To evaluate the feasibility and acceptability of a comprehensive educational strategy designed to improve care quality in rural areas of Mexico.
A demonstration study was performed in 18 public rural ...health centers in Mexico, including an educational intervention that consists of the following steps: Development of the strategy; Selection and training of instructors (specialist physicians from the referral hospital and multidisciplinary field teams); Implementation of the strategy among health care teams for six priority causes of visit, through workshops, individual tutorials, and round-table case-review sessions. Feasibility and acceptability were evaluated using checklists, direct observation, questionnaires and in-depth interviews with key players.
Despite some organizational barriers, the strategy was perceived as worthy by the participants because of the personalized tutorials and the improved integration of health teams within their usual professional practice.
The educational strategy proved to be acceptable; its feasibility for usual care conditions will depend on the improvement of organizational processes at rural facilities.
This study presents an assessment of the participation and training of nurses in public health areas in the Americas. Information was gathered through a literature review and interviews with key ...informants from Mexico, Colombia, and Paraguay. Results demonstrate that there is significant variation in definitions of public health nursing across the region and current systematized data about the workforce profile of public health nursing personnel is not available for many countries in the Americas. There are significant regional differences in the levels and types of training of nurses working in public health areas and an increasing number of nurses are pursuing training in public health at the master's and doctoral levels. Many nurses carry out some or all of the essential functions of public health, but are not considered to be public health nurses. Generally, auxiliary and technical nurses have a broader presence in public health areas than professional nurses. In the future, regional health systems reforms should support increased recruitment and training of public health nurses, as well as stronger roles in public health research and health care at the individual, community, and population levels.
To describe a political mapping on discrimination and homophobia associated to human immunodeficiency virus (HIV) in the context of public institutions in Mexico.
The political mapping was conducted ...in six Mexican states. Stakeholders who were involved in HIV actions from public and private sectors were included. Semistructured interviews were applied to explore homophobia and discrimination associated with HIV. Information was systematized using the Policy Maker software, which is a good support for analyzing health policies.
Discriminatory and homophobic practices in the public domain occurred, damaging people´s integrity via insults, derision and hate crimes. Most stakeholders expressed a supportive position to prevent discrimination and homophobia and some of them had great influence on policy-making decisions. It was found that state policy frameworks are less specific in addressing these issues.
Homophobia and discrimination associated to HIV are still considered problematic in Mexico. Homophobia is a very sensitive issue that requires further attention. Also, an actual execution of governmental authority requires greater enforcement of laws against discrimination and homophobia.
The process of regularization of workers paid by the Social Protection Health System of Mexico is described and analyzed.
Primary and secondary data collected by the external evaluation of the ...Mexican System for Social Protection in Health in 2009 were used.
The regularization clearly improved the labor conditions of workers contracted by the system but a broader systemic implication of regularization does not seem to be necessarily positive.
It is important to consider the need to guarantee that this type of changes in the contractual conditions of workers benefit all actors, particularly the insured population.
To analyze the factors associated with the expectations to migrate abroad among nursing students in Mexico City.
A cross-sectional study was conducted with a non-random sample of 420 students. A ...logistic regression model was estimated.
A total of 69% of the informants expressed their intention to move abroad, to look for employment (65%) and/or to continue their studies (26%). Of those, 50% would choose Canada as their destination, followed by Spain and the United States. The variables associated with migration expectations were: age, income, having relatives abroad, and perception of poor labor conditions and low wages in Mexico.
Results are consistent with international literature. Low wages, poor labor conditions and the limited possibilities for professional development in Mexico are factors that contribute to generate migration expectations among nursing students. Additionally, optimistic perceptions about the job market and the labor demand in more developed countries heighten expectations to migrate.
Esta pesquisa teve como objetivos identificar os grupos de usuários segundo o grau de satisfação com a atenção recebida nos Módulos Gerontológicos e determinar os principais fatores associados. ...Trata-se de estudo transversal realizado com 181 usuários nos 36 módulos do Seguro Social dos Trabalhadores Públicos, no México. O nível de satisfação foi avaliado segundo três aspectos: características gerais da atenção recebida, amabilidade no trato e infraestrutura. Foi realizada uma análise de conglomerados para identificar grupos de usuários segundo o grau de satisfação e um modelo de regressão logística ordinal para identificar os fatores associados. Estiveram satisfeitos com o serviço 53% dos usuários; medianamente satisfeitos, 34,3%; e insatisfeitos, 12,7%. Os principais fatores associados com maior grau de satisfação foram: ser mulher, maior idade e ser chefe/a de família. O sistema de saúde deve dirigir sua atenção para esse grupo populacional que é crescente e incentivar o desenvolvimento de uma atenção de qualidade que contemple as suas necessidades.
The aim of this study was to identify groups of users according to their degree of satisfaction with geriatric care services and determine the primary factors associated with satisfaction. This was a cross-sectional study of 181 people enrolled in 36 modules pertaining to the State Workers Social Security Institute (ISSSTE) in Mexico. Degree of satisfaction was measured according to the following three areas: general characteristics of services offered, friendliness of staff and infrastructure. A cluster analysis was performed to identify groups of users according to their level of satisfaction, and an ordinal logistic regression model was used to determine the associated factors. Fifty-three percent were satisfied with the services, 34.3% were fairly satisfied and 12.7% were dissatisfied. The main characteristics associated with a greater degree of satisfaction were being female, older and the head of household. The health system must address this growing population and ensure the development of quality care to meet their needs.
Se objetivó identificar grupos de usuarios según grado de satisfacción con la atención recibida en Módulos Gerontológicos, y determinar los principales factores asociados. Estudio transversal, muestra de 181 pacientes de los 36 módulos del Seguro Social de Trabajadores Estatales, en México. El nivel de satisfacción fue evaluado bajo tres aspectos: características generales de la atención recibida; amabilidad en el trato e infraestructura. Se realizó análisis de conglomerados para identificar grupos de pacientes según grado de satisfacción y un modelo de regresión logística ordinal para identificar factores asociados. Resultaron satisfechos con el servicio 53% de los pacientes; medianamente satisfechos 34,3% e insatisfechos 12,7%. Los principales factores asociados a mayor grado de satisfacción fueron: ser mujer, mayor edad, ser jefe/a de familia. El sistema de salud debe dirigir su atención a este grupo poblacional creciente, e incentivar el desarrollo de una atención calificada que contemple sus necesidades.
To identify the strategies used by Mexican migrants to access health services in the U.S. and Mexico.
Ethnographic study in five Mexican states, selected by their migration dynamics. A series of ...focus groups and in-depth interviews were conducted with health services users and providers.
Six strategies were identified and are used according to the severity of the disease: a) self-medication, b) telephone consultation with relatives, c) utilization of private services, d) travel to border towns, e) return to place of birth, f) getting medical care during their visits to places of origin.
The health care options used by Mexican migrants and their families are defined according to events related to the migration process. The implementation of public policies to protect the health of migrants on both sides of the border is critical.
Objetivo. Analizar los factores asociados con la expectativa de migrar al extranjero en estudiantes de licenciatura en enfermería de escuelas públicas en México, Distrito Federal. Material y métodos. ...Se realizó un estudio transversal con una muestra no probabilística de 420 estudiantes. Se construyó un modelo logístico multivariado. Resultados. El 69% de los informantes expresó la intención de migrar para trabajar (65%) o estudiar (26%). El 50% elegiría como destino Canadá, seguido de España y Estados Unidos. Las variables asociadas con la expectativa de migrar fueron: edad, ingreso, tener familiares en el extranjero y percibir malas condiciones laborales/salarios en México. Conclusiones. Los resultados concuerdan con la literatura internacional. Los bajos salarios, malas condiciones laborales y escasas posibilidades de desarrollarse profesionalmente en México contribuyen a generar la expectativa de migrar en la población de estudio. Adicionalmente, la percepción optimista de los estudiantes sobre el mercado extranjero y la demanda laboral de países desarrollados coadyuvan a enfatizar dicho fenómeno.
OBJETIVO: Describir y analizar el proceso de regularización del personal de salud pagado por el Sistema de Protección Social en Salud de México. MATERIAL Y MÉTODOS: Se utilizan datos primarios y ...secundarios provenientes de la evaluación del Sistema de Protección Social en Salud en 2009. RESULTADOS: La regularización mejora las condiciones laborales de los trabajadores pero sus implicaciones para el conjunto del sistema no son necesariamente positivas. CONCLUSIONES: Se requiere considerar la necesidad de que este tipo de inversiones beneficien a todos los actores interesados, principalmente la población asegurada por el sistema.
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