Authors:Damian Vazquez Abstract: Digital transformation as a strategy to strengthen essential public health functions in the AmericasDamian Vazquez15 Nov 2023 Farias et al. This article systematizes the main actions taken to address the essential public health functions (EPHF) in the context of the digital transformation of health systems. A narrative review was conducted, in which the conceptual framework of the renewed EPHF was linked to the eight guiding principles of the digital transformation of the health sector. In the selected publications, the main actions in digital transformation included electronic health records, telemedicine, digital health legislation, digital literacy, patient portals, open-source technologies, and data governance. These actions make it possible to increase the quality and efficiency of health systems, promote accessibility, and improve health outcomes. Article's language Spanish https://doi.org/10.26633/RPSP.2023.150 Special report PubDate: Wed, 15 Nov 2023 21:33:37 +000
Authors:Liliana Liebstein Abstract: Exploring facilitators and barriers to implementing expanded nursing roles in MexicoLiliana Liebstein15 Nov 2023 Casales-Hernández et al. ObjectiveTo explore the perceptions of nursing professionals regarding facilitators and barriers to the implementation of expanded nursing functions in a state in central Mexico.MethodsQualitative descriptive phenomenological study. During 2022, 18 semi-structured interviews were conducted with three types of informants: a) head nurses at state-level facilities; b) head nurses at local-level facilities; and c) heads of health units and operational nursing staff who have direct contact with patients.ResultsThe following facilitators were identified: willingness to adopt the strategy (seen as favorable by managers and acceptable by nursing staff); reorganization of functions (simplification of processes and analysis of the situation of health units); access to training; and characteristics of nursing staff (professionalization, work experience, and favorable attitude). Barriers included: conditions at the first level of care (personnel shortages, too many administrative activities, lack of physical space, materials, supplies, and consumables), resistance to change (professional jealousy of other disciplines and duplication of tasks), staff salaries, lack of training, not trusted with expanded duties, and attitude of patients (resistance to nursing care).ConclusionsBy understanding the perceptions of nursing professionals, we can identify key elements for the successful expansion of nursing functions through expansion of the competencies of operational staff. Reorganization and proper management at different levels of decision-making will be necessary. Article's language Spanish https://doi.org/10.26633/RPSP.2023.142 Original research PubDate: Wed, 15 Nov 2023 12:00:00 +000
Authors:Liliana Liebstein Abstract: Trends in mortality from cardiovascular diseases in Chile, 2000–2020Liliana Liebstein15 Nov 2023 Soto et al. ObjectiveTo analyze trends in mortality caused by cardiovascular diseases (CVD) in Chile during the period 2000–2020.MethodsData on age-adjusted mortality rates (AAMR) from CVD per 100 000 population in Chile for 2000–2020 were extracted from the World Health Organization Mortality Database. Joinpoint regression was used to analyze the trends and compute the average annual percent change (AAPC) in Chile. In addition, analyses were conducted by sex and type of CVD.ResultsBetween 2000 and 2020, the AAMR from CVD decreased in Chile from 159.5 to 94.6 per 100 000 population, with a statistically significant decrease in the AAPC of 2.6% (95% CI [–2.8, –2.4]). No joinpoints were identified. The AAMR from CVD decreased annually by 2.6% (95% CI [–2.8, –2.4]) and 2.8% (95% CI [–3.5, –2.6]) in men and women, respectively. The AAMR from ischemic heart disease reduced annually by 3.6% (95% CI [–4.6, –2.7]) with two joinpoints in 2011 and 2015. In the case of stroke, the mortality rate decreased annually by 3.7% (95% CI [–4.5, –3.0]), with two joinpoints in 2008 and 2011.ConclusionsCardiovascular disease mortality rates have decreased significantly in Chile, in both sexes, especially in women. This decrease could be explained mainly by a significant reduction in the case fatality in recent decades. These results could be a reference for developing primary prevention and acute management of CVD policies focused on populations with higher mortality. Article's language English https://doi.org/10.26633/RPSP.2023.127 Original research PubDate: Wed, 15 Nov 2023 12:00:00 +000
Authors:Liliana Liebstein Abstract: Spatial-temporal distribution of visceral leishmaniasis in Brazil from 2007 to 2020Liliana Liebstein15 Nov 2023 Nina et al. ObjectiveTo analyze the dynamics of the spatial and temporal distribution of visceral leishmaniasis in Brazil from 2007 to 2020.MethodThis ecological study focused on the spatial pattern of visceral leishmaniasis cases in Brazil from 2007 to 2020 using data from the Information System for Notifiable Diseases (SINAN). The variables analyzed were the incidence rate of visceral leishmaniasis and the visceral leishmaniasis composite indicator (VLCI), from which triennial thematic maps were constructed. The global Moran index was calculated to assess the existence of spatial autocorrelation, and the local Moran index was used to identify areas with higher and lower risk of visceral leishmaniasis in Brazil.ResultsDuring the study period, there were 48 705 cases of visceral leishmaniasis, with an incidence rate of 25.53 cases per 100 000 population. There was spatial autocorrelation in all triennial blocks, with municipalities in the North and Northeast regions having an incidence equal to or greater than 50 cases per 100 000 population. Regarding the VLCI there was an increase in the number of municipalities classified as low risk for transmission, and a growing presence of state capitals with a classification of very high risk.ConclusionThe incidence of visceral leishmaniasis varied over the trienniums. The border region between the states of Tocantins, Maranhão, and Pará, along with the state of Ceará, stood out in the spatial distribution of the disease incidence and risk stratification by VLCI. These areas should be a priority for surveillance and control efforts for the disease. Article's language Portuguese https://doi.org/10.26633/RPSP.2023.160 Original research PubDate: Wed, 15 Nov 2023 12:00:00 +000
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