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OBJECTIVES: To identify barriers and enablers to accessing school-based eye health programs in Bogotá, Colombia. METHODS: We undertook a qualitative case study that explored how structural factors, and social and cultural norms influence access to school-based eye health programs. We conducted focus groups discussions and interviews with a purposive sample of 37 participants: government stakeholders (n = 4), representatives from nongovernmental organizations (n = 3), and an eye-care practitioner, as well as teachers (n = 7), a school nurse, parents (n = 7), and children (n = 14) from private and public schools. Data were analyzed using a priori themes from the availability, accessibility, acceptability and quality framework. RESULTS: Routine vision screening in schools is not currently provided nor is there a budget to support it. Lack of collaboration between the health and education ministries and the absence of national planning affected the delivery of eye care in schools. Factors related to acceptability of school-based eye health programs included: poor acceptance of training teachers as vision screeners; stigma related to wearing spectacles; and distrust of health services. The cost of spectacles and poor access to eye health information were identified as barriers to positive child eye health outcomes by socioeconomically disadvantaged parents and children. CONCLUSION: Our findings suggest the need for a national school eye health plan and improved cooperation between health and education ministries. Interventions to improve trust in health services, tackle the lack of human resources while respecting professional qualifications, and raise awareness of the importance of eye health are recommended.
RESUMO
[ABSTRACT]. Objectives. To identify barriers and enablers to accessing school-based eye health programs in Bogotá, Colombia. Methods. We undertook a qualitative case study that explored how structural factors, and social and cultural norms influence access to school-based eye health programs. We conducted focus groups discussions and interviews with a purposive sample of 37 participants: government stakeholders (n = 4), representatives from nongovernmental organizations (n = 3), and an eye-care practitioner, as well as teachers (n = 7), a school nurse, parents (n = 7), and children (n = 14) from private and public schools. Data were analyzed using a priori themes from the availability, accessibility, acceptability and quality framework. Results. Routine vision screening in schools is not currently provided nor is there a budget to support it. Lack of collaboration between the health and education ministries and the absence of national planning affected the delivery of eye care in schools. Factors related to acceptability of school-based eye health programs included: poor acceptance of training teachers as vision screeners; stigma related to wearing spectacles; and distrust of health services. The cost of spectacles and poor access to eye health information were identified as barriers to positive child eye health outcomes by socioeconomically disadvantaged parents and children. Conclusion. Our findings suggest the need for a national school eye health plan and improved cooperation between health and education ministries. Interventions to improve trust in health services, tackle the lack of human resources while respecting professional qualifications, and raise awareness of the importance of eye health are recommended.
[RESUMEN]. Objetivo. Determinar los obstáculos y los elementos facilitadores para acceder a los programas de salud ocular en las escuelas en Bogotá (Colombia). Métodos. Se llevó a cabo un estudio cualitativo de casos que exploró cómo influyen los factores estructurales y las normas sociales y culturales en el acceso a la atención oftalmológica. Se realizaron entrevistas y grupos de opinión con una muestra intencionada de 37 participantes: interesados directos gubernamentales (n = 4), representantes de organizaciones no gubernamentales (n = 3) y un profesional de atención oftalmológica, así como docentes (n = 7), una enfermera escolar, padres (n = 7) y niños (n = 14) de escuelas privadas y públicas. Se analizaron los datos empleando temas determinados a priori sobre la disponibilidad, la accesibilidad, la aceptabilidad y el marco de calidad. Resultados. Actualmente, no se proporciona un tamizaje sistemático de la visión en las escuelas, ni se dispone de presupuesto para respaldarlo. La falta de colaboración entre los ministerios de salud y de educación, y la falta de planificación a nivel nacional tuvo repercusiones sobre la prestación de atención oftalmológica en las escuelas. Entre los factores relacionados con la aceptabilidad de los programas de salud ocular en las escuelas se encuentran una escasa aceptación de la posibilidad de capacitar a los docentes para que examinen la visión; el estigma relacionado con el uso de anteojos y la desconfianza de los servicios de salud. Los padres y los niños en una situación socioeconómica desfavorable indicaron que el costo de las gafas y el acceso limitado a la información sobre la salud ocular eran obstáculos para obtener resultados positivos de salud ocular en los niños. Conclusiones. Los resultados indican la necesidad de un plan nacional de salud ocular en las escuelas y una mejor cooperación entre los ministerios de salud y de educación. Se recomiendan intervenciones para mejorar la confianza en los servicios de salud, abordar la falta de recursos humanos al tiempo que se respetan las cualificaciones profesionales y concientizar sobre la importancia de la salud ocular.
[RESUMO]. Objetivos. Identificar barreiras e facilitadores para o acesso a programas escolares de saúde ocular em Bogotá, Colômbia. Métodos. Estudo de caso qualitativo que explorou como fatores estruturais e normas socioculturais influenciam o acesso aos cuidados com a visão. Realizamos discussões em grupos focais e entrevistas com uma amostra intencional de 37 participantes: partes interessadas do governo (n = 4), representantes de organizações não governamentais (n = 3) e um oftalmologista, bem como professores (n = 7), uma enfermeira escolar, pais de alunos (n = 7) e alunos (n = 14) de escolas públicas e particulares. Os dados foram analisados de acordo com temas escolhidos a priori, a partir do marco de disponibilidade, acessibilidade, aceitabilidade e qualidade. Resultados. O exame de visão de rotina não é realizado atualmente nas escolas, nem há espaço orçamentário para fazê-lo. A falta de colaboração entre os Ministérios da Saúde e da Educação e a ausência de planejamento em escala nacional afetaram a prestação de cuidados oftalmológicos nas escolas. Fatores relacionados à aceitabilidade dos programas escolares de saúde ocular incluíram baixa aceitação do treinamento de professores para realizar triagem de problemas visuais, estigma relacionado ao uso de óculos e desconfiança nos serviços de saúde. O custo dos óculos e o acesso limitado a informações sobre saúde ocular foram identificados como barreiras para desfechos positivos de saúde ocular infantil em pais e crianças em situação de desvantagem socioeconômica. Conclusão. Os resultados sugerem a necessidade de um plano nacional de saúde ocular nas escolas e de uma melhor cooperação entre os Ministérios da Saúde e da Educação. Recomendam-se intervenções para aumentar a confiança nos serviços de saúde, combater a falta de recursos humanos (respeitando as qualificações profissionais) e aumentar a conscientização sobre a importância da saúde ocular.
Assuntos
Saúde Ocular , Seleção Visual , Instituições Acadêmicas , Equidade , Colômbia , Saúde Ocular , Seleção Visual , Instituições Acadêmicas , Equidade , Saúde Ocular , Seleção Visual , Instituições Acadêmicas , Equidade , ColômbiaRESUMO
BACKGROUND: Hevea brasiliensis, a member of the Euphorbiaceae family, is the major commercial source of natural rubber (NR). NR is a latex polymer with high elasticity, flexibility, and resilience that has played a critical role in the world economy since 1876. RESULTS: Here, we report the draft genome sequence of H. brasiliensis. The assembly spans ~1.1 Gb of the estimated 2.15 Gb haploid genome. Overall, ~78% of the genome was identified as repetitive DNA. Gene prediction shows 68,955 gene models, of which 12.7% are unique to Hevea. Most of the key genes associated with rubber biosynthesis, rubberwood formation, disease resistance, and allergenicity have been identified. CONCLUSIONS: The knowledge gained from this genome sequence will aid in the future development of high-yielding clones to keep up with the ever increasing need for natural rubber.