Sacoto Fernando, Torres Irene, López-Cevallos Daniel F
Ecuadorian Society of Public Health Quito Ecuador Ecuadorian Society of Public Health, Quito, Ecuador.
Octaedro Foundation Quito Ecuador Octaedro Foundation, Quito, Ecuador.
Rev Panam Salud Publica. 2021 Feb 23;45:e30. doi: 10.26633/RPSP.2021.30. eCollection 2021.
This study analyzes the conditions and possibilities of sustainability of the Salud al Paso program of the Metropolitan Health Secretariat of the Municipality of Quito, Ecuador, as an example for similar initiatives, in the context of the changes made by the new administration in May 2019. The analysis of the implementation of this initiative, focused on the prevention of noncommunicable diseases (NCDs), was based on the program's user database, the information gathered on the perspectives of operational staff, knowledge of the program, and the opinion of local leaders and opinion leaders of the Quito Metropolitan District, as well as official information. Based on this data, the study identified factors that could have facilitated or hindered its sustainability and documented the rationale to suspend the on-demand activities included in the program and limit activities to the care of populations under municipal responsibility (day-care centers, schools and colleges, markets, elder care programs, and employees) and patients with identified cardiometabolic risk. The insufficient institutionalization of the program, conceived as a project with an insufficient vision of its sustainability in time, was mentioned as a possible obstacle by leaders and operational staff. The growing prevalence of NCDs requires initiatives for their prevention, which must be institutionalized to ensure their continuity and overcome eventual changes of government. In addition, future interventions similar to Salud al Paso should establish better sectoral coordination articulation, especially with the Ministry of Public Health and other service networks.
本研究以厄瓜多尔基多市都市卫生秘书处的“健康同行”项目为例，分析了在2019年5月新政府做出变革的背景下，该项目可持续发展的条件和可能性，为类似举措提供借鉴。对该以预防非传染性疾病为重点的倡议实施情况的分析，基于项目用户数据库、从运营人员视角收集的信息、对项目的了解、基多市辖区地方领导人和意见领袖的看法以及官方信息。基于这些数据，该研究确定了可能促进或阻碍其可持续性的因素，并记录了暂停该项目中按需开展活动的理由，将活动限制在对市政府负责的人群（日托中心、中小学和学院、市场、老年护理项目以及员工）和已确定患有心血管代谢风险的患者的护理上。该项目的领导者和运营人员提到，该项目制度化不足，被视为一个对其长期可持续性缺乏远见的项目，这可能是一个障碍。非传染性疾病患病率不断上升，需要采取预防举措，且这些举措必须制度化，以确保其连续性并克服政府的最终更迭。此外，未来类似于“健康同行”的干预措施应建立更好的部门协调机制，特别是与公共卫生部和其他服务网络的协调。
