Therefore, the active participation of the various actors is required, since in this way the real problems of the population are evidenced, through a plan of demands, which would be the main input to be used in the governance space of the central actors.
The usefulness of the Asis in PESComo was mentioned above, in parallel to the working meetings was built the Integral ASIS of the parish Zuata, where in addition to considering the socio-epidemiological information was applied a guide of direct observation in each locality, with the aim of compiling information on the conditions of life, incorporating economic variables, social, ecological, health services and social participation that generated a weighted indicator for the stratification of localities by conditions of vida; as well as variables on the causes and consequences of the problems selected by key actors.
The problem is serious in all social territories
The observation guide was applied with the support of one of the inhabitants, who had to be at least 3 years living in the town. Final scores were obtained for each locality and stratified from one (best) to four (worst) living conditions. The information collected made it possible to know each of the 26 localities that made up the parish Zuata for the time of the study, update the information of the Situation Room of the outpatient clinic and validate with other actors the information produced in the different work meetings.
One of the analyses carried out, with the data collected in the ASIS was to compare the means of drinking water coverage, obtaining that both the F of Snedecor and the linear trend are not statistically significant, indicating that the behavior is similar in the four strata, i.e., the problem is serious in all social territories because of the rationalization of the vital liquid in most of them. Similarly, there is a difference in intra-stratum inequity according to the coefficient of variation of Stratum 4 (113.14) higher than the other strata, suggesting the prioritization of Stratum 4 localities to initiate the intervention.
In this case, even if there is no statistical significance with the methods used, it is important to consider the existing inequalities, through the situational discussion in the context of the Zuata Parish, not forgetting that the tests of statistical significance allow to evaluate the effect of chance on the variables under study, but never decide on the relationships of cause effect.
Other criteria must also be used1. Considerations finalesLa PES combined with the ASIS constituy a fundamental tool for the strengthening of local power in salud2, allowing through a process of research-action in conjunction with authorities and communities, identify and seek solutions to some of the problems existing in the social reality.
The experience developed in the parish Zuata allowed to use the overall strategic vision to integrate the participation in the research of the actors of the community of Zuata, with information available in various health sector information systems. By integrating these two perspectives, the key actors and the health institutions, it avoids making an approach to the problems only from the public offering fragmented and at the same time increases the power of explanation of the enfoques.
That would give answers to a population problem
De the same way, through the first moment of the PES were determined the priority causes to intervene, linking them with the constitutional rights, identifying which of these were not being guaranteed as an integral, to build possible lines of action through the formulation of intervention projects.
On the other hand, the critical nodes selected from a collective discussion with the different key actors, made it possible to design an intersectoral action plan that would give answers to a population problem, which was possibly not a priority in the plans of the actors managing critical resources. Another important point is that when selecting the critical nodes considering the participation of the various actors, the actions developed will have greater acceptance and adherence of these, since they participated in the discussion.
Also, the responses designed will be more equitable to the extent that the information from ASIS is used, which clearly states that the 26 localities are different from each other and that in order to solve the problem of “deficiencies in the distribution of drinking water”, with the scarce existing resources, it will be necessary to prioritize those in the worst living conditions, i.e. vulnerables.Al combining the explanatory moment of the PES and the ASIS, both approaches are enhanced and more precisely approach the social reality, incorporating a look more equitable in the measure in which he includes the opinion of the actors who have the problems and those who manage critical resources.
The application of both approaches in a comprehensive way requires the engagement of different actors from the central level of government to local actors, in this way it is possible to facilitate the plan of intervention, a situation that in these times it is feasible in Venezuela, the policies of engagement that you are attempting to desarrollar.
Its most frequent health problems
Finally, the PES-ASIS articulation contributes to generating inputs that, concretized by the actors in an action plan, can contribute to the reduction of inequalities.
Also, the active participation of the actors makes it possible to highlight the real problems of the population and build a plan of demands closer to the needs Felt by the population. Collaboratorsh Heredia worked on the conception, methodology and writing of the article; E Artmann on the conception and writing; N Lopez on the methodology and analysis of the data and interpretation of the data; J use in data collection and analysis and data interpretation.
Homelessness has important health implications. Homeless people have higher morbidity and mortality than the rest of the population and face significant barriers to their access to health care. This article defines the demographic characteristics of this sector of the population, its most frequent health problems and the response of the health system to their needs.
Although the data presented relate mainly to Canada, much of them are also applicable to other countries, both developed and developing. In this article, homeless persons are those who sleep in the street, in vehicles, in abandoned buildings or in other places not intended for the room, as well as those who have a shelter that does not meet the basic safety and health requirements.