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Browsing by Author "Mezones, Edward"

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Acceso a salud de migrantes internacionales en pandemia en Chile: resultados de encuesta cuantitativa
(2023) Cabieses, Báltica; Blukacz, Alice; Obach, Alexandra; CARREÑO CALDERON, ALEJANDRA; Oyarte, Marcela; Alvarez, Maria; Osse, Claudio; Mezones, Edward
El objetivo del estudio fue analizar barreras de acceso a la atención de salud en Chile reportadas por migrantes internacionales residentes en la región metropolitana del país y factores asociados. Para ello, se aplicó una encuesta en formato digital sobre vulnerabilidades y recursos de comunidades migrantes en Chile para enfrentar la pandemia SARS-CoV-2. Se realizó análisis descriptivo y estratificado por variables demográficas, socioeconómicas, tipo de previsión de salud y estatus migratorio. Como resultados, inmigrantes provenientes de Haití reportaron el mayor porcentaje de barreras de acceso a la atención en salud, esto tras ajustar por variables sociodemográficas y estatus migratorio. The objective of the study was to analyze barriers to access to health care in Chile reported by international migrants residing in the metropolitan region of the country and associated factors. For this purpose, a digital survey on vulnerabilities and resources of migrant communities in Chile to face the SARS-CoV-2 pandemic was applied. A descriptive and stratified analysis was performed by demographic and socioeconomic variables, type of health provision and migratory status. As results, immigrants from Haiti reported the highest percentage of barriers to health care access, after adjusting for socio-demographic variables and migratory status.
Desafíos para el abordaje de la salud de los migrantes en Chile durante la pandemia por Covid-19: una revisión de alcance
(2023) Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Rada, Isabel; CARREÑO CALDERON, ALEJANDRA; Mezones, Edward
Objetivo.Indagar sobre los principales desafíos reportados en el marco de la emergencia sanitaria de SARS-CoV-2 según la evidencia científica disponible a la fecha en esta materia en Chile. Material y métodos. Revisión de alcance con base en tres búsquedas en Web of Science, PubMed y Google Scholar de publicaciones en inglés y español publicadas entre 2020 y 2023. Resultados. Se identificaron tres áreas clave: desafíos de acceso y uso efectivo del sistema de salud, desafíos más allá del sistema de salud, incluyendo aquellas relaciones con determinantes sociales de la salud, autocuidado e información y, finalmente, desafíos de integración de los enfoques de interculturalidad, género y cooperación internacional. Conclusiones. Se evidencian oportunidades de mejorar el abordaje de la salud de personas migrantes internacionales en Chile a raíz de la pandemia por Covid-19, de cara a futuras crisis sanitarias y para reducir brechas e inequidades que impactan la salud poblacional. Objective. To investigate the main challenges in the context of the SARS-CoV-2 health emergency according to the scientific evidence available to date in this area in Chile. Materials and methods. Scoping review based on three searches in Web of Science, PubMed and Google Scholar of publications in English and Spanish published between 2020 and 2023. Results. Three key areas were identified: the challenges of access and effective use of the health system, the challenges beyond the health system, including those related to social determinants of health, self-care and information, and finally, the challenges of integrating intercultural, gender and international cooperation approaches. Conclusions. There are opportunities to better address the health of international migrants in Chile in the wake of the Covid-19 pandemic, anticipating future health crises and to reduce gaps and inequities that impact population health.
Disparities in scientific research activity between doctors and nurses working in the Peruvian health care system: Analysis of a nationally representative sample
(2022) Vergara, Angélica; Niño, Roberto; Zeta, Ludwing; Soto, Percy; Al-kassab, Ali; Pereyra, Renee; Cabieses, Báltica; Mezones, Edward
Aim: To evaluate disparities in the frequency of scientific activity between medical doctors and nurses in Peru. Methods: We carried out a secondary data analysis of the National Health Services Users’ Satisfaction Survey (ENSUSALUD), 2016. This nationally representative survey evaluates doctors and nurses working in clinical settings. We defined scientific activity as i) having published an original article (journal indexed in Web of Science, Scopus or Medline); and ii) having authored an abstract in a national or international conference. We estimated crude and adjusted disparities prevalence ratios (aDPR) and 95% confidence intervals (95%CI). Results: We included 2025 doctors and 2877 nurses in the analysis; 71% of doctors doctor were male, and 93% of nurses were female (p<0.001). Among doctors, 13.9% had published an article, and 8.4% presented an abstract at a conference in the last two years, while these proportions were 0.6% and 2.5% for nurses, respectively. The adjusted models showed that doctors, when compared to nurses, were approximately 27 times likely to have published a paper (aDPR = 27.86; 95% CI 10.46 to 74.19) and twice as likely to have authored a conference abstract (aDPR = 2.51; 95% CI 1.39 to 4.53). Conclusions: There are important disparities in scientific activity between doctors and nurses working in clinical settings in Peru. Disparities are more significant for article publication than for authoring in conference abstracts. We suggest public policies that promote research dissemination between health professionals, with emphasis on nurses.
Emergency preparedness and response sensitive of migrant populations in Chile: postpandemic perspectives
(2024) Blukacz, Alice; Cabieses, Báltica; Obach, Alexandra; CARREÑO CALDERON, ALEJANDRA; Mezones, Edward
On August 31, 2023, the Chilean government ended the health alert for COVID-19. This milestone invites us to reflect on lessons learned in emergency preparedness and response regarding migrant populations in the country. In this context, three perspectives are presented. The first focuses on avoiding pointing to individual responsibility for non-compliance with prevention measures, as this approach ignores structural and historical inequities. Emergency recommendations should be constructed considering a collective approach and diverse sociocultural and political contexts. The second perspective calls for considering and addressing migration as a social determinant of health. During the pandemic, changes in the governance of migration around the world made migration processes more precarious, with risks to the physical and mental health of migrants, which needs better planning and evidence-based decision-making in future pandemics. The third perspective focuses on promoting intercultural health, as effective communication of contagion risks and preventive measures were hampered among migrant populations with diverse worldviews and interpretations of health and disease processes. Responding to the needs of historically marginalized communities requires establishing ways of life that respect diversity in narratives and everyday practices. Governments and health systems must incorporate migration into their emergency preparedness and response strategies, creating the conditions for optimal compliance.
Health in Chile’s Recent Constitutional Process: A Qualitative Thematic Analysis of Civil Proposals
(2022) Cabieses, Báltica; Esnouf, Sophie; Blukacz, Alice; Espinoza, Manuel; Mezones, Edward; Leyva, René
Background: In response to the recent political crisis in Chile, the “Agreement for Social Peace and the New Constitution’’ was approved. We aimed to analyze the health-related civil proposals uploaded to the official website for popular participation in the new constitution in Chile. (2) Methods: We carried out a qualitative thematic analysis of 126 health-related valid proposals. Moreover, we analyzed their link to the Health Goals 2030, established by the Ministry of Health of Chile and to the Sustainable Development Goals (SDGs). (3) Results: Sixteen main categories were reached. In all, they were organized into four main areas: (i) the right to health and the establishment of a universal health system; (ii) effective access to selected healthcare services; (iii) improving health outcomes for all and for the relevant subgroups; and (iv) the social determinants of health, health in all the policies, and community health. We found that these four areas were strongly linked to the Health Goals 2030 for Chile and to the SDGs. (4) Conclusions: Despite the fact that the new constitutional proposal was rejected in September 2022, the civil health-related proposals and the areas of health and healthcare were of interest to the citizens as the request showed a strong demand from the population for participation in matters of health, healthcare, and public health.
Healthcare and social needs of international migrants during the COVID-19 pandemic in Latin America: analysis of the Chilean case
(2022) Blukacz, Alice; Cabieses, Báltica; Mezones, Edward; Cardona, José
International migrants are a particularly vulnerable group in the context of the coronavirus disease 2019 (COVID-19) pandemic. Immigrants in Chile tend to experience multidimensional poverty and layers of social vulnerability. Our analysis aims to describe the perceived social and health-related needs of international migrants during the COVID-19 pandemic in Chile in terms of migration as a social determinant of health and layered social vulnerability. We carried out a qualitative analysis of responses to an open-ended question focused on the social and health-related needs linked to the pandemic included in an online questionnaire disseminated during April 2020 aimed at international migrants residing in Chile. The information gathered was thematically analysed. We included 1690 participants. They expressed needs related to health and others linked to the overall socio-economic and political response, employment, material conditions and psychosocial aspects. They also reported needs related to 'being a migrant'. Additionally, some participants described situations of vulnerability. We analysed their needs and situations of vulnerability identified around the following emerging frames: (a) work and living conditions, (b) regularisation traps and perceived lack of support and (c) and physical and mental health needs. International migrants in Chile report experiencing interrelated layers of social vulnerability during the COVID-19 pandemic, where 'being a migrant' exacerbates physical and mental health risks. The issues revealed are immediate and direct public health challenges, as well as different aspects of social vulnerability linked to migratory status, employment and barriers to accessing healthcare that should be addressed through comprehensive policies and measures
Inequalities in infant vaccination coverage during the COVID-19 pandemic: a population-based study in Perú
(2022) Al kassab, Ali; Silva, Claudia; Mendez, Carolina; Sangster, Lucero; Arroyave, Iván; Cabieses, Báltica; Mezones, Edward
Objective: To identify the associated factors and assess the inequalities of full vaccination coverage (FVC) among Peruvian infants aged 12–23 months during the COVID-19 pandemic in a nationally representa-tive sample. Methods: We carried out a population-based cross-sectional study based on a secondary data analysis using the 2021 Peruvian Demographic Health Survey (DHS) in infants aged 12 to 23 months. The sam-pling design was probabilistic, multistage, stratified, and independent at both departmental and area of residence levels. FVC was defined according to the WHO definition. We performed generalized linear models (GLM) Poisson family log link function to estimate crude (aPR) and adjusted prevalence ratios (aPR). Also, for inequality assessment, we calculated the concentration curve (CC), concentration index (CI), and Erreygers normalized concentration index (ECI). Results: We included 4,189 infants in our analysis. Nationwide, the prevalence of FVC was 66.19% (95% CI: 64.33–68). Being younger, having a mother with no education or primary education, belonging to a large family, having no access to mass media, having had six or fewer ANC visits, and having a mother whose age was under 20 at first delivery were inversely associated with FVC. Meanwhile, living in the Highlands or on the rest of the coast, and living in rural areas were directly associated with FVC. Wefound a pro-rich inequality in FVC based on wealth-ranked households (CI: 0.0066; ECI: 0.0175). Conclusion: FVC has dropped among Peruvian infants aged between 12 and 23 months. There were sev-eral factors associated with FVC. It was more concentrated among the better-off infants, although in low magnitude.
Intersections between gender approaches, migration and health in Latin America and the Caribbean: a discussion based on a scoping review
(2023) Cabieses, Báltica; Blukacz, Alice; Velázquez, Benelli; Farante, Sofia; Bojórquez, Ietza; Mezones, Edward
Gender is a sociocultural construct that assigns forms of behaviour, power, and roles to individuals based on their sexual differentiation. There are multiple gender approaches that help distinguish risks, health conditions and behaviours related to the body, health-disease processes, and differential opportunities to access health care. Based on a scoping review of scientific and grey literature in LAC, we discuss existing understandings of international migrants’ health in LAC with a focus on gender approaches. Our discussion covers the following seven dimensions: genderbased violence, sexual and reproductive health, sexually transmitted diseases, mental health, barriers to healthcare services, and emerging patterns of health and healthcare among men and LGBTIQA+. The evidence indicates the urgent need to adopt gender approaches when addressing migrant and refugee health in LAC. Including gender approaches into ongoing strategies for promoting and protecting the health and rights of migrants and refugees is a pending challenge in the region.
Relationship between job satisfaction, burnout syndrome and depressive symptoms in physicians: a cross-sectional study based on the employment demand – control model using structural equation modelling
(2022) Villarreal, David; Lázaro, Wilder; Castillo, Ronald; Cabieses, Báltica; Blukacz, Alice; Bellido, Luciana; Mezones, Edward
Objective: To evaluate the relationship between job satisfaction, burnout syndrome (BS) and depressive symptoms (DS) based on the job demand-control framework model on a nationally representative sample of physicians working in the Peruvian Health System. Setting: We carried out a secondary data analysis of the National Survey of Satisfaction of Users in Health 2016 in Peru. Primary and secondary outcome measures: Our study assessed the development of the predictive model and had two parts: (1) to evaluate the association among the variables based on the job demand-control framework, and (2) to assess the proposed model acceptability using the structural equation modelling approach to estimate goodness-of-fit indices (GOFIs). Participants: We excluded physicians older than 65 years, who did not report income levels or who had missing data related to the workplace. Thus, we analysed 2100 participants. Results: The prevalence of DS was 3.3%. Physicians' work-related illnesses had more probability to result in DS (prevalence ratio=2.23). DS was moderately related to BS dimensions (r>0.50); nevertheless, the relationships between DS and the three job satisfaction scales were weak (r<0.30). The first predictive model based on the variables, DS, BS and job satisfaction, had low GOFIs (comparative fit index (CFI)=0.883; root mean square error of approximation (RMSEA)=0.125). In a second evaluation, we used models with correlated errors obtaining optimal GOFIs (CFI=0.974; RMSEA=0.060). Conclusions: Our study identified a stable model to explain the relationship between job satisfaction, BS and DS among physicians. The results are consistent with the job demand-control framework. They could be applied to decision-making in occupational contexts in Latin American low/middle-income countries.
The social and health protection of migrants in Chile: qualitative analysis of civil society proposals for constitutional change
(2023) Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Esnouf, Sophie; Mezones, Edward; Espinoza, Manuel; DeJong, Jocelyn
Background: A sustained period of social, economic, and political unrest took place during October of 2019 in Chile. As an institutional solution, the "Agreement for Social Peace and the New Constitution" was signed. In this document, most political parties committed to reestablishing peace and public order in Chile, agreeing on the initiation of a constitutional process. To promote participation of civil society actors, the "Popular Initiative for Norms" was enabled. This was a platform where civilians could submit proposals for constitutional norms to be discussed by the Constitutional Convention. We aimed to analyze proposals related to migrants and migrant health. Methods: We conducted a qualitative thematic analysis of the proposals. Sixteen of them were related to migrants, and we analyzed their association to health. We also evaluated their link to the Health Goals 2030 set out by the Chilean Ministry of Health and the Global Action Plan 2019-2023 for Promoting the Health of Refugees and Migrants by the World Health Organization. Results: Four main thematic categories were identified: 1) Humans rights of migrants, refugees, and asylum seekers; 2) Nationality and regularization of migrants and refugees; 3) Political participation and cultural integration of migrants and refugees; and 4) Specific regulations on slavery and human trafficking. These resonated with broader frameworks established in the Health Goals 2030 (Chile) and the Global Action Plan 2019-2023 for Promoting the Health of Refugees and Migrants by the World Health Organization. Conclusions: The 'Popular Initiative for Norms' was a non-binding participatory mechanism. Although the proposals sent through were not guaranteed to be included in the constitutional draft-and despite the final draft being rejected last September 2022-the platform allowed to gain insights into civilian opinions. Our findings showed that there is an incipient yet weak recognition of the rights and situation of migrants in Chile. There was no direct mention of health nor an explicit contemplation of social determinants of health. Despite there being an urgent need to define strategies for migrants' health in Chile, this study demonstrated that civil awareness and interest are still insufficient.

Browsing by Author "Mezones, Edward"

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