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

{"title":"Hospital-based health technology assessment (HTA) in Latin America and the Caribbean: a scoping review.","authors":"Alex Itaborahy, Vania Cristina Canuto Santos, Flávia Cristina Ribeiro Salomon, Caroline Bregman, Iandy Mateus, Marisa Santos","doi":"10.26633/RPSP.2025.8","DOIUrl":"10.26633/RPSP.2025.8","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of hospital-based health technology assessment (HB-HTA) activities in Latin America and the Caribbean, including the technologies assessed, resources utilized, evaluation methods employed, and challenges encountered.</p><p><strong>Methods: </strong>A scoping review focused on HB-HTA using frameworks from the Joanna Briggs Institute was conducted across databases and gray literature.</p><p><strong>Results: </strong>Seventeen studies were identified, and another two documents were retrieved manually at a conference, totaling 19 files. Brazil emerged as a key player in HB-HTA activities in Latin America and the Caribbean, with public teaching hospitals leading the efforts. The primary focus of HB-HTA units was assessing medicines/pharmaceuticals and medical devices, using budget impact and cost-effectiveness/utility analyses as the main appraisal tools. The review also identified challenges such as limited human resources and financial support.</p><p><strong>Conclusions: </strong>The study highlights a growing interest in HB-HTA in Latin America and the Caribbean, driven primarily by public institutions. The findings underscore the need for tailored approaches to strengthen evidence-based decision-making in healthcare settings and address the challenges of the region's limited resources and financial constraints.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e8"},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984681","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":"[Regulation and performance of health systems: a review of analytic frameworksRegulamentação e desempenho dos sistemas de saúde: revisão das estruturas analíticas].","authors":"Ernesto Báscolo, David Debrott Sánchez, Natalia Houghton, Carina Vance","doi":"10.26633/RPSP.2024.42","DOIUrl":"10.26633/RPSP.2024.42","url":null,"abstract":"<p><p>The private health sector has expanded significantly in recent decades, both in Latin America and other regions. Governments and international organizations have dealt with this process in a heterogeneous manner. A policy approach and, above all, a regulatory framework, are required in order to put health objectives and the right to health above the profit motive that drives private sector participation. This paper reviews frameworks for analyzing the performance of health systems and the regulation of financing and service provision, primarily (but not exclusively) in the private sector. This review covers the output of the main international health agencies (Pan American Health Organization and World Health Organization), international development agencies (World Bank and Organization for Economic Cooperation and Development), and academics involved in international health policy debates. Common aspects of the different frameworks are identified, as well as substantive divergences. The purpose of this article, which is part of a larger project, is to contribute to discussions on the regulation of health systems in the Region of the Americas, consider their particularities, and describe the current context.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e42"},"PeriodicalIF":2.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877835","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":"Reasons for organ and tissue donation refusal and opposition: a scoping review.","authors":"Bartira de Aguiar Roza, Sibele Maria Schuantes-Paim, Priscilla Caroliny Oliveira, Raquel Duarte Malosti, Neide da Silva Knhis, Ana Menjivar, Mauricio Beltrán Duran, Janine Schirmer","doi":"10.26633/RPSP.2024.115","DOIUrl":"10.26633/RPSP.2024.115","url":null,"abstract":"<p><strong>Objective: </strong>To map the reasons why individuals oppose or refuse organ and tissue donation, from an international perspective.</p><p><strong>Methods: </strong>A scoping review was conducted from May 2022 to February 2024 using a three-stage search strategy across five databases and Google Scholar. Data analysis involved categorizing information based on similarities and populations studied.</p><p><strong>Results: </strong>The analysis included 92 articles and national reports. The data collected were classified into two categories. Category 1 included the reasons why individuals oppose deceased donation: lack of knowledge about the donation process, 22 (16.5%); religious beliefs, 21 (15.8%); fear of mutilation or damage to body integrity, 17 (12.8%); conflicts with health care professionals during hospitalization or distrust of professionals or the organ donation process, 11 (8.3%); and unknown reasons, 11 (8.3%). Category 2 included the reasons why individuals refuse to donate a deceased relative's organs and tissues after the family interview for deceased donation: previous written or verbal expression by the potential donor, 42 (10.1%); fear of mutilation or damage to body integrity, 41 (9.9%); conflicts with health care professionals during hospitalization or distrust of professionals or the organ donation process, 38 (9.2%); religious beliefs, 37 (8.9%); and individual motivations, 36 (8.7%).</p><p><strong>Conclusions: </strong>This scoping review found that there were two main categories of reasons behind being opposed to or declining organ and tissue donation, with 23 subcategories. By mapping these reasons across international contexts, these findings provide insights for future research and can be used to inform the development of educational initiatives on organ and tissue donation.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e115"},"PeriodicalIF":2.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877820","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":"Embracing open data for Caribbean health.","authors":"Ian R Hambleton","doi":"10.26633/RPSP.2024.141","DOIUrl":"10.26633/RPSP.2024.141","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e141"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855513","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 role of regulatory agencies within health systems during emergencies in BrazilPapel de los organismos regulatorios en los sistemas de salud en situaciones de emergencia en Brasil].","authors":"Vera Lúcia Edais Pepe, Mariana Vercesi de Albuquerque, Catia Veronica Dos Santos Oliveira","doi":"10.26633/RPSP.2024.130","DOIUrl":"10.26633/RPSP.2024.130","url":null,"abstract":"<p><p>The performance of health systems is related to ensuring the right to health, an important component of human rights that includes the right to health protection. Regulatory action by the state aims to reduce risks to health and thus help improve health system performance, particularly with respect to the principles of comprehensiveness and equity. The aim of this article is to discuss resilience from the perspective of national regulatory agencies - especially when they are faced with public health emergencies (PHEs) - and their contribution to health system resilience, taking as a model the work of the Brazilian Health Regulatory Agency (ANVISA). In the context of PHEs, health regulators have been improving their practices and working on several fronts. Regulatory agencies have used specific regulatory instruments to speed up access to effective and safe products for responding to pandemics, to ensure the quality of care, and to communicate with the public. ANVISA specifically has brought new areas of action under its purview, such as overseeing the development of mechanical ventilators. It is crucial to recognize the interdependence between improving response capacity and improving performance in dealing with PHEs. Examples include the fast-track approval of COVID-19 vaccines, which allowed more rapid vaccination; cooperation among regulatory agencies; and, in the case of Brazil, work by ANVISA to strengthen the role of the country's Unified Health System (SUS) and the right to health in the face of disinformation and denialism.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e130"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855512","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":"Transformación digital en el sector salud peruano: retos y avances recientes.","authors":"Jhamile Ponce de León Sierra, Anthony Merma Pillaca","doi":"10.26633/RPSP.2024.138","DOIUrl":"10.26633/RPSP.2024.138","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e138"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855514","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":"[Dengue lethality and inequalities in the Region of the Americas between 2014 and 2023Letalidade da dengue e desigualdades na Região das Américas entre 2014 e 2023].","authors":"Miguel Gallego-Munuera, Manuel Colomé-Hidalgo","doi":"10.26633/RPSP.2024.139","DOIUrl":"10.26633/RPSP.2024.139","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the differences in the dengue case fatality rate among the different subregions of the Americas in the period 2014-2023 and explore their relationship with the human development index (HDI) in each subregion.</p><p><strong>Methods: </strong>Longitudinal ecological study based on open-access data from each country, grouped into the corresponding subregions to calculate the different indicators. In addition, a linear regression was performed between the mean case fatality rate in each region and the weighted regional HDI.</p><p><strong>Results: </strong>There are large differences in dengue lethality by subregion and considerable variability by year. These differences in lethality are not directly correlated with the incidence recorded in each region. The regional HDI shows a close relationship with lethality: a higher HDI is generally associated with a lower case fatality rate.</p><p><strong>Conclusions: </strong>The observed differences in lethality and their relationship with subregional development levels indicate that a broad and multifactorial perspective should be taken when designing a dengue control strategy.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e139"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855509","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":"[Restructuring of the COVID-19 Vaccine Safety Committee 2020-2023 in MexicoReestruturação do Comitê para Segurança das Vacinas contra a COVID-19, 2020-2023, México].","authors":"Ana María Santibañez Copado, G Reyes Terán, Sergio Iván Váldes Fererr, Noris Pavía Ruz S, Arauz Antonio, Carmen Toledo Salinas, Juan Luis Mosqueda, Patricio Ortiz Fernández, Jesús Alberto Espinosa-Santibañez, Selma Scheffler-Mendoza, José Luis Díaz Ortega, Nadia María Romualdo-Tello","doi":"10.26633/RPSP.2024.106","DOIUrl":"10.26633/RPSP.2024.106","url":null,"abstract":"<p><strong>Objective: </strong>To describe the process of restructuring the National Expert Committee and its impact on the causality assessment of events supposedly attributable to vaccination or immunization (ESAVI) in the context of vaccine safety monitoring during the COVID-19 pandemic, 2020-2023.</p><p><strong>Method: </strong>A report was prepared on the experience of creating and operating Mexico's National Expert Committee during the aforementioned period.</p><p><strong>Results: </strong>During the 2020-2023 period, 1293 severe ESAVIs were reported after COVID-19 vaccination; after 98.6% (1275) of them had been assessed and classified, 10 specialized subcommittees were formed.</p><p><strong>Conclusions: </strong>Restructuring of the committee, assessment of adverse events with a series of prior steps, and use of the World Health Organization's causality assessment tool made it possible to generate scientific documents to validate vaccine safety and maintain trust in vaccination.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e106"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855510","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":"[Successes and challenges in achieving and sustaining the elimination of measles, rubella, and congenital rubella syndrome in the Americas, 2013-2023Conquistas e desafios para alcançar e manter a eliminação do sarampo, da rubéola e da síndrome da rubéola congênita na Região das Américas, 2013-2023].","authors":"Desirée Pastor, Pamela Bravo-Alcántara, Regina Durón, Carmelita P Tirso, Claudia Ortiz, Gloria Rey-Benito","doi":"10.26633/RPSP.2024.140","DOIUrl":"10.26633/RPSP.2024.140","url":null,"abstract":"<p><strong>Objetivo: </strong>To document the historical facts and the challenges faced in the Region of the Americas in achieving and sustaining measles, rubella, and congenital rubella syndrome (CRS) elimination between 2013 and 2023.</p><p><strong>Method: </strong>Special report with a narrative description of the main achievements, challenges, and lessons learned during the period, and an analysis of vaccination coverage, surveillance indicators, and measles outbreaks using data from the Pan American Health Organization and the United Nations Children's Fund, among others.</p><p><strong>Results: </strong>Between 2003 and 2016, regional vaccination coverage with the first dose of the measles, rubella, and mumps vaccine was between 92% and 94%; after 2017 there was a marked decline due to lower coverage levels in the most populous countries. The regional reporting rate of suspected cases remained at the expected level, with differences in each subregion. Between 2017 and 2023, measles outbreaks tested the strengths and weaknesses in the quality of each country's response. Starting in 2020, the COVID-19 pandemic had a negative impact on both vaccination coverage and the quality of epidemiological surveillance.</p><p><strong>Conclusions: </strong>The elimination of measles in 2016 and rubella in 2015 were major achievements in the Region of the Americas. Between 2017 and 2020, the main challenge was to address measles outbreaks that caused the re-establishment of endemic transmission in two countries. Between 2020 and 2023, the main challenge was to tackle the negative impact of the COVID-19 pandemic on declining vaccination coverage and surveillance indicators.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e140"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855511","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":"[Experiences and Challenges of the Ecuadorean National Advisory Commission on Serious Events Supposedly Attributable to Vaccination or Immunization, 2020-2023Experiências e desafios da Comissão Consultiva Nacional sobre Eventos Supostamente Atribuíveis à Vacinação ou Imunização graves do Equador, 2020-2023].","authors":"Daniel Simancas-Racines, Juan Marcos Parise-Vasco, Sebastián Baldeón-Espinosa, Rosa R Aguinaga, Gabriela Vinueza-Valencia, Cristina Jacome, Jeannete Zurita, Cristina Bejar, Luis Bayas, Francisco Pérez-Tasigchana, Yndira Anchayhua, Carlos Andrés Pinto-Díaz, Helvert Felipe Molina-León, Gonzalo Baquero-Paret","doi":"10.26633/RPSP.2024.91","DOIUrl":"10.26633/RPSP.2024.91","url":null,"abstract":"<p><strong>Objective: </strong>To describe the experiences of the National Advisory Commission on Serious Events Supposedly Attributable to Vaccination or Immunization (ESAVI) implemented in Ecuador for the period 2020-2023.</p><p><strong>Methods: </strong>A report analyzing the implementation, operations, and results of the National Advisory Commission on Serious ESAVI in Ecuador was prepared. A quantitative analysis of vaccination records was carried out, as well as a qualitative analysis based on expert interviews, reflecting the direct experiences and operational challenges faced by the members of the Commission.</p><p><strong>Results: </strong>Implementation of the Commission has allowed for the systematic recording and analysis of serious ESAVIs. Of 256 reported cases, 139 were analyzed: 59% were considered coincident events; 16.6%, unclassifiable; 6.5%, indeterminate; 5%, stress-related; 3.6% as events related to a programmatic error; and 9.4% as vaccine-related, which included allergic reactions, Guillain-Barré syndrome, and thrombosis, among others. The experts highlighted the need to improve staff training and technology infrastructure, and noted that the Commission played a crucial role in monitoring vaccine safety, as well as in increasing public confidence in vaccination processes.</p><p><strong>Conclusions: </strong>The National Advisory Commission has played an essential role in vaccine safety surveillance in Ecuador by ensuring reporting, causality analysis, and investigation of serious ESAVIs. Challenges were identified and will need to be addressed to maintain public trust in immunization programs.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e91"},"PeriodicalIF":2.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839131","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}