RESUMO
BACKGROUND: Physical activity (PA) is vital to the holistic development of young people. Regular participation in PA is associated with substantial benefits for health, cognitive function, and social inclusion. Recognizing the potential of PA in the context of the current peace process in Colombia, the purpose of this article is to present the methodology and results of Colombia's second Report Card on PA for children and youth. METHODS: A group of experts on PA graded 14 PA indicators based on data from national surveys and policy documents. RESULTS: National and departmental policy indicators received a grade of B, while organized sport participation, overweight, obesity, community influence, and nongovernment initiatives indicators received a grade of C. Overall PA levels, active transportation, sedentary behaviors, and school influence received a grade of D. Active play, low physical fitness, and family influence received an Incomplete grade. CONCLUSIONS: PA levels are low and sedentary behaviors are high in Colombian children and youth, with notable geographic differences. A broad policy framework translated into specific actions could provide unique opportunities to bridge the gap between knowledge and practice, and contribute to social integration goals in a postconflict setting.
Assuntos
Exercício Físico , Promoção da Saúde/organização & administração , Atividade Motora , Avaliação de Programas e Projetos de Saúde/métodos , Adolescente , Criança , Colômbia , Defesa do Consumidor , Planejamento Ambiental , Feminino , Comportamentos Relacionados com a Saúde , Política de Saúde , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Obesidade , Sobrepeso , Aptidão Física , Jogos e Brinquedos , Características de Residência , Instituições Acadêmicas , Comportamento Sedentário , Condições Sociais , EsportesRESUMO
This paper explores Colombia's road toward universal health care coverage. Using a policy-based approach, we show how, in Colombia, the legal expansion of health coverage is not sufficient and requires the development of appropriate and effective institutions. We distinguish between formal and material health coverage in order to underscore that, despite the rapid legal expansion of health care coverage, a considerable number of Colombians-especially those living in poor regions of the country-still lack material access to health care services. As a result of this gap between formal and material coverage, an individual living in a rich region has a much better chance of accessing basic health care than an inhabitant of a poor region. This gap between formal and material health coverage has also resulted in hundreds of thousands of citizens filing lawsuits-tutelas-demanding access to medications and treatments that are covered by the health system, but that health insurance companies-also known as EPS- refuse to provide. We explore why part of the population that is formally insured is still unable to gain material access to health care and has to litigate in order to access mandatory health services. We conclude by discussing the current policy efforts to reform the health sector in order to achieve material, universal health care coverage.
Assuntos
Atenção à Saúde/legislação & jurisprudência , Reforma dos Serviços de Saúde , Acessibilidade aos Serviços de Saúde , Cobertura Universal do Seguro de Saúde , Colômbia , Atenção à Saúde/economia , Atenção à Saúde/organização & administração , Disparidades em Assistência à Saúde , Direitos Humanos , Humanos , Seguro Saúde/estatística & dados numéricos , Saúde PúblicaRESUMO
BACKGROUND: Almost all nutrition policies in Colombia currently focus on either undernutrition or obesity, with the predominant emphasis on undernutrition. It is crucial to assess the prevalence of the dual burden of malnutrition in Colombia to better target programs and policies. OBJECTIVE: The aim was to estimate the national prevalence of the dual burden of malnutrition in Colombia at the individual and household levels in children aged <5 y, school-age children, adolescents, and adults. DESIGN: This was a cross-sectional analysis from the 2010 Colombian Demographic and Health Survey and the National Nutritional Survey that included 17,696 children aged <5 y, 25,508 school-aged children, 28,328 adolescents, 89,164 adults, and 10,487 households with mothers and children aged <5 y. The dual burden of malnutrition was defined as the coexistence of overweight and stunting or anemia in the same person or household. RESULTS: In Colombia, low to high prevalences of overweight and obesity (3.4-51.2%) coexist with moderate to high prevalences of anemia (8.1-27.5%) and stunting (13.2%). The observed prevalence of the dual burden was lower than expected. Approximately 5% of households had at least one stunted child aged <5 y and an overweight mother compared with an expected prevalence of 6.9% (P < 0.001). Among school-aged children, 0.1% were classified as stunted and obese and 1.4% were both anemic and overweight compared with expected prevalences of 0.5% (P < 0.001) and 1.5% (P = 0.037), respectively. Among 13- to 49-y-old women, 3.4% had anemia and were overweight compared with an expected prevalence of 3.5% (P = 0.038). CONCLUSIONS: National estimates of the dual burden of malnutrition in Colombia are lower than expected. Despite the independence of the occurrence of these conditions, the fact that the dual burden coexists at the national, household, and intraindividual levels suggests that public policies should address both conditions through multiple strategies. It is imperative to evaluate the current nutrition policies to inform malnutrition prevention efforts in Colombia and to share lessons with other countries at a similar stage of nutritional transition.