Objetive: Evaluate the relevance of the COVID 19 positive case detection policy or model implemented by the Ministry of Public Health (MPH) of Ecuador and to compare it with the experiences of other countries. Methods: Data contained the daily reports publicized by the MPH. The formulations were carried out under the Conditioned Probability modality applying Bayes’ Theorem. All the COVID-19 tests applied in relation to the confirmed cases per million inhabitants were considered, in order to obtain their level of positivity, and compared with the experience of Iceland and South Korea. Results: The probability of detecting positive cases of COVID-19 in Ecuador was higher than Iceland and South Korea, since the diagnostic tests were aimed at symptomatic patients, without identifying asymptomatic or mild symptomatic, who play an important role in the transmission of the disease. In addition, many symptomatic patients were examined but will remain undiagnosed due to the unavailability of tests and the low quality of many of them. Conclusions: The daily reports on the behavior of the COVID-19 issued by the Ecuadorian government do not adequately represent the growth in the number of those infected each day, nor the actual behavior of the epidemic, affecting possible control measures.
ResumenIntroducción: Ecuador inició una reforma en su sistema de salud en el año 2008; sin embargo, los cambios generados por la nueva Constitución de la República, en la salud pública y el acceso a atención de salud en el Ecuador, han sido escasamente evaluados y documentados. Objetivo: examinar la experiencia del Ecuador en la reforma de su sistema de salud analizando algunas de las áreas que han sufrido cambios como parte de este proceso. Metodología: se realizó investigación de tipo descriptivo, observacional. Se recuperó artículos relevantes de bases de datos que incluyó PubMed, Cochrane, ScienceDirect y UpToDate, se consultó sitios web gubernamentales y de organizaciones relacionadas con la salud como el Banco Mundial, Organización Mundial de la Salud, Organización Panamericana de la Salud, Unión de Naciones Suramericanas, entre otras. Resultados: se destaca en este periodo la decisión política de centralizar la planificación y gestión de salud a nivel del gobierno central. Se incrementa el número de consultas de morbilidad pero sin incremento de las de prevención. Las enfermedades crónicas ocupan los primeros lugares como causa de muerte. La mortalidad materna se mantiene alta y no alcanza la meta propuesta por el país. Hay importante incremento del presupuesto en salud, pero este no refleja protección financiera de los pacientes ya que el gasto de bolsillo está cerca del 50%. Conclusión: el sistema de salud del Ecuador no logra aún alcanzar plenamente objetivos sanitarios que impacten en la mejora de la calidad de la atención de la salud. También persisten barreras de acceso a atención integral y oportuna; y, limitada protección financiera. Se requiere consolidar sistemas de información que permitan acceso a información completa y oportuna.PALABRAS CLAVE: Sistema de Salud, políticas públicas de salud, salud pública, sistemas de información en salud.Abstract Introduction: Ecuador initiated a reform in its health system in 2008; however, changes in public health and access to health care in Ecuador generated by the new Constitution have been poorly evaluated and documented. Objective: To examine reform of Ecuadorian health system by analyzing some of the areas that have undergone changes as part of this process. Design: Observational descriptive research. Relevant articles were retrieved from databases that included PubMed, Cochra-ne, ScienceDirect and UpToDate; government websites and organizations related to health such as the World Bank, World Health Organization, Pan American Health Organization, Union of South American Nations, among others were consulted. Results: The political decision to centralize health planning and management at the central government level was highlighted during this period. Morbidity is increased but there is no increase in prevention. Chronic diseases occupy first places as a cause of death. Maternal mortality remains high and does not reach the goal proposed by the country. There is significant increase in the health budget, but this does not reflect the financial protection ...
Objective: This study analyzes the effects of the Pedernales earthquake (April 2016) on Ecuador’s health care system. Methods: A research was carried out in Chone Canton, which combined documentary, quantitative, and qualitative techniques. Epidemiological and service production information taken from official documents was analyzed systematically. In-depth interviews and surveys were conducted with health care program directors and technicians from the Health Centres of the Ministry of Public Health and the users. Results: Deficiencies in the health care system were already observed in Chone Canton prior to the earthquake mainly due to the lack of doctors, nurses, and hospital beds. According to the interviewees, the health district was not prepared for an emergency like the earthquake. Some buildings fell after the earthquake, and Chone Hospital was disabled. These problems coupled with preventive action failures at the community level led to an increase in diseases after the earthquake. Conclusions: The shortage of personnel and physical infrastructure, weaknesses in primary health care in the Ecuadorian health system, the lack of preparation, and limited availability of information on health indicators were the causes of the sharp increase in pre-existing diseases in the area, and of new epidemic outbreaks after the earthquake.
Los países de la subregión andina Bolivia, Chile, Colombia, Ecuador, Perú y Venezuela, integrados en el Organismo Andino de Salud – Convenio Hipólito Unanue (ORAS – CONHU) elaboraron y aprobaron mediante Resolución REMSAA XXXIII/474 del 23 de Noviembre de 2012, la Política Andina de Planificación y Gestión de Recursos Humanos en Salud y la implementación de su Plan de Acción 2013 – 2017.
RESUMENEl Sistema de Salud es uno de los mejores mecanismos sociales para ayudar a disminuir la pobreza y mejorar la equidad en la sociedad evitando que los altos costos de la atención de salud se conviertan en un gasto directo adicional de los ciudadanos. Los países de América Latina entre ellos Ecuador, desplegaron en los últimos años, importantes reformas en búsqueda de universalizar el acceso a la atención de salud. Sin embargo, aún no logran garantizar el acceso universal efectivo y oportuno para toda la población. Es necesario mirar cómo está funcionando el Sistema de Salud. Este desempeño debe medirse técnicamente, socializarse y debatirse con todos los actores sociales. Los avances reales se tienen que constatar en función de medir el impacto de las políticas y programas de salud en la población, medición que se puede complementar con un sistema de monitoreo o un observatorio del sistema de salud, que pueden ser implementadas por las universidades y centros de investigación en salud. La información que se genera en este proceso ayuda a tomar las mejores decisiones en beneficio del sistema de salud.
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