Suchergebnisse

Se presenta un análisis respecto al proceso de morir y a los criterios con que se lo interpreta y se asume la responsabilidad de su atención. Se plantea reflexiones en torno a su concepción invitando a debatirlas, para lo cual se expone como ámbitos temáticos, el por qué y para qué de la Bioética, las prácticas eutanásicas, la marginación técnico científica industrial de la nueva cultura por un "Digno Morir Humano", el rescate de la tradición moral andino amazónica para mitigar el sufrimiento y los dilemas morales que suscita la eutanasia. Los relaciona con el dolor y el sufrimiento, a la vez que enfatiza la inequidad distributiva de la riqueza al exponer la realidad de la situación política, económica y social de la región, a su vez, responsable del rol de la salud pública frente al enfermo moribundo y, al referirse de manera particular al Ecuador, describe cuatro épocas que las identifica como: Prehispánica, Colonial, Republicana y Actual. Para finalmente formular conclusiones y sugerencias relativas a la interpretación del proceso de morir, la eutanasia y la realidad actual de la salud pública, incluyendo consideraciones respecto a la autonomía que debe tener el ser humano para preservar su dignidad al morir. ; An analysis is presented regarding the process of dying and the criteria whereupon is interpreted it and how to assume the responsibility of its attention. It considers reflections around its conception inviting to debate them, for which it is exposed themes like, why and for what is the use of Bioethics, the issues about the practice of Euthanasia, the technical scientific marginalization of industrialism from the new culture for a " Human Death with Dignity", the rescue of the Amazonian Andean moral tradition to mitigate the moral suffering and dilemmas that euthanasia provokes. It relates to the pain and the suffering, at the same time that it emphasis the inefficacy in the distribution of wealth by exposing the reality of the social, economic, and political situation of the region, the roll played by the public health caring for the sick and dying patient, when referring in a particular to Ecuador, describes four stages that identifies them as: Pre- Hispanic, Colonial, Republican and Present. Finally formulating conclusions and suggestions relative to the interpretation of the dying process, euthanasia and the present reality of the public health, including considerations in respect to the autonomy and the right that must have the human being to preserve its dignity when dying. ; semestral

In 2008, Ecuador underwent a major health reform with the aim of universal coverage. Little is known about the implementation of the reform and its perceived effects in rural parts of the country. The aim of this study was to explore the perceived effects of the 2008 health reform implementation, on rural primary health care services and financial access of the rural poor. A qualitative study using focus group discussions was conducted in a rural region in Ecuador, involving health staff, local health committee members, village leaders, and community health workers. Qualitative content analysis focusing on the manifest content was applied. Three categories emerged from the texts: (1) the prereform situation, which was described as difficult in terms of financial access and quality of care; (2) the reform process, which was perceived as top-down and lacking in communication by the involved actors; lack of interest among the population was reported; (3) the effects of the reform, which were mainly perceived as positive. However, testimonies about understaffing, drug shortages, and access problems for those living furthest away from the health units show that the reform has not fully achieved its intended effects. New problems are a challenging health information system and people without genuine care needs overusing the health services. The results indicate that the Ecuadorean reform has improved rural primary health care services. Still, the reform faces challenges that need continued attention to secure its current achievements and advance the health system further. ; Funding Agencies|Centre for General Practice and Primary Health Care, County Council of Ostergotland, Sweden; County Council of Ostergotland, Sweden