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Programas y políticas de salud asociados con la disminución de la mortalidad en las personas desplazadas en los
Paul Spiegel1, Mani Sheik, Carol Gotway-Crawford
1International Emergency and Refugee Health Branch, Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. spiegel@unhcr.ch
Lancet (London, England)
|December 21, 2002
Resumen
Los programas de salud basados en la evidencia en los campamentos de refugiados son cruciales. Factores clave como la edad del campamento, la proximidad al conflicto y el acceso al agua y a la atención médica tienen un impacto significativo en las tasas de mortalidad en las poblaciones desplazadas.
Área de la Ciencia:
- Salud Pública La salud pública.
- Epidemiología La epidemiología.
- Estudios Humanitarios Los estudios humanitarios son los estudios que se realizan en el ámbito de los estudios humanitarios.
Sus antecedentes:
- Las emergencias humanitarias complejas desplazan a millones de personas, lo que requiere programas efectivos de salud y nutrición para los refugiados.
- Las políticas y programas actuales en los campamentos posteriores a la emergencia a menudo carecen de bases basadas en datos.
- Existe la necesidad de identificar indicadores específicos de salud asociados con la mortalidad en poblaciones desplazadas.
Objetivo del estudio:
- Identificar las asociaciones entre la mortalidad específica por edad y los indicadores de salud en los campos de refugiados posteriores a la emergencia.
- Informar el desarrollo de políticas y programas para organizaciones humanitarias.
Principales métodos:
- Análisis retrospectivo de los datos de mortalidad de 51 campamentos posteriores a la emergencia en siete países (1998-2000).
- Análisis de regresión multivariado que incorpora 18 variables independientes que influyen en las tasas de mortalidad bruta (CMR) y las tasas de mortalidad de menores de cinco años (<5 MR).
- Comparación de los hallazgos con los indicadores mínimos establecidos para la fase de emergencia.
Principales resultados:
- Los campamentos recién establecidos exhibieron CMRs más altos y <5 MRs en comparación con los campamentos más antiguos.
- La proximidad a las zonas de conflicto y los tiempos de viaje más largos a los hospitales se correlacionaron con un aumento de las CMR.
- El acceso limitado al agua y las altas tasas de diarrea se asociaron con un mayor número de MR <5.
- Los indicadores clave como la distancia al conflicto, la disponibilidad de agua y la densidad de personal sanitario local excedieron las recomendaciones de la fase de emergencia.
Conclusiones:
- Las intervenciones de salud y nutrición para las personas desplazadas deben estar basadas en la evidencia.
- Los programas en emergencias complejas deben dar prioridad a los indicadores asociados a la mortalidad.
- Se recomienda el desarrollo de indicadores mínimos específicos para los programas de campamentos posteriores a la emergencia.
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