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Cada recién nacido: cuellos de botella de los sistemas de salud y estrategias para acelerar la ampliación en los
Kim E Dickson1, Aline Simen-Kapeu1, Mary V Kinney2
1UNICEF, Programmes Division, New York, NY, USA.
Lancet (London, England)
|May 24, 2014
Resumen
El logro de la atención médica esencial universal podría reducir las muertes neonatales en un 71%. Las estrategias clave incluyen mejorar las habilidades del personal de salud, la protección financiera y un fuerte liderazgo para ampliar la atención a las madres y los recién nacidos.
Área de la Ciencia:
- Salud Global La salud global.
- Salud materna y neonatal Salud materna y neonatal.
- Sistemas de Salud Investigación de Sistemas de Salud
Sus antecedentes:
- Las intervenciones esenciales pueden reducir significativamente las muertes neonatales, los partos muertos y mejorar los resultados maternos e infantiles.
- La atención alrededor del nacimiento y para los recién nacidos pequeños / enfermos, crucial para reducir la mortalidad, actualmente sufre una cobertura baja e inequitativa.
- Estos paquetes de cuidados intensivos son indicadores sensibles de la funcionalidad general del sistema de salud.
Objetivo del estudio:
- Evaluar sistemáticamente los cuellos de botella que obstaculizan la atención médica materna y neonatal esencial en los países con una carga alta.
- Identificar estrategias exitosas empleadas por países en rápido progreso en la reducción de la mortalidad neonatal.
- Proponer un proceso basado en datos para los planes nacionales de salud para mejorar la calidad y la cobertura de la atención.
Principales métodos:
- Evaluación sistemática de los cuellos de botella en el cuidado de la salud con la participación de más de 600 expertos en ocho países con alta carga de mortalidad neonatal.
- Análisis de las limitaciones comunes en el personal de salud, la financiación y la prestación de servicios.
- Examen de las estrategias de los países de rápido progreso para lograr objetivos ambiciosos de reducción de la mortalidad neonatal.
Principales resultados:
- Se identificaron 2465 cuellos de botella, con problemas comunes en la fuerza laboral de salud, la financiación y la prestación de servicios en las naciones con una carga alta.
- Variaciones observadas en los cuellos de botella específicos de la intervención, por ejemplo, los desafíos del cuidado materno canguro en Asia frente a la viabilidad en África.
- Se encontró que el logro de las mejores prácticas regionales de las tasas de mortalidad neonatal podría superar el objetivo de 2035.
Conclusiones:
- Los factores clave para reducir la mortalidad neonatal incluyen la planificación estratégica de la fuerza laboral, las medidas de protección financiera y el liderazgo dinámico.
- Se propone un enfoque liderado por el país y basado en datos para mejorar los planes nacionales de salud y ampliar la atención esencial.
- Abordar la brecha de calidad en la atención al nacer y para los recién nacidos pequeños / enfermos es fundamental para llegar a todas las madres y bebés, especialmente a los más vulnerables.
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