RESUMO
With the Peace Agreement between Fuerzas Armadas Revolucionarias de Colombia (FARC), Colombia promised healthcare to 13,000 'reincorporating' FARC ex-combatants. Shortages of healthcare workers in reincorporation camps means this promise is in danger of going unfulfilled. More information is needed to determine incentives, disincentives, and recruitment of healthcare providers to address this shortage. Semi-structured interviews were conducted with healthcare providers across FARC reincorporation camps, and a multidisciplinary team conducted analysis in NVivo12 using a team-based coding method. Twenty-four healthcare professionals from 15 camps participated, of which 75% were female. Incentives to work with FARC included improved clinical skills, professional advancement, increased comfort with FARC, and contributing to the peace process. Disincentives included poor living conditions, lack of support, biases, familial commitments, and sacrificing career opportunities. Three-fourths of the sample recommended working with FARC, and 92% reported a shortage of healthcare workers. Recruitment strategies included improved resources and specialised career development for healthcare workers, facilitating interactions between FARC and healthcare professionals outside clinical scenarios, and integrating medicine for vulnerable populations into health education. This study shows the impact that working with FARC ex-combatants can have on healthcare providers and tangible suggestions for increasing provider participation to address the healthcare worker shortage.
Assuntos
Pessoal de Saúde , Motivação , Humanos , Feminino , Masculino , Colômbia , Atenção à SaúdeRESUMO
BACKGROUND: Telemedicine is becoming increasingly important in Ecuador, especially in areas such as rural primary healthcare and medical education. Rural telemedicine programs in the country need to be strengthened by means of a technological platform adapted to local surroundings and offering advantages such as access to specialized care, continuing education, and so on, combined with modest investment requirements. INTRODUCTION: This present article presents the design of a Telemedicine Platform (TMP) for rural healthcare services in Ecuador and a preliminary technical validation with medical students and teachers. MATERIALS AND METHODS: An initial field study was designed to capture the requirements of the TMP. In a second phase, the TMP was validated in an academic environment along three consecutive academic courses. Assessment was by means of user polls and analyzing user interactions as registered automatically by the platform. The TMP was developed using Web-based technology and open code software. RESULTS: One hundred twenty-four students and 6 specialized faculty members participated in the study, conducting a total of 262 teleconsultations of clinical cases and 226 responses, respectively. CONCLUSION: The validation results show that the TMP is a useful communication tool for the documentation and discussion of clinical cases. Moreover, its usage may be recommended as a teaching methodology, to strengthen the skills of medical undergraduates. The results indicate that implementing the system in rural healthcare services in Ecuador would be feasible.
Assuntos
Atenção Primária à Saúde/organização & administração , Consulta Remota/organização & administração , Serviços de Saúde Rural/organização & administração , Equador , Docentes de Medicina , Humanos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Estudantes de Medicina , Inquéritos e QuestionáriosRESUMO
BACKGROUND: At rural healthcare centers in developing countries, it is difficult to recruit healthy individuals for reference range studies. So, in this study, I evaluated complete blood count (CBC) data to determine reference ranges for a rural Haitian population. METHODS: A convenience sample of laboratory records was reviewed to obtain CBC results for 157 adult patients with normal screening examination results. Central 95% reference ranges were determined for male and female subjects. RESULTS: Relative to reference ranges obtained with United States (US)-based subjects, the hemoglobin (Hgb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and absolute neutrophil count (ANC) ranges were lower in subjects who resided in rural Haiti. The upper reference limit of the red blood cell distribution width-coefficient of variation (RDW-CV) was higher than the reference range for the US-based group. CONCLUSION: Locally derived CBC reference ranges were established using data from subjects who resided in rural Haiti. Ranges for Hgb, Hct, MCV, MCH, RDW-CV, and ANC differed from those established using data from US-based subjects.
Assuntos
Contagem de Células Sanguíneas/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial , Feminino , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Serviços de Saúde Rural , Adulto JovemRESUMO
Learning from experience is a positive approach when preparing for mobile clinic service in a developing country. Mobile clinics provide healthcare services to people in hard to reach areas around the world, but preparation for their use needs to be done in collaboration with local leaders and healthcare providers. For over 16 years, Azusa Pacific University School of Nursing has sponsored mobile clinics to rural northern Haiti with the aim to provide culturally sensitive healthcare in collaboration with Haitian leaders. Past Haiti mobile clinic experiences have informed the APU-SON approach on best practices in study abroad, service-learning, and mission trips providing healthcare services. Hopefully, lessons learned from these experiences with mobile clinic service-learning opportunities in Haiti will benefit others who seek to plan study abroad service-learning trips for students in healthcare majors who desire to serve the underserved around the world.
Assuntos
Aprendizagem , Unidades Móveis de Saúde/tendências , População Rural , Haiti , Promoção da Saúde/métodos , Humanos , Populações Vulneráveis , Recursos HumanosRESUMO
Mobile clinics have been used successfully to provide healthcare services to people in hard to reach areas around the world, but their use is sometimes controversial. There are advantages to using mobile clinics among rural underserved populations, and providing access to those who are vulnerable will improve health and decrease morbidity and mortality. However, some teams use inappropriate approaches to international service. For over 15 years, Azusa Pacific University School of Nursing has sponsored mobile clinics to rural northern Haiti with the aim to provide culturally sensitive healthcare in collaboration with Haitian leaders. Experience and exploring the literature have informed the APU-SoN approach on best practices for planning and preparing study abroad, service-learning trips that provide healthcare services. The authors hope that this description of the preparation and planning needed for appropriate and culturally sensitive service-learning experiences abroad will benefit others who seek to provide healthcare study abroad opportunities around the world.
Assuntos
Unidades Móveis de Saúde/tendências , População Rural/tendências , Haiti , Humanos , Estudantes de Enfermagem , Populações VulneráveisRESUMO
Even though access to health insurance in Colombia has improved since the implementation of the 1993 health reforms (Law 100), universal coverage has not yet been accomplished. There is still a segment of the population under the low-income (subsidized) health insurance policy or without health insurance altogether. The purpose of this research was to identify preferences and behavior regarding health insurance among the subsidized rural population in La Guajira, Colombia, and to understand why that population remains under the subsidized health insurance policy. The field experiment gathered information from 400 households regarding their socioeconomic situation, health conditions, and preferences for health insurance characteristics. Results suggest that the surveyed population gives priority to expanded family coverage, physician and hospital choice, and access to specialists, rather than to attributes associated with co-payments or premiums. That indicates that people value healthcare benefits and family coverage more than health insurance expenses, and policy makers could use these preferences to enroll subsidized population into the contributory regime.