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Introduction: In Brazil, approximately 5% are born with a congenital disorder, potentially fatal without surgery. This study aims to evaluate the relationship between gastrointestinal congenital malformation (GICM) mortality, health indicators, and socioeconomic factors in Brazil. Methods: GICM admissions (Q39-Q45) between 2012 and 2019 were collected using national databases. Patient demographics, socioeconomic factors, clinical management, outcomes, and the healthcare workforce density were also accounted for. Pediatric Surgical Workforce density and the number of neonatal intensive care units in a region were extracted from national datasets and combined to create a clinical index termed 'NeoSurg'. Socioeconomic variables were combined to create a socioeconomic index termed 'SocEcon'. Simple linear regression was used to investigate if the temporal changes of both indexes were significant. The correlation between mortality and the different indicators in Brazil was evaluated using Pearson's correlation coefficient. Results: Over 8 years, Brazil recorded 12804 GICM admissions. The Southeast led with 6147 cases, followed by the Northeast (2660), South (1727), North (1427), and Midwest (843). The North and Northeast reported the highest mortality, lowest NeoSurg, and SocEcon Index rates. Nevertheless, mortality rates declined across regions from 7.7% (2012) to 3.9% (2019), a 51.7% drop. The North and Midwest experienced the most substantial reductions, at 63% and 75%, respectively. Mortality significantly correlated with the indexes in nearly all regions (p<0.05). Conclusion: Our study highlights the correlation between social determinants of health and GICM mortality in Brazil, using two novel indexes in the pediatric population. These findings provide an opportunity to rethink and discuss new indicators that could enhance our understanding of our country and could lead to the development of necessary solutions to tackle existing challenges in Brazil and globally.

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RESUMO Este relato de experiência teve como objetivo analisar o processo de formação de ouvidores do Sistema Único de Saúde (SUS), uma parceria entre a Escola Nacional de Saúde Pública Sergio Arouca (Ensp/ Fiocruz), a Rede Brasileira de Escola de Saúde Pública (RedEscola) e a Secretaria de Gestão Estratégica e Participativa do SUS (SGEP/MS). Considerada pioneira, a formação foi desenvolvida dentro da lógica de construção participativa, envolvendo atores municipais, estaduais e nacionais das Ouvidorias do SUS, instituições/escolas de saúde pública estaduais, Conselho Nacional de Secretarias Municipais de Saúde (Conasems) e Secretaria Técnica e Executiva da RedEscola, em uma articulação de governança consertada que resultou na formação de 451 ouvidores.

ABSTRACT This experience report aimed to analyze the vocational education of ombudsmen in the Unified Health System (SUS). This project was a partnership between the Sergio Arouca National School of Public Health (ENSP/FIOCRUZ), the Brazilian Network of Public Health Schools (RedEscola), and the SUS Strategic and Participatory Management Secretary (SGEP/MS). Considered pioneering, the vocational education was developed within the logic of a participatory process which involved municipal, state and national actors from SUS Ombudsman offices, state public health institutions/schools, the National Council of Municipal Health Secretaries (CONASEMS), and the RedEscola's Technical and Executive Secretary in a consensual governance articulation resulting in the qualification of 451 ombudsmen.

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Background: In Chile, public health training grew both in enrollment and in the number of universities offering programs on the subject. Aim: To compare the academic characteristics and the contents of the master's programs in public health offered by Chilean universities. Material and Methods: A search of all master's programs that include the word "public health " in their title was made, excluding those that did not declare current students in 2020. The academic characteristics and content of each program were compiled according to the information declared by each university. The contents were grouped according to the list of core competencies for the public health professional of the Association of Schools of Public Health in the European Region (ASPHER). Results: Eleven programs were included, most of them are carried out in face-to-face modality. The academic load is expressed in Transferable Credit System credits (62-71), credits (87-125) or teaching hours (1252-2048). All programs declare to have a graduation activity, with a heterogeneous academic load. All programs have basic subjects in epidemiology and more than 60% include introductory topics in public health, research methodology, and health services management. No program declares demography or food safety as compulsory subjects. Conclusions: There is heterogeneity in the academic load and the contents between the programs. It is necessary to establish common criteria in the training of future public health professionals, at least in the compulsory subjects and the minimum academic load.

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RESUMO O presente artigo traz o relato da concepção e implementação de cursos de especialização em saúde pública em dez instituições públicas formadoras que integram a Rede Brasileira de Escolas de Saúde Pública (RedEscola). A iniciativa, inovadora pela metodologia educacional proposta, baseou-se nos princípios e diretrizes da Educação Permanente em Saúde, tendo a valorização do trabalho como eixo pedagógico, a atuação no território e o uso de metodologias ativas no processo ensino-aprendizagem.

ABSTRACT This article presents the report of the conception and implementation of specialization courses in public health in ten public educational institutions that integrate the Brazilian Network of Public Health Schools (RedEscola). This initiative, innovative due to its educational methodology, was based on the principles and guidelines of Permanent Education in Health, having the valuation of work as a pedagogical axis, the territorial action, and the use of active methodologies in the teaching-learning-process.

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PURPOSE OF REVIEW: The purpose of this study is to present changes of policies and norms aimed to reduce obesity levels that have been adopted in some Latin American countries. RECENT FINDINGS: The global increase of the excess weight within the population has been demanding governmental actions aimed at preventing health impacts generated by obesity. Over recent years, many Latin American countries have established a number of regulations aimed at reducing weight in the population using interventions that could effectively prevent childhood obesity, including the taxation of sugar-sweetened beverages (SSBs), increasing physical activity in open spaces, and, especially, front-of-package labeling. Some strategies are part of the Action Plan for Prevention of Child and Adolescence Obesity signed by all countries in Latin America, which currently have among the highest prevalence of childhood obesity in the world. Among them are the implementation of fiscal policies on energy-dense and nutrient-poor foods and taxes on SSBs; improvements in nutrition labeling, highlighting the front-of-package (FOP) labeling to promote the choice of healthier products at the time of purchase; and promotion of an active lifestyle, such as encouraging the use of bicycle paths or physical activity programs at school. The real impact of these prevention strategies implemented in Latin America on the prevalence of obesity is still unknown.

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El término tecnología adecuada se refiere a la tecnología sanitaria que se crea, produce, ofrece y monitorea en un contexto general donde se toman en cuenta los sistemas, las personas y la comunidad. Esta tecnología abarca el diseño, desarrollo y adopción de productos sanitarios, entre ellos nuevos medicamentos, vacunas y métodos diagnósticos, y de medios computadorizados aplicables a la genómica funcional, vigilancia epidemiológica, evaluación de la carga de morbilidad, adjudicación de recursos sanitarios, creación de modelos matemáticos y análisis de efectividad en función del costo. En conjunto, estos medios son especialmente promisorios para el control y la eliminación de diversas enfermedades tropicales que han recibido escasa atención. Actualmente, buena parte de la investigación y el desarrollo en torno a tecnologías adecuadas está a cargo de alianzas formadas recientemente entre los sectores público y privado. No obstante, es preciso incrementar la investigación y el entrenamiento en este campo en las escuelas de salud pública de América del Norte en vista de los efectos sanitarios y económicos que se calcula que tendrá la tecnología adecuada en países en desarrollo.

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The "Unified National Health System" of Nicaragua was established in 1979, in an attempt to transform some of Latin America's worst health indices. This system, based on the stated principles of planning, regionalization, public participation, and primary care, has prioritized the development of health professions training programs appropriate to its special needs and principles. Public Health and Epidemiology training was inaugurated in 1982. A new campus of the School of Medicine was opened in 1981, increasing the number of medical students by a factor of five. Formal residency training (never before available within the country) in primary care specialties has been established. Training for allied health personnel has been formalized in several fields, with the establishment of the Polytechnical Institute of Health. The rapid increase in number and size of training programs has created a tremendous need for educational resources both human and material. This article reviews the status of health personnel training in Nicaragua today, the integration of these programs into planning for the health system, and problems arising from their rapid appearance.

PIP: This article explores the policies and early experiences of the extensive changes in the preparation of health personnel in Nicaragua; massive changes in the health care system were launched after the victory of the Sandinista Revolution in 1979. It reviews the status of health personnel training in the country today, the integration of these programs into planning for the health system, and problems arising their rapid appearance. The Unified National Health System was established in 1979 in an attempt to transform some of Latin America's worst health indices. This system is based on the stated principles of planning, regionalization, public participation, and primary care. To implement these policies, high priority has been given to the development of health professions training programs appropriate to the system's special needs and principles. Public Health and Epidemiology training was inaugurated in 1982. A new campus of the School of Medicine was opened in 1981, increasing the number of meidcal students by a factor of 5. Formal residency training in primary care specialties has been established. Training for allied health professions has been formalized in several fields, with the establishment of the Polytechnical Institute of Health. The rapid increase in number and size of training programs has created a trmendous need for educational resources, both human and material. The greatest constraint in expanding medical education was the lack of qualified teachers. As a solution, the new health system has made public sector employment much more available and attractive; most Nicaraguan physicians today divide their time between public and private practice, and the pressures on voluntary teaching time are heavy. The Health Ministry has developed strategies for making clinical teaching more attractive and prestigious in compensation. Medical curriculum reform since 1979 is designed to turn out doctors capable along 4 lines: clinical service, teaching, administration and research. Special importance is placed on integrated teaching and service. These multiple objectives are built into the teaching program from the very beginning. To date there are 6 schools of nursing in the country (4 before 1979), with 5 times the pre-1979 enrollment. Nicaragua has made a deliberate decision not to train mid-level medical workers. However, volunteer health personnel, the Brigadistas, have played a definite role in Nicaraguan communities. They concentrate on public education and mobilize the people for immunization and sanitation campaigns. Additionally, traditional birth attendants in rural areas have been recognised by the Health Ministry and been given training to upgrade their performance. Much in the new System has emulated policies of Cuba, especially the emphasis on public education, models for personnel training and community-oriented primary care.

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