BackgroundFactors associated with violence and the abuse of older adults are understudied and its prevalence in Mexico has not been reported. The aim of this study was to identify the prevalence and factors associated with violence and abuse of older adults in Mexico.MethodsWe used Mexico’s 2012 National Health and Nutrition Survey, which included a sample of 8,894 individuals who are 60 years or older and who self-reported a negative health event related to robbery, aggression or violence in the previous 12 months. We used chi-squared test and Fisher’s exact test to analyze the variables related to violence. Adjusted estimates were completed with multiple logistic regression models for complex surveys.ResultsThe prevalence of violence was 1.7 % for both men and women. In 95 % of the cases, the aggression was from an unknown party. Verbal aggressions were the most prevalent (60 %). Among men, physical aggression was more common. Violence frequently occurred in the home (37.6 %); however, men were primarily assaulted in public places (42.4 %), in comparison to women (30.7 %). There were also differences in the risk factors for violence. Among men, risk was associated with younger age (60–64 years), higher education (secondary school or above) and higher socioeconomic status. Among women, risk was associated with depression, not being the head of the family, and region of the country.ConclusionsViolence against older adults presents differently for men and women, which means it is necessary to increase knowledge about the dynamics of the social determinants of violence, particularly in regards to the role of education among men. The relatively low prevalence found in this study may reflect the difficulty and fear of discussing the topic of violence. This may occur because of cultural factors, as well as by the perception of helplessness perpetuated by the scarce access to social programs that ensure protection and problem solving with regards to the complex social determinants of individual and family violence that this population group endures.
Resumen Se analizó la utilización de servicios de salud reproductiva (atención prenatal, parto y posparto), según la etnia de las mujeres, a partir de la Encuesta Nacional de Demografía y Salud 2010 de Colombia. La etnia fue medida por auto- reconocimiento (indígenas, afrodescendientes y ninguna) y se estimaron modelos logísticos para cada servicio. Encontramos que, respecto a quienes no pertenecen a ninguna etnia, la utilización de servicios de salud reproductiva es menor en las mujeres indígenas y afrodescendientes. En los modelos de regresión se encontró que mujeres indígenas tienen menores posibilidades de un número adecuado de controles prenatales (OR = 0,61), así como también afrodescendientes. Igual situación para la atención institucional del parto: indígenas (OR = 0,33), afrodescendientes (OR = 0,60); y en control posparto: indígenas (OR = 0,80), afrodescendientes (OR = 0,80). En conclusión, existen inequidades en la utilización de servicios de salud reproductiva en las mujeres de grupos étnicos de Colombia que deben ser atendidas con estrategias gubernamentales que garanticen el derecho a la salud.
Our results confirmed that health organizations follow a historical process in which selected national and international forces open opportunities to promote intercultural health models that respond to the needs of indigenous populations. Despite the formerly held belief that traditional and scientific medicines were incompatible, this study demonstrates the viability of intercultural health care models that may become a real possibility in the country, based on new conventions to establish alternative and intercultural health services, thereby setting an example for other regions and countries. The English version of this paper is available at: http://www.insp.mx/salud/index.html.
OBJECTIVE To analyze the impacts of the care to the population displaced by violence on the health system and the challenges that this entails.METHODS This is a narrative review of the national and international literature in PubMed, SciELO, WHO/PAHO, and Bireme. Inclusion criteria were date of publication (from 2000), relation with the subject, and language (Spanish or English). We found 292 documents, of which 91 met the inclusion criteria.RESULTS The main challenges are the intersectoral, participatory, and integral approach (with emphasis on mental health and sexual and reproductive health), ensured accessibility to health services, the need for a reliable registration and information system of the population displaced by violence and its characteristics, and the addressing of the biopsychosocial problems of the different groups, especially women, persons with disabilities or infectious diseases, adolescents, children, ethnic minorities, older adults and the lesbian, gay, bisexual, transsexual, and intersexual population.CONCLUSIONS The lack of political will to accept and see the internal displacement by violence and its importance as a humanitarian and public health problem is an obstacle to the adequate and timely care of the population displaced by violence in Mexico.
MEDICINA Y CIENCIAS DE LA SALUD RESUMENEl cuidado materno es un asunto prioritario en la prestación de servicios de salud, por lo que se trabaja continuamente en la mejora de la atención a las embarazadas. Este esfuerzo requiere información que ayude a establecer la efectividad de las estrategias empleadas, acorde a las necesidades de la población. El objetivo del presente estudio fue determinar la disponibilidad, el acceso y uso de las tecnologías de la información y comunicación (TIC) en las embarazadas atendidas por la Secretaría de Salud del Estado de Veracruz, México, así como identificar las necesidades que pueden ser resueltas o apoyadas mediante su uso. Se diseñó y aplicó un cuestionario a una muestra estratificada de 709 embarazadas, usuarias de servicios de salud del primer nivel de atención, de la ciudad de Xalapa. Los resultados mostraron que el 91.9 % del total de las mujeres encuestadas usarían alguna de las TIC para el cuidado de su salud durante el embarazo. El 95.0 % de las entrevistadas disponía de teléfono móvil, de las cuales, el 68.4 % podían conectarse a internet exclusivamente a través del celular por las funciones que poseían sus teléfonos, aunque solo el 58.0 % lo utilizaría para el cuidado de su salud. El uso de la internet representó una herramienta de gran utilidad para prestar servicios administrativos, preventivos, de promoción a la salud o de atención. Este grupo manifestó interés por el uso de las TIC para el cuidado y atención durante su embarazo, especialmente para recibir información de salud, detectar riesgos en el embarazo o problemas y necesidades específicas de la mujer. Dichos resultados sugieren que es viable promover estrategias de eSalud y mSalud en el primer nivel de atención en México.PALABRAS CLAVE: embarazo, eSalud, mSalud, salud materna, tecnologías de la información y comunicación. ABSTRACTMaternal care is a priority issue in the provision of health services, this is why we continuously work on improving care for pregnant women. This effort requires basic information that helps establish the effectiveness of the employed strategies, according to the needs of the population. This paper aims to determine the availability, access and use of information and communication technologies (ICT) in the primary care of pregnant women treated by the Health Secretary of the State of Veracruz, Mexico. It also intends to identify the needs that can be resolved or supported through the use of ICT. A questionnaire was designed and administered to a stratified sample of 709 pregnant women who were users of primary care health services in the city of Xalapa. The results showed that 91.9 % of all surveyed women would use at least one of the ICT for their health care during pregnancy. 95.0 % of those interviewed had a mobile phone, of which 68.4 % could connect to the Internet exclusively through cell phones because of the functions that their phones possessed. However, only 58.0 % would use it for their health care. The use of the internet represented a very useful tool to provide ad...
To decrease infant mortality in rural areas of Mexico, geographic access has to be improved as well as investment in resources and training health personnel in intercultural competence and primary health care skills.
Introducción. Las políticas y programas del gobierno, orientados a disminuir las inequidades, tienen efectos sociales, económicos e impacto sobre las condiciones de salud; además, suelen carecer de procesos de evaluación que midan el impacto de sus intervenciones. Por lo tanto, este estudio plantea una línea de base del índice de pobreza multidimensional (IPM) en dos comunidades vulnerables, que permitirá evaluar, con posterioridad, el impacto del desarrollo en una zona franca.Materiales y métodos. El diseño del estudio fue observacional, descriptivo y transversal, a fin de establecer la línea de base de determinantes sociales de la salud, contenidos en el IPM y el efecto potencial de la intervención sobre las variables y dimensiones del IPM en dos corregimientos, antes del desarrollo de una zona franca.Resultados. Los hallazgos muestran las condiciones de vida precarias y de inequidad de las dos poblaciones, sobre todo en la dimensión educativa, los derechos de la población infantil y las condiciones de la vivienda. Las variables que mejor explican la pobreza son el analfabetismo, el rezago escolar y los pisos de tierra sobre los que es inadecuado habitar. La prevalencia de pobreza en Caimalito (80.9%) y Puerto Caldas (66.5%) supera la general de Colombia (24.8%) y de la región central (26.1%). Asimismo, la incidencia ajustada de pobreza en Caimalito (20.1%) y Puerto Caldas (18.5%) son mayores que la de Colombia (13%).Conclusión. Es necesario modificar variables del índice que no discriminen hogares pobres. La simulación de intervenciones aisladas tienen poco o ningún efecto en la reducción de la pobreza.
Heroin consumption in Mexico is low compared with its use in the United States; however, this practice is more common in the northern region of Mexico than in the rest of the country, being documented only in cities that are located exactly at the Mexico-U.S. border. The Mexican legal framework is focused on rehabilitation, but its effects on the lives of users are unknown. The objective of this research was to analyze how the regulatory Mexican framework is conceptualized and practiced in the daily life of a group of heroin users from a northern city, where consumption has recently spread and has not been documented. We collected the official registered data from users and conducted a qualitative study in Hermosillo, Sonora. A research on the legal framework was conducted, as well as on the city’s context. Data on heroin users can be found at HIV health center, as there is no other source of such records. The Mexican legal framework aims at rehabilitation and at avoiding criminalization; however, the daily life of users drives them towards crime circuits: people commit crimes to stay in prison, where they can control the addiction and get heroin, in case of abstinence. The Mexican State has no empirical information to improve its programs and laws related to the use of heroin. The daily practices of users become not only epidemiological but social risks to the community and to the users themselves. Also, the lack of access due to stigmatization, criminalization and violence, increases the inequities, creating a cycle that reproduces poverty and suffering as part of a social structure. Therefore, changes are needed in the justice system.
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