Barbar Ana Elisa Medeiros
Comitê Internacional da Cruz Vermelha, Brasília (DF), Brasil.
Rev Panam Salud Publica. 2018 Sep 24;42:e142. doi: 10.26633/RPSP.2018.142. eCollection 2018.
The present article aims at discussing the singularities of primary health care (PHC) in contexts where violence, strongly supported by guns, is routinely, chronically, and systemically present, and to gauge the capacity of PHC as empowerment channel for communities where armed violence is an expressive vulnerability. Based on the Declaration of Alma-Ata and on the PHC principles described by Barbara Starfield, and focusing on community participation and social determinants of health, the discussion departs from the realities observed in Latin America and the commitment to access and universal coverage set forth in the third Sustainable Development Goal. The qualitative and quantitative characterization of armed violence and its consequences must be qualified using an intersectoral approach with heavy community participation in search of coherent and significant responses. The protection and safety of health care workers must be ensured to guarantee the continuous provision of health care services in contexts of violence.
本文旨在探讨在枪支大力支持的暴力行为经常、长期且系统存在的背景下,初级卫生保健(PHC)的独特之处,并评估初级卫生保健作为武装暴力构成明显脆弱性的社区赋权渠道的能力。基于《阿拉木图宣言》以及芭芭拉·斯塔菲尔德所描述的初级卫生保健原则,并聚焦于社区参与和健康的社会决定因素,讨论从拉丁美洲观察到的现实以及第三个可持续发展目标中提出的获取和全民覆盖的承诺出发。必须采用部门间方法,让社区大量参与,以寻求连贯且有意义的应对措施,对武装暴力及其后果进行定性和定量描述。必须确保医护人员的保护和安全,以保证在暴力环境中持续提供医疗保健服务。