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Colombia health policy

Florian Dams, Javier Leonardo Gonzalez Rodriguez, Kei Long Cheung, Ben F M Wijnen, Mickaël Hiligsmann
OBJECTIVES: Several studies, mostly from developed countries, have identified barriers and facilitators with regard to the uptake of health technology assessment (HTA). This study elicited, using best-worst scaling (BWS), what HTA experts in Colombia consider to be the most important barriers and facilitators in the use of HTA, and makes a comparison to results from the Netherlands. METHODS: Two object case surveys (one for barriers, one for facilitators) were conducted among 18 experts (policy makers, health professionals, PhD students, senior HTA-researchers) from Colombia...
March 7, 2018: Journal of Medical Economics
Sergio I Prada, Victoria E Soto, Tatiana S Andia, Claudia P Vaca, Álvaro A Morales, Sergio R Márquez, Alejandro Gaviria
Background: High pharmaceutical expenditure is one of the main concerns for policymakers worldwide. In Colombia, a middle-income country, outpatient prescription represents over 10% of total health expenditure in the mandatory benefits package (POS), and close to 90% in the complementary government fund (No POS). In order to control expenditure, since 2011, the Ministry of Health introduced price caps on inpatient drugs reimbursements by active ingredient. By 2013, more than 400 different products, covering 80% of public pharmaceutical expenditure were controlled...
2018: Cost Effectiveness and Resource Allocation: C/E
Philipp Hessel, Mauricio Avendano, Carlos Rodríguez-Castelán, Tobias Pfutze
The countries of Latin American are aging rapidly. Because most countries in the region lack adequate social protection systems, many Latin American governments have introduced noncontributory pension programs to reduce poverty and food shortages. This study assessed the effects of a large national noncontributory pension program on the health and health care use of older people in Colombia. Using an instrumental variables approach that exploited differential rollout of the program across municipalities, we found evidence that the program led to significant but small improvements in self-reported health and reductions in hospitalizations among men...
March 2018: Health Affairs
Adrianna Murphy, Benjamin Palafox, Owen O'Donnell, David Stuckler, Pablo Perel, Khalid F AlHabib, Alvaro Avezum, Xiulin Bai, Jephat Chifamba, Clara K Chow, Daniel J Corsi, Gilles R Dagenais, Antonio L Dans, Rafael Diaz, Ayse N Erbakan, Noorhassim Ismail, Romaina Iqbal, Roya Kelishadi, Rasha Khatib, Fernando Lanas, Scott A Lear, Wei Li, Jia Liu, Patricio Lopez-Jaramillo, Viswanathan Mohan, Nahed Monsef, Prem K Mony, Thandi Puoane, Sumathy Rangarajan, Annika Rosengren, Aletta E Schutte, Mariz Sintaha, Koon K Teo, Andreas Wielgosz, Karen Yeates, Lu Yin, Khalid Yusoff, Katarzyna Zatońska, Salim Yusuf, Martin McKee
BACKGROUND: There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development. METHODS: We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE) study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from -1 (pro-poor) to 1 (pro-rich), standardised by age and sex...
March 2018: Lancet Global Health
Juan Carlos Rivillas, Raul Devia Rodriguez, Gloria Song, Andréanne Martel
OBJECTIVES: This paper assesses inequalities in access to reproductive and maternal health services among females affected by forced displacement and sexual and gender-based violence in conflict settings in Colombia. This was accomplished through the following approaches: first, we assessed the gaps and gradients in three selected reproductive and maternal health care services. Second, we analyzed the patterns of inequalities in reproductive and maternal health care services and changes over time...
2018: PloS One
Alcides J Padilla, Juan C Trujillo
Solid waste management in many cities of developing countries is not environmentally sustainable. People traditionally dispose of their solid waste in unsuitable urban areas like sidewalks and satellite dumpsites. This situation nowadays has become a serious public health problem in big Latin American conurbations. Among these densely-populated urban spaces, the Colombia's capital and main city stands out as a special case. In this study, we aim to identify the factors that shape the attitudes towards source-separated recycling among households in Bogotá...
December 16, 2017: Waste Management
Carolina Zapata-Villa, Andrés A Agudelo-Suárez, Doris Cardona-Arango, Elena Ronda-Pérez
This study aims to understand the migratory experience and the employment, work and health conditions of the returned migrants from Spain to Colombia. A qualitative study was conducted by means of 23 semi-structured interviews with Colombian returned migrant workers. Qualitative narrative content analysis was performed using Atlas.Ti software. Main findings are represented by nine categories emerged from the participants' discourses: (1) impact of the economic crisis on work and employment conditions in Spain, (2) economic crisis and return, (3) characteristics of returnees, (4) perception of the returnees about Colombia, (5) the role of social support networks, (6) employment and working conditions in Colombia, (7) health and wellbeing, (8) future plans and expectations, (9) the experience of being immigrant...
December 14, 2017: Journal of Immigrant and Minority Health
Francis A Mhimbira, Luis E Cuevas, Russell Dacombe, Abdallah Mkopi, David Sinclair
BACKGROUND: Pulmonary tuberculosis is usually diagnosed when symptomatic individuals seek care at healthcare facilities, and healthcare workers have a minimal role in promoting the health-seeking behaviour. However, some policy specialists believe the healthcare system could be more active in tuberculosis diagnosis to increase tuberculosis case detection. OBJECTIVES: To evaluate the effectiveness of different strategies to increase tuberculosis case detection through improving access (geographical, financial, educational) to tuberculosis diagnosis at primary healthcare or community-level services...
November 28, 2017: Cochrane Database of Systematic Reviews
María Y Pinilla, César E Abadía
In this article, we narrate and analyze the historical configuration that a group of female workers and a collective of social organizations made about the Hospital San Juan de Dios (HSJD) and Instituto Materno Infantil (IMI) in Bogotá, Colombia, within the neoliberal crisis in health. Our ethnographic research intersects the Latinamerican traditions of collaborative ethnography and historic anthropology. The research was conducted in two sites. In the first one, from 2005 until 2015, we had informal conversations and conducted workshops and semi-structured interviews with IMI workers...
April 2017: Revista Peruana de Medicina Experimental y Salud Pública
Victor Andres Arias Espana, Alfonso R Rodriguez Pinilla, Paul Bardos, Ravi Naidu
Environmental contaminants can have negative effects on human health and land, air and water resources. Consequently, there have been significant advances in regulation for protecting the environment in developed countries including the development of remediation frameworks and guidelines. On the other hand, fewer studies have been reported on the risks and health effects of contaminants in developing regions and there is scarce information regarding contaminated land assessment and environmental remediation...
November 9, 2017: Science of the Total Environment
Jung-Seok Lee, Vittal Mogasale, Jacqueline K Lim, Mabel Carabali, Kang-Sung Lee, Chukiat Sirivichayakul, Duc Anh Dang, Diana Cristina Palencia-Florez, Thi Hien Anh Nguyen, Arthorn Riewpaiboon, Pornthep Chanthavanich, Luis Villar, Brian A Maskery, Andrew Farlow
BACKGROUND: Dengue fever is a major public health concern in many parts of the tropics and subtropics. The first dengue vaccine has already been licensed in six countries. Given the growing interests in the effective use of the vaccine, it is critical to understand the economic burden of dengue fever to guide decision-makers in setting health policy priorities. METHODS/PRINCIPAL FINDINGS: A standardized cost-of-illness study was conducted in three dengue endemic countries: Vietnam, Thailand, and Colombia...
October 2017: PLoS Neglected Tropical Diseases
Javier Eslava-Schmalbach, Paola Mosquera, Juan Pablo Alzate, Kevin Pottie, Vivian Welch, Elie A Akl, Janet Jull, Eddy Lang, Srinivasa Vittal Katikireddi, Rachel Morton, Lehana Thabane, Bev Shea, Airton T Stein, Jasvinder Singh, Ivan D Florez, Gordon Guyatt, Holger Schünemann, Peter Tugwell
The availability of evidence-based guidelines does not ensure their implementation and use in clinical practice or policy making. Inequities in health have been defined as those inequalities within or between populations that are avoidable, unnecessary and also unjust and unfair. Evidence-based clinical practice and public health guidelines ('guidelines') can be used to target health inequities experienced by disadvantaged populations, although guidelines may unintentionally increase health inequities. For this reason, there is a need for evidence-based clinical practice and public health guidelines to intentionally target health inequities experienced by disadvantaged populations...
December 1, 2017: Health Policy and Planning
Juan Pablo Garcés, Luisa Consuelo Rubiano, Yenifer Orobio, Martha Castaño, Elizabeth Benavides, Adriana Cruz
INTRODUCTION: Colombia promotes the diagnosis and treatment of gestational syphilis in a single visit using rapid diagnostic tests to prevent mother-to-child transmission. Additionally, integrated health programs pursue the coordinated prevention of mother-to-child transmission of syphilis/HIV. OBJECTIVE: To identify knowledge gaps among health workers in the prevention of mother-to-child transmission of syphilis/HIV and to provide recommendations to support these programs...
September 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
Patricia Najera Hamrick, Sylvain Aldighieri, Gustavo Machado, Deise Galan Leonel, Luz Maria Vilca, Sonia Uriona, Maria Cristina Schneider
BACKGROUND: In the Americas, yellow fever virus transmission is a latent threat due to the proximity between urban and wild environments. Although yellow fever has nearly vanished from North and Central America, there are still 13 countries in the Americas considered endemic by the World Health Organization. Human cases usually occur as a result of the exposure to sylvatic yellow fever in tropical forested environments; but urban outbreaks reported during the last decade demonstrate that the risk in this environment still exists...
September 2017: PLoS Neglected Tropical Diseases
Juliana Quintero, Tatiana García-Betancourt, Andrea Caprara, Cesar Basso, Elsa Garcia da Rosa, Pablo Manrique-Saide, Giovanini Coelho, Gustavo Sánchez-Tejeda, Felipe Dzul-Manzanilla, Diego Alejandro García, Gabriel Carrasquilla, Eduardo Alfonso-Sierra, Cyntia Monteiro Vasconcelos Motta, Johannes Sommerfeld, Axel Kroeger
Prior to the current public health emergency following the emergence of chikungunya and Zika Virus Disease in the Americas during 2014 and 2015, multi-country research investigated between 2011 and 2013 the efficacy of novel Aedes aegypti intervention packages through cluster randomised controlled trials in four Latin-American cities: Fortaleza (Brazil); Girardot (Colombia), Acapulco (Mexico) and Salto (Uruguay). Results from the trials led to a scaling up effort of the interventions at city levels. Scaling up refers to deliberate efforts to increase the impact of successfully tested health interventions to benefit more people and foster policy and program development in a sustainable way...
September 2017: Pathogens and Global Health
Randy Uang, Eric Crosbie, Stanton A Glantz
The objective of this paper is to examine the implementation of Colombia's tobacco control law. Methods involved are triangulated government legislation, news sources, and interviews with policy-makers and health advocates in Colombia. Colombia, a middle-income country, passed a tobacco control law in 2009 that included a prohibition on tobacco advertising, promotion, and sponsorship; and required pictorial health warning labels, ingredients disclosure, and a prohibition on individual cigarette sales. Tobacco companies challenged the implementation through litigation, tested government enforcement of advertising provisions and regulations on ingredients disclosure, and lobbied local governments to deprioritise policy responses to single cigarette sales...
August 17, 2017: Global Public Health
Monica Uribe-Gómez
Recent years have witnessed discussion on the need for changes in the health systems of Latin America. This initiative, spearheaded once again by the World Bank as Universal Health Coverage, focuses on strategies for protection against financial risks and unified access to essential services and medicines. Although the World Bank approaches have been incorporated in different ways by the region's countries since the 1980s, there have also been important breaks with this trend, for example in Argentina, Brazil, Uruguay, and Ecuador, which have sought at different times to implement policies and programs emphasizing non-market-driven values...
July 27, 2017: Cadernos de Saúde Pública
Juan Carlos Rivillas, Fabian Dario Colonia
Health inequalities often result from social inequities, and those, in turn, are generated by social determinants of health (SDoH). Hence, to reduce health inequalities, it is necessary to consider all health-related determinants. Disadvantages arise even before birth, and they tend to accumulate throughout an individual's life. Thus, policy actions intended to overcome these health inequalities should take place before birth and continue throughout life. This review aimed to describe the first steps of that Colombia has taken to reduce health inequalities during generational transitions through an inter-sectorial coordination upon SDoH...
2017: Global Health Action
Ninfa Del Carmen Vega-Monsalve
This study describes the level of implementation of the Program for Safety and Health at Work in companies located in the Department of Antioquia, Colombia, and associated factors. A cross-sectional survey included 73 companies with more than 50 workers each and implementation of the program. A total of 65 interviews were held, in addition to 73 checklists and process reviews. The companies showed suboptimal compliance with the management model for workplace safety and health proposed by the International Labor Organization (ILO)...
July 13, 2017: Cadernos de Saúde Pública
Judith Recht, André M Siqueira, Wuelton M Monteiro, Sonia M Herrera, Sócrates Herrera, Marcus V G Lacerda
In spite of significant progress towards malaria control and elimination achieved in South America in the 2000s, this mosquito-transmitted tropical disease remains an important public health concern in the region. Most malaria cases in South America come from Amazon rain forest areas in northern countries, where more than half of malaria is caused by Plasmodium vivax, while Plasmodium falciparum malaria incidence has decreased in recent years. This review discusses current malaria data, policies and challenges in four South American Amazon countries: Brazil, Colombia, Peru and the Bolivarian Republic of Venezuela...
July 4, 2017: Malaria Journal
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