Health Secretary Research Articles

Pharmacies should face 'special measures' to discourage temporary closures, says PDA

Community pharmacies should be put into “special measures” by NHS Scotland to protect patients from temporary pharmacy closures, the Pharmacists’ Defence Association (PDA) has said. In a statement on 10 August 2022, the organisation said that Humza Yousaf, Scottish cabinet secretary for health and social care, needed to take “necessary action” to stop businesses that […]

Scottish health minister backs protected learning time for pharmacists

Humza Yousaf, Scottish cabinet secretary for health and social care, has said he is committed to achieving protected learning time for healthcare professionals, while speaking on a panel alongside Clare Morrison, director for Royal Pharmaceutical Society (RPS) Scotland. Yousaf made the commitment at the Scottish National Party conference in Aberdeen on 8 October 2022, during […]

Contribution of the Tobacco Tax to the Financing of Health Systems in Democratic Republic of the Congo

Tobacco is an illicit product sold in the world and involves fatal communicable diseases and deaths. In several countries, tobacco revenue contributes to the health of victims. This study aimed to evaluate the contribution of tobacco taxes to the financing of the health system in Democratic Republic of Congo (DRC) during the period of 3 years (from 2019 to 2021) in order to give some suggestions. A descriptive literature review on the tobacco tax was conducted from three tobacco tax collection services: the services of the General Secretariat of Health in DRC (SGSH), the Program of the National Health Account (PNHA) and the General Direction of Customs and Assizes (GDCA). The analysis revealed that no retrocession and no activity covered by the tax collected on tobacco does not contribute to the financing of the health sector, in order to reduce the burden of households already impoverished by diseases caused by tobacco.

‘Competing priorities’: why is the rollout of e-prescribing taking so long?

Setting up electronic prescribing systems in NHS hospital trusts has, so far, taken 30 years and counting. Although the first electronic prescribing and medicines administration (ePMA) systems rolled out in the early 1990s, the government’s latest push to expedite the process came in February 2018, when former health secretary Jeremy Hunt committed £75m “to help […]

Varicose Vein Stripping in 66,577 patients in 11 years in public hospitals in São Paulo.

The aim of this study was to evaluate the epidemiology of varicose vein stripping in Brazil's largest city, São Paulo. Open and anonymous data regarding varicose vein surgeries between 2008 and 2018 were evaluated from the TabNet platform of the Municipal Health Secretary of São Paulo, Brazil. Most patients were female and adults. A total of 66,577 varicose vein surgeries were performed in public hospitals and outpatient clinics in São Paulo, with a statistically significant increase for both unilateral (p=0.003) and bilateral (p<0.001) procedures. Since 2016, unilateral procedures have been performed more frequently than bilateral procedures. Most procedures were associated with same-day (54.8%) or next-day (32%) discharge. The in-hospital mortality rate was 0.0045%. The total amount reimbursed was $20,693,437.94, corresponding to a mean value of $310.82 per procedure. Surgeries to treat chronic vein disease totaled 66,577 in 11 years, demanding $20,693,437.94 from the public health system. The majority of treated patients were female, over 40 years of age, and local residents. Procedure rates have increased over the years. The in-hospital mortality rate was very low (0.0045%).

An analysis of the profile of health secretaries: interfaces between health and political-electoral processes

RESUMO O trabalho objetiva sistematizar informações sobre os secretários de saúde inseridos em governos estaduais e municipais, para refletir sobre influências técnicas, acadêmicas e partidárias na conformação de suas trajetórias, buscando contribuir para o delineamento de um panorama da gestão do Sistema Único de Saúde (SUS) nas instâncias subnacionais. O estudo é apoiado em fontes secundárias, incluindo bases de dados oficiais, portais de governos e notícias divulgadas pela mídia comercial. Foram processadas informações dos secretários dos 26 estados e suas capitais, além do Distrito Federal, no cargo no mês de maio de 2021, gerando 53 currículos, que foram categorizados como especializados (79%), profissionais de saúde (75%), políticos de carreira (25%) e empresários (19%). Apesar da significativa influência partidária, encontrou-se um processo de formação de quadros burocráticos pelos partidos, para além da disputa eleitoral. Dos treze políticos de carreira identificados, onze também foram tipificados pela análise como ‘especializados’, interpelando acepções sobre oposição entre perfis ‘técnico’ versus ‘político’, sugerindo a relevância das interseções das trajetórias. Uma excepcionalidade de insulamento técnico da saúde não foi confirmada. Dessa forma, não é realista a imagem de que forças político-partidárias sejam antagônicas à capacitação acadêmica e à experiência na administração pública, sugerindo que a saúde se apresenta, simultaneamente, especializada e politizada.

Participatory modeling of educational activities in the Healthcare Planning strategy: backing for assessment of effectiveness

The Healthcare Planning strategy is a powerful device for reorganization of work processes in healthcare networks and has been implemented by the Brazilian National Council of State Health Secretaries since 2013 in 25 health regions in 11 states, offering a set of educational activities for healthcare workers in the Brazilian Unified National Health System. This study aims to describe the process of participatory and consensual modeling of educational activities to back the assessment of the strategy's effectiveness. Development of the modeling used consultation with 18 key informants, selected intentionally according to their proximity to the educational activities' planning and execution. The key informants analyzed the initially proposed modeling, stating their degree of agreement with the content and providing suggestions and commentary, analyzed by the researchers. Minimum total agreement, predetermined at 75%, was obtained after three rounds of consultation. Important suggestions were provided throughout the rounds, evidencing priority elements for backing assessment of the strategy's effectiveness. Final total agreement in the modeling varied from 76.5% to 100%, according to the component, demonstrating that participatorily modeling can be considered satisfactory. This construction can encourage studies on strategies that seek to improve the health system's effectiveness through development of health workers' competencies, skills, and attitudes.

Patient records: when will community pharmacies get access?

There has been a series of big promises on extending access to patient records from government ministers, but community pharmacies in most of the country are still waiting. In 2013, then health secretary Jeremy Hunt promised “interoperable” medical records that enabled health information to “follow patients around the health and social care system”, as part […]

Barriers to Access to Palliative Care in Colombia: A Social Mapping Approach Involving Stakeholder Participation.

This study aimed to identify barriers to access to palliative care through a social mapping approach. In Colombia, the barriers to access to palliative care denote an enormous geographic disparity of resources and health needs, making it necessary to conduct community-based participatory research using an approach such as social mapping. A qualitative research design was used. Stakeholders from health insurance companies, regulatory authorities, regional health secretariats, health care professionals, patient and caregiver organizations, scientific societies, and medical journalists from 7 Colombian regions participated. It involved 3 stages. Stage 1: Semi-structured, audio-recorded interviews were conducted with 36 stakeholders and were subsequently transcribed and analyzed. Stage 2: An electronic survey was conducted to obtain feedback on the first outline of the map and the categories that emerged from stage 1. Stage 3: The nominal group technique was used to analyze and validate the barriers to access to palliative care included in the final map. The COREQ checklist was used. Twenty-seven barriers to access to palliative care related to limited availability of medications, stakeholders' poor knowledge of regulations, limited formal education in palliative care, few patients' support networks, patient care fragmentation, few specialized programs of palliative care, and mistaken beliefs about palliative care were identified. Stakeholders' diverse perspectives and opinions were crucial to understanding the development of palliative care in Colombia and its challenges. Better knowledge about palliative care can open opportunities to overcome the barriers identified in this study, directly impacting access to palliative care.

ENTRE(LAÇAR) PARA GOVERNAR: ESTRATÉGIAS BIOPOLÍTICAS EM CAMPANHAS PUBLICITÁRIAS PARA DOAÇÃO DE ÓRGÃOS E TECIDOS

ABSTRACT Objective to analyze the organ and tissue donation advertising campaigns as biopolitical strategies. Method a qualitative research study inspired on the Post-Structuralist strand of Cultural Studies. Data collection took place between July and September 2020 and the research corpus consisted in the visual and textual components of 421 organ and tissue donation advertising pieces from institutional websites of the Ministry of Health, State Health Secretariats, State Transplantation Centers and the Brazilian Association of Organ Transplantation. The data were managed using the Ethnograph v6 program, submitted to analysis as proposed by Janice Morse and discussed following Michel Foucault's theoretical notions of Biopower and Biopolitics. Results two categories are presented. In the first, the representation of cultural and age diversity in the campaigns was discussed as a way to include all people in the donation and transplantation process; in the second, the use of heroism, altruism and empathy to mobilize the donor's “I” was addressed. Conclusion the inclusion of cultural and age diversity and the use of characteristics such as empathy, altruism and heroism in advertising campaigns are biopolitical strategies used by the Brazilian State to drive the population towards organ donation.

Simulação realística em incidente com múltiplas vítimas: apoio da Força Nacional do SUS para organização do cenário

This study aims to describe the experience of the National Force of the Unified Health System (FN-SUS) in supporting states to organize realistic simulation (SR) in different scenarios involving multiple victims, within the scope of the Training “Preparation of Response an Incident with Multiple Victims". This is a critical-reflective study of the experience report type referring to the period from October 2021 to September 2022, involving an average of 150 professionals represented by FN-SUS technicians, State Health Secretariats, members of the Emergency Care Network and other agencies working in the response to incidents with multiple victims. The results converged into three thematic categories: contextualization of training, approximation with the state and planning and construction of the scenario. One of the greatest legacies of the construction of this training with SR consists of the perception that while this methodology promotes a space for interaction between the different agents resp. ondedores, also launches the main challenges encountered in the structure of the local network, thus bringing together different professionals in search of the best strategies in light of the sovereign objective of saving the greatest number of lives.

Inter-professional relationships in the Family Health Strategy: perception of health management.

to analyze the teamwork in the Family Health Strategy from the perspective of professionals from the Primary Care Department and the municipal manager/secretary of health of a Municipal Health Secretariat. an exploratory/qualitative study. All professionals of the Department and municipal manager/municipal health secretary/interior of Minas Gerais participated. Data collection was through semi-structured interviews/May to November/2019. Data analysis: Content analysis/thematic mode and work process theoretical referential. three categories emerged: Inter-professional relations permeated by non-material instruments of work; Professional training, experience, and profile influence teamwork; and Proposals for the realization of teamwork in the Family Health Strategy. Results revealed assumptions for teamwork in the referred Strategy, facilitators/difficulties/strategies for its realization, according to the professionals. Final Considerations: collaboration/communication/proactivity to facilitate teamwork. Need for approximation between municipal management and Family Health Strategy to achieve teamwork.

Gary Blau rejoins SAMHSA

Gary Blau, Ph.D., is a licensed clinical psychologist who will now serve as the senior advisor for children, youth and families at the federal Substance Abuse and Mental Health Services Administration (SAMHSA), officials announced Dec. 13, 2021. He rejoins SAMHSA after spending over 15 years as the chief of the Child, Adolescent and Family Branch, where he provided national leadership for child, adolescent and young adult mental health, and helped created “systems of care” across the United States. Prior to rejoining SAMHSA, Blau was the executive director of The Hackett Center for Mental Health, the first regional center of the Meadows Mental Health Policy Institute. Blau received the U.S. Department of Health and Human Services Secretary's Award for Meritorious Service for his national leadership in children's mental health, and he was the first recipient of the Rock Star Award, presented by Youth MOVE National for “being a true champion for the youth movement and advocate for youth voice.” This award has now been named the Dr. Gary Blau Professional of the Year Award and is given annually to a mental health professional who has distinguished themselves as a voice for youth.

Business Intelligence for the Programs of the Secretaries of Health, Education and Planning in a Territorial Entity

Territorial entities in Colombia are bound by the law to register and report to different instances the control information of the government programs they administer. However, so much information is distributed on various state and owned platforms that the result is processed and generated in different formats. This situation makes the comprehensive management of territorial data difficult, since, although the information exists, it is isolated, and its analysis is carried out independently by each party responsible for the process. The objective of this research is the Implementation of a business intelligence model that allows integration and analysis of data from the programs of the Health, Education, and Planning ministries for a Territorial Entity. Ralph Kimball's methodology was used, implementing a star topology model in the Datamart using MySQL as a database manager, an ETL system was built with the Pentaho tool which allows the extraction, transformation, and loading of the data in the Datamart. The cubes, reports and Dashboard are obtained with the management of tools such as Pentaho and Power BI, thus it is possible to make a correct interpretation of the resulting information. After applying Business Intelligence, it is possible to generate an adequate analysis of the information, allowing decision-making and application of new strategies to solve specific problems using control panels, visualization of indicators and generation of reports.

SAMHSA, State Leaders Describe Collaborations to Address Social Determinants of Health

SAMHSA, State Leaders Describe Collaborations to Address Social Determinants of Health

Cutaneous leishmaniasis in protected environmental areas in the Eastern Amazon: the case of São Félix do Xingu, Pará, Brazil

Cutaneous Leishmaniasis is a disease transmitted to men and animals by infected female phlebotomine sandflies and is considered a great environmental and public health problem in the Amazon region. Thus, the study aimed to analyze the spatial distribution of this disease in São Félix do Xingu, in the state of Pará, Brazil, and its relationship with epidemiological and environmental variables, in the period from 2012 to 2016. The data used were from the Information System of the Pará State Secretariat of Health, the National Institute for Space Research and the Brazilian Institute of Geography and Statistics. The statistical and spatial analysis of the variables were done using non-parametric chi-square statistical test, kernel interpolation technique and the Bivariate Global Moran Index. The municipality had 183 confirmed cases, non-homogeneously distributed in 5 administrative districts. The individuals most affected were adult males with brown skin, an elementary level of education and rural area residents. In the case series, a direct relationship was observed between the increase of the number of cases and deforestation in the study area. The spatial analysis showed different types of land use and cover related to case clusters in the municipality. Additionally, there was a presence of cases in protected areas and a great epidemiological silence in indigenous lands. Thus, this disease is a large and complex public health problem in the municipality, related to social and environmental risk factors.

Prevalence of aortic coarctation in Bogotá-Colombia from 2001 to 2018. The diagnostic needs to improve.

Objectives:Aortic coarctation is the most frequent structural anomaly out of congenital heart diseases. This congenital defect is an important cause of death worldwide. We sought to determine the prevalence of aortic coarctation in Colombia and whether new policies have had an impact on its diagnosis.Methods:In this study information from the Bogotá birth defect surveillance program during the years 2001-2018 from 63 hospitals was used. 537,026 live births of any weight and stillbirths of any weight were analyzed. The information was stored in a database on the servers of the Health Secretariat and the Pontificia Uni­versidad Javeriana. We analyzed the presence of aortic coarctation according to the newborn’s sex, weight, size, mother’s age, and gestational age at the time of birth and when coarctation is accompanied by other types of congenital malformations.Results:The prevalence of aortic coarctation in Bogotá during the years 2001-2018 found in this study was 1.25 in 10,000 live births. We also found that prevalence of aortic coarctation in Bogotá changes throughout the years having a significant increase in the year 2018 with 6.57 cases in 10,000 live births.Conclusions:This prevalence is higher than the one found in a study with data from 2001 to 2014, which suggests an improvement in the country’s epidemiological surveillance and medical training. However, the prevalence found in Bogotá is still lower compared to the prevalence worldwide and from other continents, the prevalence for Latinamerica was significantly lower as compared to those in Asia, Europe, and United States so we emphasize the importance of continuing with improvements, such as standardizing screening methods and sensitivity of said methods in a local scale as well as a continental scale.

Diagnosis, treatment, and notification of syphilis during pregnancy in the state of Goiás, Brazil, between 2007 and 2017.

ABSTRACTOBJECTIVE To analyze the evolution of syphilis during pregnancy notification regarding clinical classification, diagnosis and treatment in the state of Goiás, Brazil, between 2007 and 2017.METHODS This is a time-series study, analyzing data provided by the Health Secretariat of the state of Goiás. The variables related to the diagnosis and treatment of pregnant women and their partners were analyzed, and their evolution trend during the years. Descriptive statistics and percentage calculation were used. Cochran-Armitage test with a significance level α = 0.05 was used to determine increase and decrease trends.RESULTS During the period, 7,774 cases were notified. The highest percentage of notifications occurred in the second trimester of pregnancy (39.8%) and corresponded to primary syphilis (34.1%). The most frequent treatment prescribed was benzathine benzylpenicillin with a dosage of 7.2 million (43.8%). Between 2007 and 2017, there was an increasing trend in the notification percentage of latent (14.1% to 30.7%), secondary (5.2% to 19%), and tertiary syphilis (4.4% to 11.4%). The treatment with benzathine benzylpenicillin with a dosage of 7.2 million also increased (19.3% to 59.6%). The percentages of primary syphilis decreased (43.4% to 22.1%), as well as other treatments’ percentages.CONCLUSIONS Latent syphilis notification of pregnant women and treatment with penicillin at the dosage of 7,200,000 IU increased. Notification forms’ data completeness also increased for the variables clinical classification and treatment, suggesting improvements in the notification process.

Understanding parents\u2019 views toward the newly enacted HPV vaccine school entry policy in Puerto Rico: a qualitative study

BackgroundThe Human papillomavirus vaccine (HPV) is an essential tool for the prevention of HPV-related cancers. In Puerto Rico, the Secretary of Health established a school entry requirement of at least one dose of HPV vaccination in girls and boys aged 11 and 12 years, taking effect in August 2018. Our study aimed to examine parents’ and guardians’ views of unvaccinated children about the process of implementation of the new HPV vaccination school entry policy in Puerto Rico and identify potential barriers and facilitators related to the implementation of this requirement.MethodsDuring April through November 2019, we conducted three focus groups (n = 12) and eight in-depth semi-structured interviews with parents of children aged 11 and 12 who had not yet initiated the HPV vaccine series. The interview topics addressed were: perception of vaccination, HPV vaccine and it is inclusion as new school entry requirement practice, procedure of the sources of information, influencers, and willingness to change. The interviews were recorded and transcribed by our staff members. We identified emergent themes through thematic analysis.ResultsThe participants’ perspective on the HPV vaccine school requirement was mixed. Lack of information of the HPV vaccines and lack of communication about the school-entry requirement were the themes most mentioned in the interviews. Moreover, previous negative experiences from friends or family members and adverse effects deterred some participants from vaccinating their kids. We discussed barriers in the process of soliciting an exemption.ConclusionMost barriers mentioned by study participants are modifiable. Information about the HPV vaccine mandate’s implementation and educational materials regarding HPV vaccine safety need to be provided to address parents’ concerns related to the vaccine’s side effects. Schools (teachers, principal directors, and administrative staff), the government, and parent organizations need to be part of these efforts. This multilevel approach will help to improve disseminating information about HPV vaccination to clarify doubts and misinformation among parents.

SARS-CoV-2 variants in severely symptomatic and deceased persons who had been vaccinated against COVID-19 in São Paulo, Brazil.

ABSTRACTCOVID-19 vaccination began in São Paulo, Brazil in January 2021, first targeting healthcare workers (HCWs) and the elderly, using the CoronaVac vaccine (Sinovac/Butantan) and subsequently the Oxford/AstraZeneca (ChAdOx1) vaccine (AstraZeneca/FIOCRUZ-RJ). Studies on such vaccines have shown efficacy in preventing severe cases and deaths, but there is a lack of information regarding their effectiveness. This manuscript presents data from the Instituto Adolfo Lutz (IAL), a public health laboratory located in São Paulo City that receives samples from 17 Regional Health Departments under the Secretary of Health of São Paulo, for SARS-CoV-2 genomic surveillance. Through May 15, 2021 IAL received 20 samples for analysis from COVID-19 vaccinated individuals who needed hospitalization and/or died from COVID-19. Next-generation sequencing was performed on an Ion Torrent S5 platform using the AmpliSeq™ SARS-CoV-2 kit. Almost all cases were vaccinated with CoronaVac and presented the gamma variant of concern (VOC). Cases of death were observed mostly in the elderly in nursing homes, and severe cases in younger frontline HCWs. This data confirmed that the SARS-CoV-2 gamma variant is highly transmissible, severe, and lethal for COVID-19 in these groups of individuals, thereby highlighting the importance of continuous vaccination and non-pharmacological prevention measures to avoid virus dissemination and the emergence of new VOCs.