August, 2016 - SUPPORT Summary of a systematic review | print this article |

¿Los cambios en la educación previa al otorgamiento de licencias de los trabajadores de salud impactan en el suministro de trabajadores de salud?

Background



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Pariyo GW, Kiwanuka SN, Rutebemberwa E, et al. Efectos de los cambios en la educación previa al otorgamiento de licencias a los trabajadores de salud en la contratación de trabajadores de la salud. Base de Datos Cochrane de Revisiones Sistemáticas 2009, Número 2. Art. No.: CD007018.

Summary of findings

Relevance of the review for low-income countries

Findings Interpretation*
APPLICABILITY
Results came from only one study conducted back in 1988.  Neonates with suspected or confirmed late onset sepsis were enrolled. Factors that need to be considered to assess whether the intervention effects are likely to be transferable to other settings include:
  • Organisms responsible of infection change between developed and developing countries as well as mortality associated with the disease.
  • Organisms have changed over time and since the study information became available.
  • The choice of the antibiotic therapy must be based on the prevalence of microorganisms in different neonatal care units and different settings
EQUITY
Risk factors for late onset neonatal sepsis are not limited to intrinsic factors due to immature immune responses and barriers. Extrinsic factors such as medical treatments and devices, invasive procedures and prolonged hospital stay are crucial in the development of late onset neonatal infection Preventive strategies for sepsis addressing intrinsic and extrinsic risk factors could reduce the burden that imposes late onset neonatal sepsis in particular developing countries settings, were at least part of disease cases can be avoided.
ECONOMIC CONSIDERATIONS
No data on costs of the implementation of neither of the two antibiotic regimens was provided in the systematic review The ideal antibiotic regimen is likely to be the one that reduces complications and sequelae of sepsis, rates of treatment failure and antibiotic resistance with minimum adverse effects and risks.
There is no information that indicates superiority of any of the evaluated regimens for any of these outcomes.
MONITORING & EVALUATION
Little evidence exist about effectiveness, short and long term security of therapy, bacteriological resistance rates and costs of different antibiotic regimens for the treatment of late onset neonatal sepsis.

There is a need for more research in the evaluation of effectiveness of different antibiotic regimens in the treatment of late onset neonatal sepsis taken in count local characteristics of the population and microbiological surveillance.

Monitoring of microorganisms responsible for sepsis in different countries and settings is vital for the election of the right antibiotic therapy in specific neonatal populations.

Security of different antibiotic regimens most be carefully evaluated given that the therapy is often empiric and many neonates are nor actually infected.


*Judgements made by the authors of this summary, not necessarily those of the review authors, based on the findings of the review and consultation with researchers and policymakers in low-income countries. For additional details about how these judgements were made see: http://www.support-collaboration.org/summaries/methods.htm

 

Additional information

Literatura relacionada

Grobler L, Marais BJ, Mabunda S. Intervenciones para aumentar la proporción de profesionales de la salud que practican en áreas rurales y otras áreas desatendidas. Base de Datos Cochrane de Revisiones Sistemáticas 2015, Número 6. Art. No.: CD005314.

Kessel RA. La A.M.A y el suministro de médicos. Derecho y Problemas Contemporáneos 1970; 35: 267-83.

Organización Mundial de la Salud. Informe sobre la salud en el mundo. Organización Mundial de la Salud 2006.

Wilson NW, Couper I, de Vries E, et al. Una revisión crítica de las intervenciones para corregir la distribución desigual de profesionales de la medicina a áreas rurales y remotas. Rural Remote Health 2009, 9: 1060.

Wyss K. Un enfoque para clasificar las limitaciones de recursos humanos para alcanzar los Objetivos de Desarrollo del Milenio relacionados con la salud. Recursos Humanos para la Salud 2004; 2: 1-11.

 

 

Este resumen fue preparado por

Peter Steinmann, Instituto Suizo de Salud Tropical y Salud Pública, Suiza.

 

 

Conflicto de intereses

Ninguno declarado. Para más detalles, consulte: www.supportsummaries.org/coi

 

 

Agradecimientos

Este resumen ha sido revisado por: Ben Marais, George Pariyo y Hanna Bergman.

 

 

Esta revisión debe ser citada como

Pariyo GW, Kiwanuka SN, Rutebemberwa E, et al. Efectos de los cambios en la educación previa al otorgamiento de licencias a los trabajadores de salud en la contratación de trabajadores de la salud. Cochrane Base de Datos de Revisiones Sistemáticas 2009, Número 2. Art. No.: CD007018.

 

 

El resumen debe ser citado como

Steinmann P. ¿Los cambios en la educación previa al otorgamiento de licencias de los trabajadores de salud impactan en el suministro de trabajadores de salud? Un Resumen de Soporte de una revisión sistemática. Agosto 2016. www.supportsummaries.org

 

 

Palabras claves

Políticas de salud basada en evidencia, revisión sistemática, investigación sobre sistemas de salud, cuidado de la salud, países de ingresos bajos y medianos, países en desarrollo, atención primaria de salud, educación, retención, inscripción, trabajador de salud, minorías, tutoría.



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