RESUMO
Backgrounds: The signing of the peace accords in Colombia created challenges that are inherent to post-conflict transitions. One of those is the process of reintegrating ex-combatants into society, in which ensuring their rights to health is a particularly significant challenge in rural areas affected by armed conflict. These areas, known as Territorial Spaces for Training and ReintegrationReincorporation (ETCR, in Spanish), are geographically dispersed throughout 24 municipalities and 13 departments in Colombia. This study aimed to describe how ex-combatants in ETCR regions perceived access to health services one year after the signing of the peace accords. Methods: A descriptive, cross-sectional study was performed between September and October 2018. It included 591 adults and their families, from 23 ETCRs. The study was designed, culturally validated, and piloted. Interviewers were trained and a structured survey was administered containing five dimensions that characterized the perception of effective access to health services. Results: The majority of interviewees were women, heads of household, young adults, ex-combatants, and residents in an ETCR. In total of 96.4% were enrolled in Colombia's subsidized health system, and 20.8% indicated that a member of their household required emergency health services. The regional health center provided the majority of the services. Most of those surveyed (96.0%) reported that they did not have to pay for the services, and that they received respectful (91.6%) and good quality (66.6%) care. There were few referrals to disease prevention and health promotion activities, and only 19.0% of households reported having been visited by extramural health care teams, whose activities were highly valued (80%). Lastly, there was little knowledge about community health activities. Conclusions: While residents of ETCR regions have a favorable perception of their access to health services, they need to be made aware of extramural and public health activities.
Assuntos
Atenção à Saúde , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Adulto , Conflitos Armados , Colômbia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
Resumen Antecedentes. La presencia de mosquitos en el sur de Bogotá se constituye en una molestia sanitaria debido a sus altas densidades. Objetivo. Caracterizar la abundancia mensual y la actividad de picadura de los mosquitos. Materiales y métodos. Se recolectaron mosquitos utilizando trampas Shannon, durante una noche por mes y por un periodo de seis meses, en dos sitios aledaños a fosos de excavación minera, inundadas por el río Tunjuelito. Resultados. Se recolectaron un total de 18891 mosquitos. 99,93% se determinaron como culex quinquefasciatus. Los meses de mayor abundancia de mosquitos fueron marzo y abril, los cuales presentan mayor precipitación. Se encontraron dos patrones de actividad nocturna, uno con un solo pico hacia la media noche en el sitio más cercano a las minas de excavación y otro con dos picos definidos en el sitio más cercano a las viviendas. La tasa de paridad fue de 64,4%. Conclusión. Este comportamiento diferente posiblemente esté asociado a las condiciones microambientales, como luz y actividad minera de la zona durante las 24 horas del día, pero no se encontró que estuviera relacionado con la presencia o ausencia de lluvia.
Summary Background. Culex quinquefasciatus is a nuisance for humans and animals, in the southern area of Bogotá, due to its high abundance. Objective. Characterize the abundance of these mosquitoes monthly and their activity during the night. Materials and Methods. Mosquitoes were collected using a Shannon trap, during one night each month, from December 2006 to May 2007 in two places located near mining excavation pits. These pits were flooded with water of the Tunjuelito river in 2002. Results. During the study, 18891 mosquitoes were collected. 99.93 % were identified as Culex quinquefasciatus. These mosquitoes were most abundant in March and April, the highest rainfall months. Two patterns of nocturnal activity were found: in one of them, a unique peak in the darkest hours was found, in an area of active mining. In the other area, located nearest to houses, mosquitoes showed two activity peaks. Conclusions. The difference in these two behavioral patterns could be explained by micro-environmental conditions such as light and the intensity of mining activity, but it could not be associated with the presence of rain.