IntroductionAsthma is a common long-term disorder and strategies to improve asthma control are still a challenge. Integrated delivery of health systems is critical for effective asthma care: there is limited information on experiences of care coordination for asthma from Latin America, especially on perspectives of health personnel and in the context of the COVID-19 pandemic.Methods and analysisThis protocol details a qualitative approach to analyse health workers’ perspectives of healthcare coordination for asthma control during COVID-19 pandemic in Ecuador and Brazil, at primary and specialised levels, through in-depth semistructured interviews using a video communications platform. The analysis will identify knowledge and perspectives based on coordination of clinical information, clinical management and administrative coordination. Theoretical sampling will be used to obtain approximately equal numbers of women and men within each level of healthcare; data saturation will be used to determine sample size. Transcripts will be analysed using content-coding procedures to mark quotations related to major topics and subthemes included in the interview guide, and narrative analysis will be based on a theoretical framework for healthcare coordination to identify new themes and subthemes.Ethics and disseminationEthical approval was obtained from the ethics committees of Hospital General Docente Calderón, Quito, Ecuador; and Universidade Federal da Bahia, Salvador, Brazil. The findings of this study will be disseminated through peer-reviewed articles, conference presentations and condensed summaries for key stakeholders and partners.
Background Knowledge of medical specialists' numbers and geographical distribution are essential for planning health services and health workforce supply. However, although the distribution of physicians is a significant concern for society and policymakers in Ecuador, no studies have evaluated the distribution of specialists in the country. This study aimed to explore the geographical and temporal distribution of medical specialists in Ecuador over 18 years from 2000 to 2017 and analyse its implications for health planning and medical training. Methods We conducted an ecological time-series study based on the National Statistical Register of Resources and Health Activities data. This register provides administrative information for health professionals working in public and private health institutions. Rates of medical specialists by year, geographical area, and speciality were estimated. We used joint-point analyses to identify time trends for medical specialists and physicians in training. Results From 2000 to 2017, medical specialists grew from 2737 to 10,929. The rate of medical specialists per 10,000 population increased from 4 in 2000 to 10.3 in 2017. Based on Joint point analysis, two temporal trends were identified. Between 2000 to 2015, specialists increased by 4.1% per year, and between 2015 and 2017, they increased by 20% per year. For the entire study period, three cities (Quito, Guayaquil, and Cuenca) accounted for more than 50% of the specialists in the country. However, medical specialists in other cities and rural areas increased from 37% in 2000 to 46% in 2017. The provinces of Esmeraldas, Carchi, Bolívar and Los Ríos presented rates of less than 6 specialists per 10,000 population by 2017. Of the 46 medical specialities identified by 2017, three represented more than 30% of the professionals (gynaecology 12%, paediatrics 11% and family and community health 8.4%). Conclusions This study shows that the number of medical specialists in Ecuador has increased significantly over the last two decades, although with inequalities in the distribution of specialists between provinces and regions. The results of this study provide background for the Ecuadorian health system when introducing Human Resources of Health (HRH) policies.
Este estudio tiene como objetivo determinar el efecto de la calidad normada en dos modelos de evaluación de la educación superior desde el punto de visa del mejoramiento continuo y cuánto han contribuido al progreso de la universidad. La metodología empleada es de tipo cualitativo porque hace posible entender, describir, interpretar y analizar los contextos y personajes que intervienen en la mejora de la educación superior desde el análisis de los estándares de calidad, los métodos de investigación considerados son el fenomenológico y el hermenéutico. Los resultados del estudio exhiben la gran disparidad que existe de modelo a modelo en términos de métricas de evaluación y expone las brechas casi insalvables que se muestran en ciertas áreas, así como los manifiestos avances en otras. El mejoramiento de la calidad en las instituciones de educación superior debe ser desarrollado de forma incremental, porque cuando se plantean metas irreales se corre el riesgo de quedar a la mitad del camino, con la consiguiente ausencia de guías para la toma de decisiones.
La entrada de las competencias en la educación superior, da cuenta de la necesidad de conectar el mundo educativo con el mundo laboral. Es necesario conocer qué competencias genéricas son importantes en la formación del abogado, desde la percepción de los docentes como actores del proceso enseñanza aprendizaje. El estudio de tipo cuantitativo responde a un diseño descriptivo del estado de la formación de competencias en los estudiantes de Derecho. La investigación de corte transversal recolectó datos en un solo momento, su propósito fue analizar la incidencia de la importancia de las competencias genéricas en una población. Existe coincidencia en el orden de importancia en dos competencias de las consideradas como más importantes para los docentes de Derecho con el proyecto Tuning Latinoamérica: Capacidad de abstracción, análisis y síntesis y Capacidad para identificar, plantear y resolver problemas. Mientras que con el proyecto Tuning Europa, se presentan también dos coincidencias: Conocimientos generales básicos y Capacidad crítica y autocrítica. Las normas ecuatorianas demandan un cambio en la agenda de la docencia universitaria, sin embargo, una educación por competencias con docentes de Derecho alejados del libre ejercicio profesional por la carga laboral pone en duda el desarrollo de competencias en los estudiantes universitarios.
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