Social determinants for health and neonatal anesthesia in Colombia
Abstract
The social determinants of health are the social characteristics in which people's lives and work develop, giving them the capacity to act in specific contexts and are responsible for the health conditions of individuals and populations.
Recent World Bank data show that Colombia has made modest progress in terms of social equity. These data reveal that neonatal mortality in remote areas of the country is similar to that found in Sub-Saharan Africa. In these regions, there is no access to specialized neonatal health services. As for anesthesia services, this age group has the highest mortality and perioperative complication rates related to prematurity, the quality of health services and, especially, the expertise of the anesthesiologist.
In Colombia, efforts to implement formal university programs for sub-specialization in pediatric anesthesiology have not received governmental support. Meanwhile, the Colombian Society of Anesthesiology, through its Committee of Pediatric Anesthesiology, has created ongoing education opportunities, which, although important, are insufficient to meet the needs of the country.
For this reason, a State policy is required, aimed at meeting its social debt and that considers the specialized training of human resources as a pillar for the promotion of equity in health, so that the surgical neonate does not have to travel in the procurement of services, but rather have the State bring those services to them.
References
Krieger N. Glosario de epidemiologia social. Pan Am J Public Health. 2002;11(5/6):480-90. doi: https://doi.org/10.1590/S1020-49892002000500028
Organización de Naciones Unidas (ONU). Declaración Universal de Derechos Humanos. GA Res 217A(III) UGR 71. ONU; 1948.
Bello Á, Rangel M. Etnicidad, "raza" y equidad en América Latina y el Caribe (LC/R1967/Rev1). Santiago: CEPAL; 2000.
Marmot M. The status syndrome: how social standing affects our health and longevity. New York: Times Books; 2004.
Álvarez Castaño LS. Los determinantes sociales de la salud: más allá de los factores de riesgo. Rev Gerenc Polit. 2009;8(17):69-79.
Valdivia N. El uso de categorías étnico/raciales en censos y encuestas en el Perú: balance y aportes para una discusión. Lima: GRADE; 2011.
Hernández LJ. Epidemiología social anglosajona y epidemiología social latinoamericana. Hay diferencias pero también convergencias. Rev Salud Pública. 2013;15(6):804-6.
Carmona-Meza Z, Parra-Padilla D. Social determinants of health:analysis from the colombian context. Salud Uninorte. 2015;31(3):608-20. doi: https://doi.org/10.14482/sun.31.3.7685
Morales-Borrero C, Borde E, Eslava-Castañeda JC, Concha-Sánchez SC. ¿Determinación social o determinantes sociales? Diferencias conceptuales e implicaciones praxiológicas. Rev Salud Pública. 2013;15(6):797-808.
Arango V, Lucía A. Nuevas dimensiones del concepto de salud: el derecho a la salud en el Estado social de derecho [internet]. 2007 [cited: 2022 jun. 21]. Available at: http://www.redalyc.org/articulo.oa?id=309126689006
Ministerio de Protección Social República de Colombia. Plan Decenal de Salud Pública 2012-2021 [internet]. 2012 [cited: 2022 Jun. 21]. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/PDSP.pdf
Islam MA, Biswas B. Socio-economic factors associated with increased neonatal mortality: A mixed-method study of Bangladesh and 20 other developing countries based on demographic and health survey data. Clin Epidemiol Glob Health. 2021;11. doi: https://doi.org/10.1016/j.cegh.2021.100801
Gopalan SS, Das A, Howard N. Maternal and neonatal service usage and determinants in fragile and conflict-affected situations: a systematic review of Asia and the Middle-East. BMC Wom Health. 2017;17(1):1-12. doi: https://doi.org/10.1186/s12905-017-0379-x
Liu L Oza S, Hogan D, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388(10063):3027-35. doi: https://doi.org/10.1016/S0140-6736(16)31593-8
Unicef U. Levels and trends in child mortality. New York: UNICEF; 2015.
Ministerio de Salud. Análisis de situación salud (ASIS) en Colombia 2020 [internet]. 2020 [cited: 2022 Jun. 21]. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asis-2020-colombia.pdf.
Sistema Integrado de la Protección Social [internet]. 2021 [cited: 2022 Jun. 21]. Available at: https://sig.sispro.gov.co/sigmsp/index.html
Instituto Nacional de Salud. Mortalidad perinatal y neonatal [Internet]. 2018 [cited: 2022 Jun. 21]. Available at: https://pixabay.com/es/negro-blanco-beb %C3 %A9-ni %C3 %B1o-peque %C3 %B1o-1444737/
Banco Internacional de Reconstrucción y Fomento/Banco Mundial. Hacia la construcción de una sociedad equitativa en Colombia [internet]. 2021. [cited: 2022 Jun. 21]. Available at: https://www.bancomundial.org/es/news/infographic/2021/10/27/hacia-la-construccion-de-una-sociedad-equitativa-en-colombia
Sociedad Colombiana de Neonatología. Disponible en https://ascon.org.co/
Gerónimo Ortega NR. El parto pretérmino desde los registros del nacido vivo en Colombia, período 2008-2017. Revista Médica de Risaralda. 2020;26(2). doi: https://doi.org/10.22517/25395203.22091
Ortiz E, Núñez J. Etnicidad y exclusión social en Colombia. Revista de la CEPAL. 2021(134):33-55. doi: https://doi.org/10.18356/16820908-2021-134-2
Jaramillo-Mejía MC, Chernichovsky D, Jiménez-Moleón JJ. Regional disparities in infant mortality in Colombia. Rev Peru Med Exp Salud Publica. 2013;30(4):550-9. doi: https://doi.org/10.17843/rpmesp.2013.304.232
Schaaf JM, Liem S, Mol B, Abu-Hanna A, et al. Ethnic and racial disparities in the risk of preterm birth: a systematic review and meta-analysis. Am J Perinatol. 2013;30(6):433-50. doi:
https://doi.org/10.1055/s-0032-1326988
Boghossian NS, Geraci M, Lorch S, et al. Racial and ethnic differences over time in outcomes of infants born less than 30 weeks' gestation. Pediatrics. 2019;144(3). doi:
https://doi.org/10.1542/peds.2019-1106
Liu J, Sakarovitch C, Sigurdson K, et al. Disparities in health care-associated infections in the NICU. Am J Perinatol. 2020;37(2):166-73. doi: https://doi.org/10.1055/s-0039-1688481
Patel AL, Johnson T, Meier P. Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units. Pediatr Res. 2020;89(2):344-52. doi: https://doi.org/10.1038/s41390-020-01263-y
Ravi D, Iacob A, Profit J. Unequal care: Racial/ethnic disparities in neonatal intensive care delivery. Semin Perinatol. 2021;45(4). doi: https://doi.org/10.1016/j.semperi.2021.151411
Barfield WD. Public health implications of very preterm birth. Clin Perinato. 2018;45(3):565-77. doi: https://doi.org/10.1016/j.clp.2018.05.007
de Graaff JC, Johansen M, Hensgens M. Best practice & research clinical anesthesiology: Safety and quality in perioperative anesthesia care. Update on safety in pediatric anesthesia. Best Pract Res Clin Anaesthesiol. 2021;35(1):27-39. doi: https://doi.org/10.1016/j.bpa.2020.12.007
Zielinska M, Piotrowski A, Vittinghoff M. Neonatal anaesthesia in Europe - Is it time to create standards? Anaesth Crit Care Pain Med. 2022;41(2):101044. doi: https://doi.org/10.1016/j.accpm.2022.101044
Bhananker SM Ramamoorthy C, Geiduschek JM, et al. Anesthesia-related cardiac arrest in children: update from the Pediatric Perioperative Cardiac Arrest Registry. Anesth Analg. 2007;105:344-50. doi: https://doi.org/10.1213/01.ane.0000268712.00756.dd
McCann ME, Schouten J, Dobija N, et al. Infantile postoperative encephalopathy after general anesthesia. Pediatrics. 2014;133:e751-7. doi: https://doi.org/10.1542/peds.2012-0973
Habre W, Disma N, Virag K, et al. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe. Lancet Respir Med. 2017;5(5):412-25. doi: https://doi.org/10.1016/S2213-2600(17)30116-9
Disma N, Veyckemans F, Virag K, et al. Morbidity and mortality after anaesthesia in early life: results of the European prospective multicentre observational study, neonate and children audit of anaesthesia practice in Europe (NECTARINE). Br J Anaesth. 2021;126(6):1157-72. doi: https://doi.org/10.1016/j.bja.2021.02.016
McQueen KA, Malviya S, Gathuya ZN, Tyler DC. International advocacy for education and safety. Paediatric Anaesthesia. 2012;22:962-8. doi: https://doi.org/10.1111/pan.12008
Lunn JN. Implications of the National Confidential Enquiry into Perioperative Deaths for pediatric anesthesia. Paediatr Anaesth. 1992;2:69-72. doi: https://doi.org/10.1111/j.1460-9592.1992.tb00482.x
Auroy Y, Ecoffey C, Messiah A, et al. Relationship between complications of pediatric anesthesia and volume of pediatric anesthetics. Anesth Analg. 1997;84:234-5. doi: https://doi.org/10.1213/00000539-199701000-00060
Ministerio de Salud y Desarrollo Social de la Nación de Argentina. Marco de referencia para la formación en residencias del equipo de salud. Agosto, 2019.
SEDAR. Pautas para la formación en anestesia pediátrica de la SEDAR [internet]. S.f. [cited: 2022 Jun. 21]. Available at: https://www.sedar.es/images/images/site/SECCIONES/pediatrica/FormacionPediatrica.pdf
ACGME International. Case Log Information for Anesthesiology Programs [internet]. 2017 [cited: 2022 Jun. 21]. Available at: https://www.acgme-i.org/globalassets/acgme-international/specialties/anesthesiology/040.anesth.case_log_information.pdf
Residency Training Program: Case Requirements [internet]. S. f. [cited: 2022 Jun. 21]. Available at: https://depts.washington.edu/anesth/education/residents/caserequirements.shtml
Documento Marco del Plan de Estudios y Competencias para un programa de Anestesiología en Colombia. Sociedad Colombiana de Anestesiología y Reanimación-S.C.A.R.E. [internet]. S. f. [cited: 2022 Jun. 21]. Available at: https://scare.org.co/wp-content/uploads/Documento-Marco-del-Plan-de-Estudios-y-Competencias-para-un-programa-de-Anestesiologia-en-Colombia-1.pdf
Echeverry Marín PC. The new challenges in pediatric anesthesia in Colombia. 2017;45(1):5-7. Colombian Journal of Anesthesiology. doi: https://doi.org/10.1016/j.rca.2016.10.003
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