RESUMEN
Background: Equity in vaccination against COVID-19 is a public health concern. The objective of this study was to analyze socioeconomic inequalities related to vaccination for the first and second doses from primary series against COVID-19 in Ecuador. Methods: Secondary database study in 12,743,507 respondents from 15 years and over. The COVID-19 section of the National Survey of Employment, Unemployment and Underemployment (ENEMDU) was analyzed. Socioeconomic characteristics and vaccination against COVID-19 were associated with the at least one dose and second dose. Poisson regressions for complex samples were obtained. Results: As of the date of the survey, 87.3% of the sample (95% CI 86.7%-87.8%) had received at least one vaccine against COVID-19. A lower probability of having received at least one vaccine against COVID-19 was found in rural areas (PR 0.82, 95% CI 0.74-0.91), indigenous population (PR 0.43, 95% CI 0.29-0.64), no level of education (PR 0.25, 95% CI 0.14-0.43), and the lowest economic income (PR 0.42, 95% CI 0.35-0.52). A significantly lower probability of vaccination with two or more doses was found in rural vs urban area (PR 0.88, 95% CI 0.80-0.96), women vs men (PR 0.85, 95% CI 0.77-0.91), indigenous population vs white (PR 0.44, 95% CI 0.33-0.59) and individuals in the lowest income quartile vs highest income quartile (PR 0.48, 95% CI 0.42-0.55). Underemployment, population economically inactive (PR 0.77, 95% CI 0.67-0.88 and PR 0.71, 95% CI 0.61-0.83) and individuals with no level of education (PR 0.39, 95% CI 0.27-0.58) also were less likely to complete the primary phase of vaccination compared with individuals in the highest income quartile, employment and postgraduate level of education. Conclusions: There were socioeconomic inequalities with the primary series of vaccine against COVID-19, with a greater disadvantage for rural residents, women, indigenous populations, lower economic income and lower levels of education.
RESUMEN
Antecedentes El Hospital Nazareth, I Nivel, Empresa Social del Estado durante la vigencia 2001, realizaba la prestación de los servicios concentrada en los centros de atención con intervenciones extramurales esporádicas. Objetivo Desarrollar un nuevo modelo de prestación de servicios en salud familiar con enfoque de riesgo, que reconozca a la familia como sujeto de sus intervenciones y explore el contexto en el que viven sus integrantes, aproximándose al conocimiento de su cultura. Métodos El modelo de prestación de servicios se desarrolló en cuatro fases: aprestamiento, caracterización, implementación y seguimiento y evaluación. Con el fin de cubrir al 100% de la población el campo aplicativo del modelo se realizó en tres ámbitos, a saber: familiar, de jomada e institucional. Resultados Durante el segundo semestre del año 2001 se inició la planeación de una nueva forma de prestación de servicios, considerándose innovadora, exitosa, con proyección de resultados que impactaron positivamente la estabilidad financiera de la institución, y que de igual manera lograron contribuir al mejoramiento de la calidad de vida de las familias de la localidad 20 del Sumapaz. Conclusiones Como resultados del desarrollo de este modelo cabe mencionar haber deshospitalizado las acciones en salud, haber realizado una atención integral a partir de procesos de interacción y haber incentivado la demanda inducida.
Background During 2001, the Nazareth Hospital, Level I, Empresa Social del Estado, provided services concentrated in care centers with sporadic extra-mural interventions. Objective To develop a new model for the provision of family health services with a risk approach, which recognizes the family as the subject of its interventions and explores the context in which its members live, approaching the knowledge of their culture. Methods The service delivery model was developed in four phases: preparation, characterization, implementation, and monitoring and evaluation. In order to cover 100% of the population, the model was applied in three areas, namely: family, day care and institutional. Results During the second semester of 2001, the planning of a new form of service provision began, which was considered innovative, successful, with projected results that had a positive impact on the financial stability of the institution, and which also contributed to the improvement of the quality of life of the families of the Sumapaz locality 20. Conclusions As results of the development of this model, it is worth mentioning that health actions have been dehospitalized, that comprehensive care has been provided based on interaction processes and that induced demand has been encouraged.