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1.
Am J Primatol ; 86(7): e23635, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38738522

RESUMO

The golden lion tamarin (GLT) is an Endangered primate endemic to Brazil's lowland Atlantic Forest. After centuries of deforestation and capture for the pet trade, only a few hundred individuals survived, all in isolated forest fragments 85 km from Rio de Janeiro city. Intensive conservation actions, including reintroduction of zoo-born tamarins, increased numbers to about 3700 in 2014. The most severe yellow fever epidemic/epizootic in Brazil in 80 years reduced two of the largest GLT populations by over 90%. Herein we report the results of a 2023 survey of GLTs designed to examine the dynamics of population recovery following yellow fever. Results indicate that populations hard hit by yellow fever are recovering due in part to immigration from adjacent forest fragments. No local extirpations were observed. About 4800 GLTs live in the survey area. This represents a 31% increase since the baseline survey completed in 2014. Two factors explain most of the increase: four large areas that had no GLTs or very low-density populations in 2014 are now at moderate density (three areas) or low density (one area), explaining 71% of overall increase since 2014. Increase in forest area within our survey area may explain up to 16% of the increase in GLT numbers since 2014. Results of computer simulations suggest that strengthening forest connectivity will facilitate metapopulation resilience in the face of mortality factors such as yellow fever.


Assuntos
Leontopithecus , Dinâmica Populacional , Febre Amarela , Animais , Febre Amarela/epidemiologia , Brasil/epidemiologia , Doenças dos Macacos/epidemiologia , Espécies em Perigo de Extinção , Conservação dos Recursos Naturais , Feminino , Masculino
2.
J Occup Environ Hyg ; 21(3): 189-201, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38408355

RESUMO

Work-related deaths are a persistent occupational health issue that can be prevented. However, prevention opportunities can be hampered by a lack of adequate public health resources. The Western States Occupational Network (WestON) is a network of federal, state, and local occupational health professionals that includes a 19-state region of the United States. To encourage public health collaboration, WestON partners examined work-related fatalities within the region. Fatality counts (numerators) were obtained from the U.S. Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries restricted-access research files for all workers ages ≥15 years and fatally injured in WestON states from 2011 through 2017. Estimates of full-time equivalent hours worked (FTE) (denominators) were retrieved from the BLS Current Population Survey. Annual average fatality rates were calculated as number of fatalities per 100,000 FTE over the study period. Rates were stratified by state, select demographics, industry sector, and event/exposure types. Pearson chi-squared tests and rate ratios with 95% confidence probability limits were used to assess rate differences. All analyses were conducted using SAS v.9.4. From 2011 through 2017, the annual average overall occupational fatality rate for the WestON region was 3.5 fatalities per 100,000 FTE, comparable to the overall U.S. fatality rate. Male workers had a fatality rate almost 10 times higher than female workers in the region. Fatality rates increased with successive age groups. Alaska and New Mexico had significantly higher fatality rates for all racial/ethnic groups compared to respective regional rates. Wyoming, North Dakota, and Montana had the three highest occupational fatality rates among foreign-born workers. Agriculture/forestry/fishing, mining/oil/gas extraction, and transportation/warehousing/utilities were industry sector groups with the three highest fatality rates regionally. Transportation-related incidents were the most frequent event type associated with occupational fatalities for all 19 states. Work-related fatalities are a crosscutting occupational public health priority. This analysis can be an impetus for collaborative multistate initiatives among a dynamic and varied occupational public health network to better meet the needs of a rapidly changing workforce.


Assuntos
Saúde Ocupacional , Traumatismos Ocupacionais , Masculino , Estados Unidos/epidemiologia , Humanos , Feminino , Traumatismos Ocupacionais/epidemiologia , Acidentes de Trabalho/prevenção & controle , Indústrias , Emprego
3.
Popul Stud (Camb) ; 78(1): 3-20, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36977422

RESUMO

Effective government services rely on accurate population numbers to allocate resources. In Colombia and globally, census enumeration is challenging in remote regions and where armed conflict is occurring. During census preparations, the Colombian National Administrative Department of Statistics conducted social cartography workshops, where community representatives estimated numbers of dwellings and people throughout their regions. We repurposed this information, combining it with remotely sensed buildings data and other geospatial data. To estimate building counts and population sizes, we developed hierarchical Bayesian models, trained using nearby full-coverage census enumerations and assessed using 10-fold cross-validation. We compared models to assess the relative contributions of community knowledge, remotely sensed buildings, and their combination to model fit. The Community model was unbiased but imprecise; the Satellite model was more precise but biased; and the Combination model was best for overall accuracy. Results reaffirmed the power of remotely sensed buildings data for population estimation and highlighted the value of incorporating local knowledge.


Assuntos
Censos , Humanos , Colômbia , Teorema de Bayes
4.
Econ Hum Biol ; 52: 101320, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38101182

RESUMO

In this paper I examine the evolution of parental gender preferences in Argentina (i.e., parents who prefer a certain gender composition in their children). To do this, I use census microdata that spans the 19th, 20th, and 21st centuries. The estimation strategy exploits the plausibly random assignment in the gender of children. The results show a persistent preference for a mixed gender composition (i.e., having at least one boy and one girl) instead of children of the same gender. This translates into an increase in the probability of having a third child, conditional on already having two children of between 9%-23% for those couples who have children of the same gender -in relation to couples with children of opposite genders-. These preferences are heterogeneous over time and have important implications in terms of fertility (i.e., the reduction of these mixed gender preferences -in favor of greater gender-neutrality- could contribute to reducing the number of children per couple). In addition, the findings of this work support the empirical literature that uses the gender composition of the first two children as an instrumental variable to study the impact of fertility on labor participation.


Assuntos
Fertilidade , Criança , Feminino , Masculino , Humanos , Argentina
5.
Rev. biol. trop ; Rev. biol. trop;71(1)dic. 2023.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1449520

RESUMO

Introduction: Habitat alterations result in biodiversity loss, particularly in regions with high levels of diversity and endemism. Raptors are an essential part of the functionality and stability of ecosystems and indicators of habitat quality. In the paramo grassland ecosystems in the high Andes of Northern South America, raptors contain a high concentration of threatened species. Objective: To describe the raptor community structure and determine the species associations. Methods: We made monthly raptor counts in eight transects from October 2021 to September 2022 and used a principal component analysis to determine species associations. Results: We identified 149 individuals (seven species, three families) in two communities: abundant (Carunculated Caracara, Variable Hawk, Andean Condor and Turkey Vulture; PCI = 47 %), and scarce (Cinereous Harrier, Peregrine Falcon and Aplomado Falco; PCII = 27 %). Conclusion: We provide a valid description and understanding of raptor community structure, identifying two communities and the dynamics between them. The first is characterized by an increased abundance of generalist and regionally common species, when the abundance of these species decreases, the second community is defined, characterized by an increase in the abundance of specialist and rare species at the local scale.


Introducción: Las alteraciones del hábitat provocan la pérdida de biodiversidad, especialmente en regiones con altos niveles de diversidad y endemismo. Las aves rapaces son una parte esencial de la funcionalidad y estabilidad de los ecosistemas, y son indicadores de la calidad del hábitat. En los ecosistemas de páramo en los Andes del norte de Sudamérica, hay una concentración de especies rapaces amenazadas. Objetivo: Describir la estructura de la comunidad de aves rapaces y determinar las asociaciones entre las especies. Métodos: Hicimos conteos mensuales de rapaces en ocho transectos, de octubre 2021 a setiembre 2022 y usamos un análisis de componentes principales para determinar las asociaciones entre especies. Resultados: Identificamos 149 individuos (siete especies, tres familias) en dos comunidades: abundantes (e.g., Caracara Curiquingue, Gavilán Variable, Cóndor Andino y Gallinazo Cabecirrojo; PCI = 47 %), y poco abundantes (e.g., Caracara Curiquingue, Gavilán Variable, Cóndor Andino y Gallinazo Cabecirrojo; PCII = 27 %). Conclusiones: Nuestro enfoque proporciona una descripción y comprensión válida de la estructura de la comunidad de rapaces. Identificamos dos comunidades y la dinámica entre ellas. La primera se caracteriza por una mayor abundancia de especies generalistas y regionalmente comunes, cuando la abundancia de estas especies disminuye, se define la segunda comunidad, caracterizada por un aumento de la abundancia de especies especialistas y raras a escala local.

6.
Int J Equity Health ; 21(Suppl 2): 200, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855052

RESUMO

BACKGROUND: Indigenous Maya women in the rural highlands of Guatemala have traditionally faced constraints to decision-making and participation in community affairs. Anecdotal experiences from previous Curamericas Global projects in Guatemala and Liberia have suggested that interventions using the CBIO+ Approach (which consists of implementing together the Census-Based, Impact-Oriented Approach, the Care Group Approach, and Community Birthing Centers), can be empowering and can facilitate improvements in maternal and child health. This paper, the eighth in a series of 10 papers examining the effectiveness of CBIO+ in improving the health and well-being of mothers and children in an isolated mountainous rural area of the Department of Huehuetenango, explores changes in women's empowerment among mothers of young children associated with the Curamericas/Guatemala Maternal and Child Health Project, 2011-2015. METHODS: Knowledge, practice, and coverage (KPC) surveys and focus group discussions (FGDs) were used to explore six indicators of women's empowerment focusing on participation in health-related decision-making and participation in community meetings. KPC surveys were conducted at baseline (January 2012) and endline (June 2015) using standard stratified cluster sampling. Seventeen FGDs (9 with women, 3 with men, 2 with mothers-in-law, and 3 with health committees), approximately 120 people in all, were conducted to obtain opinions about changes in empowerment and to identify and assess qualitative factors that facilitate and/or impede women's empowerment. RESULTS: The KPC surveys revealed statistically significant increases in women's active participation in community meetings. Women also reported statistically significant increases in rates of participation in health-related decision-making. Further, the findings show a dose-response effect for two of the six empowerment indicators. The qualitative findings from FGDs show that the Project accelerated progress in increasing women's empowerment though women still face major barriers in accessing needed health care services for themselves and their children. CONCLUSION: The Project achieved some notable improvements in women's decision-making autonomy and participation in community activities. These improvements often translated into making decisions to practice recommended health behaviors. Traditional cultural norms and the barriers to accessing needed health services are not easily overcome, even when empowerment strategies are effective.


Assuntos
Censos , Saúde da Criança , Criança , Masculino , Humanos , Feminino , Pré-Escolar , Guatemala , Grupos Focais , Mães
7.
Int J Equity Health ; 21(Suppl 2): 201, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855068

RESUMO

BACKGROUND: Community-based health interventions have been an integral part of recent health gains globally. An innovative approach to delivering community health care combines the Census-Based, Impact-Oriented (CBIO) Approach with Care Groups and Community Birthing Centers called Casas Maternas Rurales. CBIO+ was adopted by Curamericas/Guatemala in its Maternal and Child Health Project, 2011-2015. Here, we describe the opinions of Project staff and local government health care workers about the strengths and challenges of CBIO+.  METHODS: Self-administered questionnaires, key informant interviews, and focus group discussions were used to obtain the views of 21 staff members from Curamericas/Guatemala as well as 15 local government health workers. The evaluation focused on four primary areas: (1) advisability of integrating the CBIO+ Approach into the government's rural health system, (2) staff knowledge of the CBIO+ Approach, (3) advantages, disadvantages and challenges of the CBIO+ Approach, and (4) proposed improvements to the CBIO+ Approach. The data were coded into categories and from these categories themes were derived. RESULTS: The most commonly mentioned advantage of CBIO+ was the inclusion of the community in program planning, which improved participation. Many respondents noted that the CBIO+ Approach was challenging to implement in communities with internal conflicts. Among other challenges mentioned were coordinating (both among the Project staff and with others in the communities), maintenance of a high level of community participation, and overcoming opposition of men to women's participation in Care Groups. The staff mentioned a number of possible changes, including increasing male involvement, raising salaries for community-level paid staff, providing volunteers with incentives, and improving coordination both internally and externally. There was a strong demand among the local Ministry of Public Health and Social Welfare staff for the Project to continue. CONCLUSION: The CBIO+ Approach and its implementation by Curamericas/Guatemala was overall embraced by local staff. By eliciting feedback while the project was ongoing, actionable areas for improvement were identified.


Assuntos
Censos , Saúde da Criança , Criança , Humanos , Feminino , Masculino , Guatemala , Família , Cognição
8.
Int J Equity Health ; 21(Suppl 2): 195, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855098

RESUMO

BACKGROUND: The Curamericas/Guatemala Maternal and Child Health Project, 2011-2015, included implementation research designed to assess the effectiveness of an approach referred to as CBIO+ , composed of: (1) the Census-Based, Impact-Oriented (CBIO) Approach, (2) the Care Group Approach, and (3) the Community Birthing Center Approach. This is the second paper in a supplement of 10 articles describing the implementation research and its findings. Paper 1 describes CBIO+ , the Project Area, and how the Project was implemented. OBJECTIVE: This paper describes the implementation research design and details of how it was carried out. METHODS: We reviewed the original implementation research protocol and the methods used for all data collection related to this Project. The protocol and methods used for the implementation research related to this Project were all standard approaches to the monitoring and evaluation of child survival projects as developed by the United States Agency for International Development Child Survival and Health Grants Program (CSHGP) and the CORE Group. They underwent independent peer review supervised by the CSHGP before the implementation research began. RESULTS: The study area was divided into two sets of communities with a total population of 98,000 people. Project interventions were implemented in Area A from 2011 until the end of the project in 2015 (44 months) and in Area B from late 2013 until 2015 (20 months). Thus, Area B served as a quasi-comparison area during the first two years of Project implementation. The overarching study question was whether the CBIO+ Approach improved the health and well-being of children and mothers. The outcome indicators included (1) changes in population coverage of evidence-based interventions, (2) changes in childhood nutritional status, (3) changes in the mortality of children and mothers, (4) quality of care provided at Community Birthing Centers, (5) the impact of the Project on women's empowerment and social capital, (6) stakeholder assessment of the effectiveness of the CBIO+ Approach, and (7) the potential of wider adoption of the CBIO+ Approach. CONCLUSION: The implementation research protocol guided the assessment of the effectiveness of the CBIO+ Approach in improving the health and well-being of children, mothers, and their communities.


Assuntos
Censos , Saúde da Criança , Criança , Humanos , Feminino , Guatemala , Coleta de Dados , Mães
9.
Int J Equity Health ; 21(Suppl 2): 197, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855101

RESUMO

BACKGROUND: This is the fourth paper in our supplement on improving the health and well-being of rural indigenous Maya mothers and children in the Western Highlands of Guatemala, where the prevalence of stunting is the highest in Latin America and among the highest in the world. Reducing childhood undernutrition was one of the objectives of the Maternal and Child Health Project, 2011-2015, implemented by Curamericas/Guatemala. The implementation research portion of the Project attempted to determine if there were greater improvements in childhood nutritional status in the Project Area than in comparison areas and whether or not a dose-response effect was present in terms of a greater improvement in the Project Area with a longer duration of interventions.  METHODS: The Project provided nutrition-related messages to mothers of young children, cooking sessions using locally available nutritious foods, a lipid-based nutrient supplement (Nutributter®) for a short period of time (4 months), anti-helminthic medication, and repeated growth monitoring and nutrition counseling. Measures of height and weight for calculating the prevalence of underweight, stunting, and wasting in under-2 children were analyzed and compared with the anthropometric data for children in the rural areas of the Northwestern Region and in the Western Highlands of Guatemala. RESULTS: The prevalence of stunting declined in Area A from 74.5% in September 2012 to 39.5% in June 2015. Area A comprised approximately one-half of the Project Area and was the geographic area with the greatest intensity and duration of nutrition-related Project interventions. Minimal improvements in stunting were observed in the Northwestern Region, which served as a comparison area. Improvements in multiple output and outcome indicators associated with nutritional status were also observed in Areas A and B: infant and young child feeding practices, routine growth monitoring and counseling, and household practices for the prevention and treatment of diarrhea. CONCLUSION: The Project Area in which Curamericas/Guatemala implemented the CBIO+ Approach experienced a reduction in the prevalence of stunting and other measures of undernutrition in under-2 children. Given the burden of undernutrition in Guatemala and other parts of the world, this approach merits broader application and further evaluation.


Assuntos
Desnutrição , Magreza , Criança , Lactente , Feminino , Humanos , Pré-Escolar , Magreza/epidemiologia , Magreza/prevenção & controle , Saúde da Criança , Guatemala/epidemiologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/prevenção & controle , Mães
10.
Int J Equity Health ; 21(Suppl 2): 198, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855128

RESUMO

BACKGROUND: The Curamericas/Guatemala Maternal and Child Health Project, 2011-2015, implemented the Census-Based, Impact-Oriented Approach, the Care Group Approach, and the Community Birthing Center Approach. Together, this expanded set of approaches is known as CBIO+. This is the fifth of 10 papers in our supplement describing the Project and the effectiveness of the CBIO+ Approach. This paper assesses causes, levels, and risk factors for mortality along with changes in mortality. METHODS: The Project maintained Vital Events Registers and conducted verbal autopsies for all deaths of women of reproductive age and under-5 children. Mortality rates and causes of death were derived from these data. To increase the robustness of our findings, we also indirectly estimated mortality decline using the Lives Saved Tool (LiST). FINDINGS: The leading causes of maternal and under-5 mortality were postpartum hemorrhage and pneumonia, respectively. Home births were associated with an eight-fold increased risk of both maternal (p = 0.01) and neonatal (p = 0.00) mortality. The analysis of vital events data indicated that maternal mortality declined from 632 deaths per 100,000 live births in Years 1 and 2 to 257 deaths per 100,000 live birth in Years 3 and 4, a decline of 59.1%. The vital events data revealed no observable decline in neonatal or under-5 mortality. However, the 12-59-month mortality rate declined from 9 deaths per 1000 live births in the first three years of the Project to 2 deaths per 1000 live births in the final year. The LiST model estimated a net decline of 12, 5, and 22% for maternal, neonatal and under-5 mortality, respectively. CONCLUSION: The baseline maternal mortality ratio is one of the highest in the Western hemisphere. There is strong evidence of a decline in maternal mortality in the Project Area. The evidence of a decline in neonatal and under-5 mortality is less robust. Childhood pneumonia and neonatal conditions were the leading causes of under-5 mortality. Expanding access to evidence-based community-based interventions for (1) prevention of postpartum hemorrhage, (2) home-based neonatal care, and (3) management of childhood pneumonia could help further reduce mortality in the Project Area and in similar areas of Guatemala and beyond.


Assuntos
Saúde da Criança , Hemorragia Pós-Parto , Criança , Recém-Nascido , Gravidez , Humanos , Feminino , Guatemala/epidemiologia , Censos , Família
11.
Int J Equity Health ; 21(Suppl 2): 196, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855129

RESUMO

BACKGROUND: This is the third in a series of 10 articles describing the Curamericas/Guatemala Maternal and Child Health Project, 2011-2015, and its effectiveness in improving the health and well-being of 15,327 children younger than 5 years of age and 32,330 women of reproductive age in the Department of Huehuetenango in180 communities that make up the municipalities of San Sebastian Coatán, Santa Eulalia, and San Miguel Acatán. The Project combined the Census-Based, Impact-Oriented (CBIO) Approach with the Care Group Approach and the  Community Birthing Center (Casa Materna Rural) Approach. This combined approach we refer to as CBIO+. The Project trained women volunteers every two weeks (in Care Groups) to provide health education to neighboring households. Messages focused on the promotion of maternal and newborn health, nutrition, prevention and treatment of acute respiratory infection and diarrhea in children, and immunizations. METHODS: Household knowledge, practice and coverage (KPC) surveys were executed at baseline in January 2011 and at endline in June 2015 to measure changes in levels of knowledge of danger signs, key household practices (such as Essential Newborn Care and handwashing), and health service utilization (such as antenatal care and care seeking for a child with signs of pneumonia) in two separate Project Areas (Area A with 41 months and Area B with 20 months of full intervention implementation). RESULTS: For the 24 indicators of the interventions under the Project's control, statistically significant improvements were observed for 21 in Area A and 19 in Area B. However, for some of the interventions that required support from the government's Extension of Coverage Program (immunization, family planning, and vitamin A administration) no improvements were noted because of the cessation of the program by the government after Project implementation began. In both Areas A and B one-half of the indicators improved by at least two-fold. CONCLUSION: This community-based Project has been effective in quickly achieving marked improvements in indicators for interventions that are important for the health of mothers and children. These achievements are notable in view of the challenging context in which the Project was implemented.


Assuntos
Censos , Saúde da Criança , Gravidez , Criança , Recém-Nascido , Feminino , Humanos , Guatemala , Família , Serviços de Planejamento Familiar
12.
Int J Equity Health ; 21(Suppl 2): 202, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855130

RESUMO

BACKGROUND: This is the final of 10 papers that describe the implementation of the Expanded Census-Based, Impact-Oriented Approach (CBIO+) by Curamericas/Guatemala in the Cuchumatanes mountains of the Department of Huehuetenango and its effectiveness in improving the health and well-being of women and children in a population of 98,000 in three municipalities. The CBIO+ Approach consists of three components: the CBIO (Census-Based, Impact-Oriented) Approach, the Care Group Approach, and the Community Birthing Center Approach. METHODS: Each of the preceding papers was summarized. An assessment was made regarding the degree to which the initial implementation research hypotheses were confirmed. The total field cost per capita for operation of the Project was calculated. An assessment of the cost-effectiveness of the Project was made based on the estimated impact of the Project, the number of lives saved, and the number of disability-adjusted life years averted. RESULTS: The Project attained a number of notable achievements in terms of expanding the coverage of key maternal and child health interventions, improving the nutritional status of children, reducing the mortality of children and mothers, providing quality care for mothers at the Community Birthing Centers (Casas Maternas Rurales) that integrate traditional midwives (comadronas) into the care of women during childbirth at the birthing centers, as well as empowering women and building social capital in the communities. CBIO+ is an effective and affordable approach that is particularly notable for its capacity to engage communities in the process of improving the health of mothers and children. Overall, there is strong and consistent evidence in support of the research hypotheses. The findings did produce evidence of declines in under-5 and maternal mortality, but they were not as robust as had been hoped. CONCLUSION: CBIO+ is an approach that has been effective in engaging communities in the process of improving the health of their mothers and children and in reducing health inequities in this marginalized, difficult-to-reach population of Indigenous Maya people. The CBIO+ Approach is cost-effective and merits further development and broader application in Guatemala and beyond.


Assuntos
Saúde da Criança , Análise de Custo-Efetividade , Criança , Humanos , Feminino , Guatemala , Família , Censos
14.
Int J Equity Health ; 21(Suppl 2): 203, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855139

RESUMO

BACKGROUND: The Curamericas/Guatemala Maternal and Child Health Project, 2011-2015, was implemented in the Western Highlands of the Department of Huehuetenango, Guatemala. The Project utilized three participatory approaches in tandem: the Census-Based, Impact-Oriented (CBIO) Approach, the Care Group Approach, and the Community Birthing Center Approach. Together, these are referred to as the Expanded CBIO Approach (or CBIO+). OBJECTIVE: This is the first article of a supplement that assesses the effectiveness of the Project's community-based service delivery platform that was integrated into the Guatemalan government's rural health care system and its special program for mothers and children called PEC (Programa de Extensión de Cobertura, or Extension of Coverage Program). METHODS: We review and summarize the CBIO+ Approach and its development. We also describe the Project Area, the structure and implementation of the Project, and its context. RESULTS: The CBIO+ Approach is the product of four decades of field work. The Project reached a population of 98,000 people, covering the entire municipalities of San Sebastián Coatán, Santa Eulalia, and San Miguel Acatán. After mapping all households in each community and registering all household members, the Project established 184 Care Groups, which were composed of 5-12 Care Group Volunteers who were each responsible for 10-15 households. Paid Care Group Promoters provided training in behavior change communication every two weeks to the Care Groups. Care Group Volunteers in turn passed this communication to the mothers in their assigned households and also reported back to the Care Group Promoters information about any births or ï»¿deaths that they learned of during the previous two weeks as a result of their regular contact with their neighbors. At the outset of the Project, there was one Birthing Center in the Project Area, serving a small group of communities nearby. Two additional Birthing Centers began functioning as the Project was operating. The Birthing Centers encouraged the participation of traditional midwives (called comadronas) in the Project Area. CONCLUSION: This article serves as an introduction to an assessment of the CBIO+ community-based, participatory approach as it was implemented by Curamericas/Guatemala in the Western Highlands of the Department of Huehuetenango, Guatemala. This article is the first of a series of articles in a supplement entitled Reducing Inequities in Maternal and Child Health in Rural Guatemala through the CBIO+ Approach of Curamericas.


Assuntos
Censos , Saúde da Criança , Criança , Feminino , Humanos , Guatemala , Comunicação , Mães
15.
Int J Equity Health ; 21(Suppl 2): 204, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855147

RESUMO

BACKGROUND: In Guatemala, Indigenous women have a maternal mortality ratio over twice that of non-Indigenous women. Long-standing marginalization of Indigenous groups and three decades of civil war have resulted in persistent linguistic, economic, cultural, and physical barriers to maternity care. Curamericas/Guatemala facilitated the development of three community-built, -owned, and -operated birthing centers, Casas Maternas Rurales (referred to here as Community Birthing Centers), where auxiliary nurses provided physically accessible and culturally acceptable clinical care. The objective of this paper is to assess the management of complications and the decision-making pathways of Birthing Center staff for complication management and referral. This is the sixth paper in the series of 10 articles. Birthing centers are part of the Expanded Census-based, Impact-oriented Approach, referred to as CBIO+. METHODS: We undertook an explanatory, mixed-methods study on the handling of pregnancy complications at the Birthing Centers, including a chart review of pregnancy complications encountered among 1,378 women coming to a Birthing Center between 2009 and 2016 and inductively coded interviews with Birthing Center staff. RESULTS: During the study period, 1378 women presented to a Birthing Center for delivery-related care. Of the 211 peripartum complications encountered, 42.2% were successfully resolved at a Birthing Center and 57.8% were referred to higher-level care. Only one maternal death occurred, yielding a maternal mortality ratio of 72.6 maternal deaths per 100,000 live births. The qualitative study found that staff attribute their successful management of complications to frequent, high-quality trainings, task-shifting, a network of consultative support, and a collaborative atmosphere. CONCLUSION: The Birthing Centers were able to resolve almost one-half of the peripartum complications and to promptly refer almost all of the others to a higher level of care, resulting in a maternal mortality ratio less than half that for all Indigenous Guatemalan women. This is the first study we are aware of that analyzes the management of obstetrical complications in such a setting. Barriers to providing high-quality maternity care, including obtaining care for complications, need to be addressed to ensure that all pregnant women in such settings have access to a level of care that is their fundamental human right.


Assuntos
Centros de Assistência à Gravidez e ao Parto , Morte Materna , Serviços de Saúde Materna , Gravidez , Criança , Recém-Nascido , Feminino , Humanos , Saúde da Criança , Guatemala
16.
PeerJ ; 11: e14763, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36710865

RESUMO

Background: Among the New World vultures, the Andean condor is considered one of the most culturally and ecologically important species. However, their populations are declining over their entire distributional range. In response, conservation strategies have been implemented in many countries to reverse the increasing extinction risk of this species. The initiatives rely on extensive population surveys to gather basic information necessary to implement policies and to intervene efficiently. Still, there is a need to standardize the surveys based on seasonality and suitable environmental conditions throughout the species distribution. Here, we provide the first assessment of how daily temperature, rainfall, and seasonality influence surveys of Andean condors on a communal roost in the central Peruvian Andes. Methods: Using an autoregressive generalized linear model, we associated environmental variables with visual surveys of adult and young condors at three different times of the day and three times a week between June 2014 and March 2015. Results: We found that both adults and young Andean condors showed a threefold reduction in the use of the communal roost after the beginning of the rainy season. Colder and drier days (dry season) are preferable for surveying, as we expect the total number of condors using communal roosts to reduce under rainy (rainfall = -0.53 ± 0.16) and warmer days (temperature = -0.04 ± 0.02) days. Therefore, the significant variation in the use of roosts across seasons and hours should be carefully accounted for in national surveys, at the risk of undermining the full potential of the communal roost surveys. Moreover, we also found a strong bias towards immatures (about 76%) in the adult:immature ratio and a remarkable absence of Andean condors during the wet season. These results suggest that the species might be using other unknown communal roosts hierarchically. Such results provide key information for selecting priority areas for conservation and selecting the best time to survey this species in the tropical Andes. Finally, it may open a fruitful avenue for further research on the protection of the Andean condor.


Assuntos
Falconiformes , Animais , Aves/fisiologia , Inquéritos e Questionários , Estações do Ano , Chuva
17.
Popul Stud (Camb) ; 77(2): 179-195, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36106791

RESUMO

The Brazilian period total fertility rate (PTFR) dropped to 1.8 in 2010 (1.5 among those with high education). Due to shifts in fertility timing, the PTFR may provide a misleading picture of fertility levels. The consequences of these changes for the cohort total fertility rate (CTFR)-a measure free from tempo distortions-and for educational differences in completed fertility remain unknown. Due to data limitations, CTFR forecasts in low- and middle-income countries are rare. We use Brazilian censuses to reconstruct fertility rates indirectly and forecast the CTFR for all women and by educational level. Four forecasting methods indicate that the CTFR is unlikely to fall to the level of the PTFR. Educational differences in the CTFR are likely to be stark, at 0.7-0.9, larger than in many high-income countries with comparable CTFRs. We show how the CTFR can be forecasted in settings with limited data and call for more research on educational differences in completed fertility in low- and middle-income countries.


Assuntos
Coeficiente de Natalidade , Fertilidade , Feminino , Humanos , Brasil , Demografia , Escolaridade , Países em Desenvolvimento , Dinâmica Populacional , Previsões
18.
Rev. bras. estud. popul ; 40: e0253, 2023. tab, graf
Artigo em Português | LILACS, Coleciona SUS | ID: biblio-1529863

RESUMO

Resumo No Brasil, o estudo da condição de legitimidade (filiação) é tópico que vem sendo tratado pela literatura especializada, tanto no âmbito da História quanto no da Demografia Histórica, sobretudo a partir da década de 1980. O objetivo deste artigo é contribuir para o avanço da temática, mapeando a incidência e a distribuição espacial da ilegitimidade no estado de São Paulo, no final do século XIX, a partir de uma perspectiva diferente daquela dos estudos já elaborados, especialmente em relação ao recorte temporal e às fontes utilizadas. Assim, foram analisados os dados sobre a filiação na população paulista a partir dos Recenseamentos Gerais da População Brasileira, realizados em 1890 e 1900, acrescidos de outras fontes de cunho estatístico, produzidas para o estado de São Paulo. Os resultados apontam um quadro diferenciado em relação às várias zonas que compõem o estado e, embora as fontes sejam distintas, corroboraram o papel fundamental da imigração internacional, pois, nas áreas onde ela foi mais intensa, verificou-se a queda nos percentuais da ilegitimidade.


Abstract In Brazil, the study of the condition of legitimacy (affiliation) is a topic that has been studied by the specialized literature, both in the field of History and in that of Historical Demography, especially from the 1980s onwards. The objective of this article is to contribute to the advancement of the debate on illegitimacy, mapping the incidence and the spatial distribution of the phenomenon in the state of São Paulo, at the end of the 19th century, from a different perspective of previous studies, especially in relation to the considered period and the used sources. Thus, data on affiliation in the São Paulo population were analysed from the General Censuses of the Brazilian Population, carried out in 1890 and 1900, in addition to other statistical sources produced for the state of São Paulo. The results point to a different picture in relation to the various zones that make up the state of São Paulo and, although the sources are different, the results corroborate the fundamental role of international immigration, because in the areas where it was more intense, there was a decrease in the percentages of illegitimacy.


Resumen En Brasil, el estudio de la condición de legitimidad (filiación) es un tema que viene siendo abordado por la literatura especializada tanto en el campo de la Historia como en el de la Demografía Histórica, especialmente a partir de la década del ochenta del siglo XX. Es nuestra intención contribuir al avance del tema, mapeando la incidencia y la distribución espacial de la ilegitimidad en el estado de São Paulo, a finales del siglo XIX, desde una perspectiva diferente a la de estudios anteriores, en especial en relación con el marco temporal y las fuentes utilizadas. Así, los datos de afiliación en la población paulista fueron analizados a partir de los censos generales de población brasileña de 1890 y de 1900, además de otras fuentes estadísticas producidas para el estado de São Paulo. Los resultados apuntan a un cuadro diferente en relación con las diversas zonas que componen el estado de São Paulo y, aunque las fuentes son diferentes, los resultados corroboran el papel fundamental de la inmigración internacional, pues en las áreas donde fue más intensa disminuyeron los porcentajes de ilegitimidad.


Assuntos
Humanos , História do Século XIX , Política Pública , Ilegitimidade , Dinâmica Populacional , Demografia , Emigração e Imigração , População , Fatores Socioeconômicos , Brasil , Censos , Imigração Ilegal
19.
Rev. bras. estud. popul ; 40: e0247, 2023. tab, graf
Artigo em Inglês | LILACS, Coleciona SUS | ID: biblio-1521756

RESUMO

Abstract This article aims to analyze residential segregation by race (racial segregation) and income (economic segregation) in Brazil and explore its relationship with socioeconomic and socio-spatial factors. Residential segregation was assessed using the dissimilarity index based on the 2010 demographic census and considering urban census tracts since segregation is sociologically considered an urban problem. The results for racial segregation showed that it is more evident in cities in the South and Southeast of Brazil and mainly affects the self-declared black population. The approach used to calculate economic segregation involved examining the income level of different low-income groups. Therefore, we consider families that earned between 0 and 1 minimum wage as the group with the greatest social vulnerability. We did not find significant correlations between racial and income segregation indices with aspects such as urbanization (urban population size). Finally, we present the racial segregation indices stratifying families by income thresholds for the 27 Brazilian capitals and conclude that per capita household income is a preponderant factor for the segregation of the poorest, especially in families whose residents self-identify as black.


Resumo Este artigo tem como objetivo analisar a segregação residencial por raça (segregação racial) e renda (segregação econômica) no Brasil e explorar sua relação com fatores socioeconômicos e socioespaciais. A segregação residencial foi avaliada pelo índice de dissimilaridade baseado no Censo Demográfico de 2010 e considerando setores censitários urbanos, uma vez que a segregação é entendida sociologicamente como um problema urbano. Os resultados mostram que a segregação racial é mais evidente nas cidades do Sul e Sudeste do Brasil, atingindo principalmente a população autodeclarada preta. A abordagem utilizada para calcular a segregação econômica envolveu examinar o nível de renda de diferentes grupos de baixa renda. Portanto, consideramos as famílias que ganham entre 0 e 1 salário mínimo - o grupo de maior vulnerabilidade social. Não encontramos correlações significativas entre os índices de segregação racial e de renda com fatores como a urbanização (tamanho da população urbana). Por fim, apresentamos os índices de segregação racial estratificando as famílias por faixas de renda para as 27 capitais brasileiras e concluímos que a renda domiciliar per capita é fator preponderante para a segregação dos mais pobres, principalmente nas famílias cujos moradores se autodeclaram pretos.


Resumen Este artículo tiene como objetivo analizar la segregación residencial por raza (segregación racial) y renta (segregación económica) en Brasil y explorar su relación con factores socioeconómicos y socioespaciales. La segregación residencial se evaluó utilizando el índice de disimilitud con base en el censo demográfico de 2010 y considerando las secciones censales urbanas ya que la segregación es considerada sociológicamente como un problema urbano. Los resultados para la segregación racial mostraron que esta es más evidente en ciudades del sur y del sudeste de Brasil y que afecta principalmente a la población autodeclarada negra. El enfoque usado para calcular la segregación económica implicó examinar el nivel de ingresos de diferentes grupos de bajos ingresos. Por lo tanto, consideramos que las familias que ganaban entre cero y un salario mínimo son el grupo con mayor vulnerabilidad social. No encontramos correlaciones significativas entre los índices de segregación racial y los de ingresos con factores como la urbanización (tamaño de la población urbana). Finalmente, presentamos los índices de segregación racial estratificando a las familias por umbrales de renta para las 27 capitales brasileñas y concluimos que la renta per cápita de los hogares es un factor preponderante para la segregación de los más pobres, en especial en las familias cuyos habitantes se autodeclaran negros.


Assuntos
Humanos , Fatores Socioeconômicos , População Negra , Segregação Social , Instabilidade Habitacional , Segregação Residencial , Censos , Índice de Vulnerabilidade Social , Vulnerabilidade Social
20.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1523035

RESUMO

La pandemia por COVID-19 generó una crisis de salud pública sin precedentes a nivel mundial, provocando la muerte directa o indirecta de alrededor de 14,9 millones de personas en un período de 2 años. Ante esto, el desarrollo de vacunas para evitar la muerte, cuadros graves y cortar la cadena de propagación del virus, se estableció como prioridad mundial. El proceso de vacunación ha demostrado su efectividad, pero ha existido reticencia a vacunarse dentro de la población. El objetivo de la presente investigación fue analizar la relación de variables censales con respecto a la frecuencia de vacunación para la semana del 24 de mayo de 2021 en Chile. Para ello, se recurrió a datos secundarios del censo del 2017 y del Ministerio de Salud y, a través de una regresión lineal múltiple, se determinó que la escolaridad, la vivienda de residencia y la etnicidad son variables que impactan en la cantidad de personas vacunadas por comuna. Los hallazgos obtenidos aportan información relevante para la generación de políticas públicas(AU)


The COVID-19 pandemic generated an unprecedented public health crisis worldwide, which caused the direct or indirect death of about 14.9 million people in a period of two years. In view of this, the development of vaccines to prevent death and serious illnesses and to cut the chain of spread of the virus was established as a global priority. Although the vaccination process has demonstrated the effectiveness of vaccination, there has been reluctance within the population. Therefore, the objective of this research was to identify the relation of census variables with respect to the frequency of vaccination for the week of May 24, 2021 in Chile. For this purpose, secondary data from the 2017 Census and the Ministry of Health were used and, through a multiple linear regression, it was determined that schooling, residence dwelling and ethnicity are variables that impact the number of people vaccinated per commune. The findings obtained provide relevant information for the generation of public policies(AU)


Assuntos
Humanos , Masculino , Feminino , Etnicidade/estatística & dados numéricos , Censos , Vacinas contra COVID-19/uso terapêutico , Chile
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