS Initiative in the Dominican RepublicDesenvolvimento de capacidades em saúde por meio da iniciativa HEARTS na República Dominicana].","authors":"Vhania Batista, Yenny Rodríguez, Tomiris Estepan, Andelys De La Rosa","doi":"10.26633/RPSP.2024.110","DOIUrl":"https://doi.org/10.26633/RPSP.2024.110","url":null,"abstract":"<p><p>Continuous education of health teams is essential to ensure outcomes that have a positive impact on community health. In 2019, through an agreement with the Ministry of Public Health and Social Assistance (MISPAS), the Dominican Republic began implementing HEARTS, an initiative of the Pan American Health Organization (PAHO). This aligned MISPAS with global best practices for the prevention and management of hypertension and cardiovascular disease, with a view to reducing mortality rates due to this noncommunicable disease (NCD). Hypertension is the leading cause of cardiovascular disease, which is the NCD responsible for the most deaths worldwide. Medical interns in the Dominican Republic have the enormous task of providing timely diagnosis and treatment for people with high blood pressure and various cardiovascular risk factors. In the country's health system, therefore, it is a priority to train and educate undergraduate students before they become medical interns. The HEARTS initiative has produced a series of high-quality virtual courses that are free of charge and available year-round at PAHO's Virtual Campus for Public Health. Through an agreement with MISPAS, these courses are a unique opportunity for medical schools that are members of the Dominican Association of Medical Schools and Faculties (ADOFEM) to use e-learning as an innovative and powerful tool to train members of healthcare teams.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e110"},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626119","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":"HIV prevalence among cervical (pre)cancer diagnoses in Suriname: a retrospective population study.","authors":"Deborah Stijnberg, Regillio Charles, Mike Mc Kee, Mikel Chan, Antoon Grunberg, Ward Schrooten, Malti Adhin","doi":"10.26633/RPSP.2024.122","DOIUrl":"https://doi.org/10.26633/RPSP.2024.122","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of HIV in women with (pre)cancerous cervical lesions in Suriname and their retention in care.</p><p><strong>Methods: </strong>A retrospective population study including all women diagnosed with (pre)invasive cervical intraepithelial neoplasia (CIN I to III or cervical cancer) in the only pathology department, during 2010-2020. The HIV test coverage and the HIV positivity ratio were determined through matching pathology data with the national HIV test database. The relation between retention in HIV care up to 2022 and different covariates was determined through Kaplan-Meier survival analysis and log-rank tests.</p><p><strong>Results: </strong>There were 2 901 (1 395 CIN I, 396 CIN II, 444 CIN III, and 666 cervical cancer) diagnoses of (pre)invasive cervical neoplasia. An overall HIV test coverage of 57.5% and a positivity ratio of 5.8% were found, with no difference among the (pre)cancer stages. The undiagnosed prevalence (women not previously known HIV-positive at cervical diagnosis) was 1.6% and 2.9% among precancer and cancer diagnoses, respectively. The median time in care of women with cervical cancer was 8 months for those not on antiretroviral therapy (ART) and 4 years for those starting ART. Among women with precancer stages this was 5 and 10 years, respectively (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>HIV testing, followed by treatment initiation when found HIV-positive, should be prioritized in women diagnosed with cervical neoplasia. This will enhance the individual clinical outcomes and facilitate the control of the HIV epidemic in Suriname.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e122"},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626343","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":"Maternal mortality in Panama from 1998 to 2022.","authors":"Yovani Chavez, Tania Herrera","doi":"10.26633/RPSP.2024.114","DOIUrl":"https://doi.org/10.26633/RPSP.2024.114","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine maternal mortality in Panama, analyzing its direct obstetric deaths, indirect obstetric deaths, and contributory conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cohort study used publicly available data from the National Institute of Statistics and Census to present a 25-year retrospective analysis of maternal deaths in the Republic of Panama from 1998 to 2022. Public data were sourced from the National Institute of Statistics and Census website of Panama. Relevant codes from the &lt;i&gt;International Statistical Classification of Diseases and Related Health Problems, Tenth Revision&lt;/i&gt; (ICD) were used. The maternal mortality ratio (MMR) was defined as the number of maternal deaths per 100 000 live births. Trendline reliability with &lt;i&gt;R&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; was performed to analyze the data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1 026 maternal deaths occurred in Panama from 1998 through 2022, of which 61.2% were attributed to direct obstetric causes; 23.9%, indirect obstetric causes; 13.6%, contributory conditions; and 1.4% were unknown or undetermined. The average MMR was 60.1. The trendline reliability resulted in &lt;i&gt;R&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 0.1 (y = -0.5147x + 1094.7), which is not statistically significant but meets the 2030 Sustainable Development Goals. The specific primary causes of direct obstetric deaths were: 12.9% due to postpartum hemorrhage (ICD O72); 9.2%, eclampsia (ICD O15); 6.7%, puerperal sepsis (ICD O85); and 6.3%, pre-eclampsia (ICD O14). For indirect obstetric deaths, the primary causes were: 14.9% due to other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth, and the puerperium (ICD O99); and 7.3%, maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth, and the puerperium (ICD O98).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings of this study confirmed that there were substantially more direct obstetric causes (61.2%) than indirect obstetric causes (23.9%), contributory causes (13.6%), or unknown/undetermined causes (1.4%) of maternal mortality, despite being highly preventable. Although Panama is right on track to fulfill the target of 70 MMR by 2030, these results highlight the lack of health care access due to the absence of obstetrician-gynecologists per 100 000 population in indigenous comarcas, where 30.8% of the maternal mortalities occur. Furthermore, the health system in Panama is not immune to pandemics and crises. From 1998 to 2022, there were 5 years when the MMR in Panama exceeded 70: 2001, 2002, 2006, 2011, and 2020. These findings also underscore the dichotomy between statistics and health policy. While the trendline reliability was insignificant (&lt;i&gt;R&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 0.1), the MMR satisfies requirements for the 2030 Sustainable Development Goals. Future studies should consider factors related to indirect obstetrics and contributory causes of deaths, health care access, COVID-19, cesarean s","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e114"},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626361","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":"The private market for antimicrobials: an exploration of two selected mining and frontier areas of Guyana.","authors":"Horace Cox, Friederike Roeder, Lucy Okell, Reza Niles-Robin, Kashana James, Olivia Valz, Katharina Hauck, Elisa Sicuri","doi":"10.26633/RPSP.2024.109","DOIUrl":"10.26633/RPSP.2024.109","url":null,"abstract":"<p><strong>Objective: </strong>To identify challenges that may raise pathogens' resistance to antimicrobial drugs by exploring the private market for antimicrobials in two selected mining and frontier areas of Guyana.</p><p><strong>Methods: </strong>The private sector supply was mapped by approaching all authorized pharmacies and informal outlets, e.g., street vendors and grocery stores, around the two selected towns. Interviews were conducted with a) sellers on the availability of drugs, expiration dates, prices, and main producers; and b) customers on purchased drugs, diagnoses, and prescriptions received before purchasing drugs, and intention to complete the treatment. The information collected was described, and the determinants of the self-reported intention of customers to complete the whole treatment were identified.</p><p><strong>Results: </strong>From the perspective of the supply of antimicrobials, essential medicines faced low and insecure availability, and prescriptions frequently deviated from diagnoses. From the perspective of the demand for antimicrobials, one-third of purchased antibiotics had a high potential for antimicrobial resistance as per the World Health Organization AWaRe classification. A high price reduced the self-reported intention to complete the treatment among those who had a prescription, while buying the medication in a licensed pharmacy increased such intention.</p><p><strong>Conclusions: </strong>In Guyana, there persists a need to establish and revise policies addressing both supply and demand, such as restricting the sale of antimicrobials to licensed pharmacies and upon prescription, improving prescription practices while reducing the financial burden to patients, guaranteeing access to first-line treatment drugs, and instructing patients on appropriate use of antimicrobials. Revising such policies is an essential step to contain antimicrobial resistance in the analyzed areas and across Guyana.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e109"},"PeriodicalIF":2.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569504","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":"[Challenges to the Digital Inclusion of Women in a Vulnerable Area in ColombiaDesafios da inclusão digital das mulheres em uma área vulnerável na Colômbia].","authors":"Sara Arango Valencia, Sara Pérez Arias, Juan Guillermo Barrientos Gómez, María Camila Gómez Ramírez, Iván Felipe Luna","doi":"10.26633/RPSP.2024.108","DOIUrl":"10.26633/RPSP.2024.108","url":null,"abstract":"<p><strong>Objective: </strong>To identify women's technological capabilities and describe their appropriation and use of technology in a community in a vulnerable area of Colombia.</p><p><strong>Method: </strong>Observational cross-sectional study conducted in the subregion of Urabá, Colombia. A survey was conducted in primary health care centers, in which 1478 women between 18 and 49 years of age responded to questions about their technological capabilities, their experience with the use of web-based information, and their appropriation of technology.</p><p><strong>Results: </strong>Access to and use of information and communication technologies (ICTs) varied according to age, educational level, and socioeconomic stratum, with observed differences in preferences and critical consumption of information.</p><p><strong>Conclusion: </strong>The women in this study faced multiple access barriers to appropriate use of ICTs for health promotion. The appropriation of these tools in Colombia, specifically in the Urabá subregion, is a complex challenge that requires a comprehensive and multidimensional approach.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e108"},"PeriodicalIF":2.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569483","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":"Validación de los dispositivos digitales para medir la presión arterial en Perú: un llamado a la acción regulatoria.","authors":"Fabian A Chavez-Ecos, Alexander Parra-Huaroto, Leonardo J Uribe-Cavero, Henry Anchante-Hernández, Carlos J Toro-Huamanchumo","doi":"10.26633/RPSP.2024.117","DOIUrl":"10.26633/RPSP.2024.117","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e117"},"PeriodicalIF":2.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569452","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":"Reach and effectiveness of a HEARTS hypertension pilot project in Guatemala.","authors":"Irmgardt Alicia Wellmann, José Javier Rodríguez, Benilda Batzin, Guillermo Hegel, Luis Fernando Ayala, Kim Ozano, Meredith P Fort, Walter Flores, Lesly Ramirez, Eduardo Palacios, Mayron Martínez, Manuel Ramirez-Zea, David Flood","doi":"10.26633/RPSP.2024.100","DOIUrl":"10.26633/RPSP.2024.100","url":null,"abstract":"<p><p>The World Health Organization Global Hearts initiative (HEARTS) and technical package aim to improve the primary health care management of hypertension and other risk factors for cardiovascular disease at the population level. This study describes the first HEARTS implementation pilot project in Guatemala's Ministry of Health (MOH) primary health care system. This pilot began in April 2022 in six primary health care facilities in three rural indigenous municipalities. The project consisted of HEARTS-aligned strategies adapted to enhance program sustainability in Guatemala. Outcomes were defined using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. The primary <i>reach</i> outcome was treatment count, defined as the absolute number of patients per month receiving medication treatment for hypertension. The primary <i>effectiveness</i> outcomes were mean systolic blood pressure (BP), mean diastolic BP, and proportion of patients with BP control (<130/80 mmHg). In the first month of the post-implementation period, there was a statistically significant increase of 25 patients treated per month above the baseline of 20 to 25 patients (<i>P</i> = .002), followed by a significant increase of 2.4 additional patients treated each month (<i>P</i> = .005) thereafter. The mean change in systolic BP was -4.4 (95% CI, -8.2 to -0.5; <i>P</i> = 0.028) mmHg, and the mean change in diastolic BP was -0.9 (95% CI, -2.8 to 1.1; <i>P</i> = .376) mmHg. The proportion of the cohort with BP control increased from 33.4% at baseline to 47.1% at 6 months (adjusted change, 13.7%; 95% CI, 2.2% to 25.2%; <i>P</i> = .027). These findings support the feasibility of implementing the HEARTS model for BP control throughout the MOH primary health care system, which is where most Guatemalans with hypertension seek care.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e100"},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473627","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 map of chikungunya treatmentsMapa de la evidencia sobre el tratamiento del chikunguña].","authors":"Andressa Silva de Castro, Carlos Henrique Nery Costa, Dorcas Lamounier Costa, Andressa Barros Ibiapina, Chrisllayne Oliveira da Silva, Jaiane Oliveira Costa, Fábio Solon Tajra, Carmen Verônica Mendes Abdala","doi":"10.26633/RPSP.2024.99","DOIUrl":"https://doi.org/10.26633/RPSP.2024.99","url":null,"abstract":"<p><strong>Objective: </strong>Based on a review of the literature, to create a map of the available evidence on the treatment methods for chikungunya.</p><p><strong>Method: </strong>In May 2022, a literature search on chikungunya was conducted using the PubMed and Virtual Health Library platforms. To create the evidence map, studies that mentioned chikungunya fever were selected and characterized based on the type of intervention, outcome, and direction of the effect (positive, negative, potentially positive or potentially negative, inconclusive, or no effect), following the methodology recommended by the Latin American and Caribbean Center on Health Sciences Information (BIREME).</p><p><strong>Results: </strong>Fifteen studies (systematic reviews, controlled clinical trials, and narrative reviews) with both pharmacological and non-pharmacological interventions were included. All interventions focused on symptom mitigation; no study specifically investigated ways to combat the virus itself. Only one study on pharmacological interventions reported a positive effect, involving monotherapy with hydroxychloroquine and combined therapy with methotrexate plus sulfasalazine and hydroxychloroquine for reducing and relieving pain caused by post-chikungunya arthritis. The only study to report a negative effect described the use of chloroquine for post-chikungunya arthralgia. Among non-pharmacological interventions, positive effects were noted for transcranial direct current stimulation, elastic band exercises, and the Pilates method, particularly for pain relief and improvement of joint function.</p><p><strong>Conclusion: </strong>Although the review did not identify any treatments that act directly on the virus after the onset of the disease, the evidence map suggests that it is possible to treat the symptoms and sequelae of chikungunya with both pharmacological and non-pharmacological therapies.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e99"},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506885","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":"[Intentional search and reclassification of maternal deaths: quality information and its analysis to reduce maternal mortalityBusca intencional e reclassificação de mortes maternas: informação de qualidade e sua análise para reduzir a mortalidade materna].","authors":"Bremen De Mucio, Antonio Sanhueza, Patricia Soliz, Sebastián García Saiso, Suzanne Serruya, Aline P Jiménez, Arturo Barranco, Manuel Yañez, Luis M Torres","doi":"10.26633/RPSP.2024.116","DOIUrl":"https://doi.org/10.26633/RPSP.2024.116","url":null,"abstract":"<p><strong>Objective: </strong>To describe the methodology of the intentional search and reclassification of maternal deaths (BIRMM, acronym in Spanish), which allows the identification and correction of misclassification and underreporting of maternal deaths.</p><p><strong>Methods: </strong>The BIRMM methodology, initially developed in Mexico in 2003 and disseminated in other Latin American countries since 2012, was used. BIRMM consists of four key components: i) reclassification of confirmed maternal deaths; ii) identification and investigation of suspected cases of maternal death; iii) cross-referencing with other information sources; and iv) publication of results and statistical analysis.</p><p><strong>Results: </strong>The application of BIRMM makes it possible to identify and analyze maternal deaths in maternal mortality committees, which has facilitated the implementation of effective response plans, contributing to a sustained reduction in maternal mortality in the countries.</p><p><strong>Conclusions: </strong>The BIRMM methodology is an effective tool for correcting underreporting and misclassification of maternal deaths, allowing better surveillance and response to this problem. Its adoption and routine implementation are essential to improve the quality of maternal mortality information and reduce maternal deaths in the Region of the Americas. The sustainability of this methodology depends on institutional commitment and political will in the countries.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e116"},"PeriodicalIF":2.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473624","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}