Regional Overview of Specific Populations, Workforce Considerations, Training, and Diseases in Latin America

Stolovitzky, J. Pablo; Alvarado, Jacqueline

doi:10.1016/j.otc.2018.01.015

Cited by 6 publications

(11 citation statements)

References 15 publications

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“…These studies also found the highest ratio was in Argentina (56 per million). These trends align with our findings, however, we found a lower ratio in Guatemala and higher ratio in Argentina which may be explained by population increases, or increases in the numbers of ENTs, respectively 10 12. In 2001, Madriz surveyed 15 countries in LA and the Caribbean to determine the resources available for hearing impairment, including prevalence data, training programmes and equipment.…”

Section: Discussionsupporting

confidence: 88%

“…The findings of this study concur with previous literature from both the LA region and elsewhere. Two studies found that Guatemala had the poorest ratio of ENTs/100 000 population (4 per million), which was only 11% of the ratio in the USA 10 12. These studies also found the highest ratio was in Argentina (56 per million).…”

Section: Discussionmentioning

confidence: 96%

“…As a consequence, countries in the region show variation in terms of human resource shortages for healthcare 9. Previous research has found substantial shortages in the number of ENTs in 50% of LA countries 10. Other professionals involved in ear and hearing care, such as audiologists and speech therapists, are in even shorter supply 11.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Inequality in the distribution of ear, nose and throat specialists in 15 Latin American countries: an ecological study

et al. 2019

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ObjectiveTo explore sociogeographical inequalities in the availability and distribution of ear, nose and throat specialists (ENTs) in 15 Latin American (LA) countries.DesignEcological.SettingSpanish and Portuguese-speaking countries of LA.The number of registered ENTs in 2017 was obtained from the National ENT Society in each country.Outcome measuresThe ENT rate/million population was calculated at the national and subnational (eg, state) level. Three measures were calculated to assess subnational distributive inequality of ENTs: (1) absolute and (2) relative index of dissimilarity; and (3) concentration index (using the Human Development Index as the equity stratifier). Finally, the ratio of ENTs/million population in the capital area compared with the rest of the country was calculated.ResultsThere was more than a 30-fold difference in the number of ENTs/million population across the included countries—from 61.0 in Argentina (95% CI 58.7 to 63.4) to 2.8 in Guatemala (95% CI 2.1 to 3.8). In all countries, ENTs were more prevalent in advantaged areas and in capital areas. To attain distributive equality, Paraguay would need to redistribute the greatest proportion of its ENT workforce (67.3%; 95% CI 57.8% to 75.6%) and Brazil the least (18.5%; 95% CI 17.6% to 19.5%).ConclusionsThere is high inequality in the number and distribution of ENTs between and within the 15 studied countries in LA. This evidence can be used to inform policies that improve access to ear and hearing services in the region, such as scale-up of training of ENTs and incentives to distribute specialists equally. These actions to reduce inequities, alongside addressing the social determinants of ear and hearing health, are essential to realise Universal Health Coverage.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 96%

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Inequality in the distribution of ear, nose and throat specialists in 15 Latin American countries: an ecological study

et al. 2019

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“…The dearth of workforce seen in developing countries is believed to be related to 'brain drain'. Paucity of training opportunities and complex socio-political backdrops, such as conflict in the Middle East, lead to surgeons seeking opportunities abroad in developed countries, which then retain them due to their own reliance on international medical graduates [6][7][8]. Lack of training can limit the procedures performed in centres which then limits the training of subsequent trainees creating a vicious cycle [9].…”

Section: Challenges Of Surgical Training In the Developing Worldmentioning

confidence: 99%

Otolaryngology education and training in the COVID-19 and post-COVID-19 digital era: a developing world perspective

Quraishi

2021

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review This article reviews the literature on the challenges to Otolaryngology training in the developing world, the solutions that have been implemented thus far and the role of technology in first the Digital, and now the Covid era. Recent findings There is an increasing prevalence of Otolaryngological pathology in the developing world. Efforts to treat this are hampered by multiple factors including appropriate medical training. A number of solutions have been implemented for this both in terms of face-to-face as well as virtual training. Summary The Covid era has created new challenges for Otolaryngology training in the developed world, sparking a huge shift in the delivery of education. Traditional forms of training have disadvantaged colleagues in the developing world and so this change in training modalities may benefit the developing world.

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“…Notwithstanding, a few evidence-based health policies for DHH adults have been enacted in Latin America in the last decade (2,11). Using cochlear implants (CI) has been a costeffective intervention to alleviate hearing loss and consequently improve DHH people's health status, social inclusion, and labour reinsertion (12,13).…”

Section: Introductionmentioning

confidence: 99%

A country-wide health policy in Chile for deaf adults using cochlear implants: analysis of health determinants and social impacts

Bustos-Rubilar

Kyle

Luna

et al. 2023

Preprint

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Background: Post-lingual deafness represents a critical challenge for adults' well-being with substantial public health burdens. One treatment of choice has been cochlear implants (CI) for people with severe to profound hearing loss (HL). Since 2018, Chile has implemented a high-cost policy to cover CI treatment, the Ley Ricarte Soto (LRS) health policy. However, wide variability exists in the use of this device. To date, no study has been published on policy evaluation in Chile or other Latin American countries. Objectives: This study aimed to evaluate the impact of the LRS policy on the treatment success and labour market inclusion among deaf or hard of hearing (DHH) adults using CI. We examined and characterised outcomes based on self-reports about treatment success and occupation status between 2018 and 2020. Design: We performed a prospective study using hospital clinical records and an online questionnaire with 76 DHH adults aged >15 who had received CIs since the introduction of the LRS policy in 2018. Using univariate and multivariate regression models, we investigated the relationship between demographic, audiological, and social determinants of health and outcomes, including treatment success for social inclusion (International Outcome inventory for Hearing Aids and CIs assessment: IOI-HA) for social inclusion and occupation status for labour market inclusion. Results: Our study showed elevated levels of treatment success in most of the seven sub-scores of the IOI-HA assessment. Similarly, around 70% of participants maintained or improved their occupations after receiving their CI. We found a significant positive association between treatment success and market inclusion. Participants diagnosed at younger ages had better results than older participants in both outcomes (P=0.078 and P= 0.011, respectively). Regarding social determinants of health, finding suggested participants with high social health insurance and a shorter commute time to the clinic (p=0.070 and p=0.086, respectively) had better results in treatment success. For labour market inclusion, participants with high education levels and better pre- CI occupation (p=0.069 and p=0.021, respectively) had better post-CI occupation status, and findings suggested an impact of high education levels. Conclusions: In evaluating the LRS policy for providing CIs for DHH adults in Chile, we found positive effects relating to treatment success and occupation status. Our study supports the importance of age at diagnosis and social determinants of health, which should be assessed by integrating public services and bringing them near each beneficiary. Although evidence-based guidelines for candidate selection given by the LRS policy might contribute to good results, these parameters could limit the policy access to people who do not meet the requirements of the guidelines due to social inequalities

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Regional Overview of Specific Populations, Workforce Considerations, Training, and Diseases in Latin America

Cited by 6 publications

References 15 publications

Inequality in the distribution of ear, nose and throat specialists in 15 Latin American countries: an ecological study

Inequality in the distribution of ear, nose and throat specialists in 15 Latin American countries: an ecological study

Otolaryngology education and training in the COVID-19 and post-COVID-19 digital era: a developing world perspective

A country-wide health policy in Chile for deaf adults using cochlear implants: analysis of health determinants and social impacts

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