Background: Real-world evidence (RWE) is increasingly used to inform health technology assessments for resource allocation, which are valuable tools for emerging economies such as in America. Nevertheless, the characteristics and uses in South America are unknown.Objectives: To identify sources, characteristics, and uses of RWE in Argentina, Brazil, Colombia, and Chile, and evaluate the context-specific challenges. The implications for future regulation and responsible management of RWE in the region are also considered.Methods: A systematic literature review, database mapping, and targeted gray literature search were conducted to identify the sources and characteristics of RWE. Findings were validated by key opinion leaders attending workshops in 4 South American countries.Results: A database mapping exercise revealed 407 unique databases. Geographic scope, database type, population, and outcomes captured were reported. Characteristics of national health information systems show efforts to collect interoperable data from service providers, insurers, and government agencies, but that initiatives are hampered by fragmentation, lack of stewardship, and resources. In South America, RWE is mainly used for pharmacovigilance and as pure academic research, but less so for health technology assessment decision making or pricing negotiations and not at all to inform early access schemes.Conclusions: The quality of real-world data in the case study countries vary and RWE is not consistently used in healthcare decision making. Authors recommend that future studies monitor the impact of digitalization and the potential effects of access to RWE on the quality of patient care.

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Introducción: Las desigualdades en salud cardiovascular se han documentado en la literatura tanto en países desarrollados como no desarrollados y existe una asociación inversa entre la incidencia y mortalidad por causa específica de enfermedades cardiovasculares y los niveles de ingreso, educación y empleo.

Resumen En el marco de los estudios sociales y demográficos sobre salud sexual y reproductiva, este artículo se interroga sobre la situación de los jóvenes en Argentina, poniendo foco en la problemática de las Enfermedades de Transmisión Sexual (ETS) y en el alcance de los derechos sexuales. Los objetivos son indagar en los calendarios y características del inicio de la vida sexual de jóvenes argentinos e indagar en la situación actual de conocimientos, prácticas y acceso a educación sexual. A partir de los datos de la Encuesta Nacional sobre Salud Sexual y Reproductiva (2013) se trabajó con el universo de jóvenes de 15 a 29 años de edad (n = 2084 mujeres; n = 1872 hombres, sin ponderar) y se analizaron las diferencias de los calendarios del inicio de la vida sexual, así como el conocimiento y prevención de las ETS por sexo, grupos de edades, ingreso de los hogares y regiones geográficas. Se encontró un panorama nacional con tendencias marcadas en los calendarios de primera relación sexual fundamentalmente por sexo, así como sobre los conocimientos sobre ETS. No obstante, el análisis diferenciado por región e ingreso del hogar en cada sexo mostró grandes heterogeneidades que indicarían limitaciones en el acceso a educación sexual y el efectivo cumplimiento de derechos de la población, así como un riesgo acentuado de contraer ETS en ciertos grupos sociales.

Objective. Evaluate primary health care functions from the perspective of patients with tuberculosis from slums in the city of Buenos Aires, Argentina. Methods. Cross-sectional observational study with adult patients with tuberculosis (TB) and without TB (NoTB), living in slums (S) and outside them (NoS). Participants’ perceptions were evaluated using the Primary Care Assessment Tool for users (abbreviated version), which measures four main domains (first contact, ongoing care, coordination with specialists, and comprehensiveness) and selected secondary domains. A Likert scale was used, ranging from “No, not at all” (1 point) to “Yes, definitely” (4 points). Scores ≥ 3 were considered to indicate adequate performance of functions. Averages were calculated for each domain, as well as two overall scores: with and without secondary domains. Results. 83 participants were included (20 TB-S, 21 TB-NoS, 19 NoTB-S, and 23 NoTB-NoS). The evaluated functions were perceived as inadequate. The TB-S group gave the lowest overall scores, not reaching 3 points in any domain. There were no significant differences in domains or overall scores between groups. Participants with TB gave lower scores in all domains, except in family-centered care, where they gave a significantly higher score than NoTB participants. The overall score without secondary domains was lower for TB participants than for the NoTB groups. Conclusions. According to the perception of participants with TB and without TB, primary health care functions are not satisfactory, either in slums or outside them.