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Hacer frente a la derivación pediátrica - La experiencia de los padres ugandeses
Stefan Peterson1, Jesca Nsungwa-Sabiiti, Wilson Were
1WHO, Uganda. stefan.peterson@phs.ki.se
Lancet (London, England)
|June 15, 2004
Resumen
Las derivaciones para niños enfermos en Uganda a menudo son incompletas debido a los altos costos y problemas de transporte. La mejora de la asequibilidad y el empoderamiento de los trabajadores de la salud son cruciales para una atención sanitaria infantil efectiva.
Área de la Ciencia:
- La pediatría es la medicina de los niños.
- Salud Pública La salud pública.
- Sistemas de Salud Investigación de Sistemas de Salud
Sus antecedentes:
- La estrategia de Gestión Integrada de Enfermedades Infantiles (IMCI) se basa en la remisión oportuna de niños gravemente enfermos a los hospitales.
- La finalización efectiva de la derivación es esencial para reducir la mortalidad infantil en entornos con recursos limitados.
Objetivo del estudio:
- Evaluar la tasa de finalización y los costos asociados de las derivaciones hospitalarias para niños gravemente enfermos en las zonas rurales de Uganda.
- Identificar las barreras que impiden a los cuidadores completar las derivaciones hospitalarias.
Principales métodos:
- Se realizó un estudio en 12 centros de salud en zonas rurales de Uganda.
- El estado de finalización de la derivación de 227 niños fue seguido durante dos semanas.
- Se recopilaron datos sobre los costos de referencia y las razones por las que no se completaron.
Principales resultados:
- Solo el 28% de los niños referidos completaron la derivación hospitalaria en dos semanas.
- El costo medio de referencia fue de 8,85 USD, con una variabilidad significativa.
- Las principales barreras incluyeron la falta de fondos (90%), problemas de transporte (26%) y responsabilidades domésticas (17%).
Conclusiones:
- El alto costo de la derivación pediátrica en las zonas rurales de Uganda dificulta su eficacia.
- La reducción de los costos de referencia y el refinamiento de los criterios de IMCI son necesarios para una atención pediátrica realista.
- Se recomienda capacitar a los trabajadores de salud de primer nivel para manejar enfermedades infantiles graves.
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