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首页> 外文期刊>Occupational Diseases and Environmental Medicine >Meso-American Nephropathy in El Salvador: Increasing Farmer Participation in MeN Prevention Efforts
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Meso-American Nephropathy in El Salvador: Increasing Farmer Participation in MeN Prevention Efforts

机译：萨尔瓦多的中美洲肾病：增加农民对预防甲乙脑的努力

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Objectives: This paper highlights and discusses major factors affecting Salvadoran farmers’ involvement in National Health System-led efforts to prevent MeN in El Salvador and includes some recommendations to enhance their involvement. Methods: The study, conducted in El Salvador in June 2018, involved 10 life-long farmers residing in five MeN-affected communities in Chalatenango and Usulutan Departments who were either MeN-free or MeN-controlled, to understand through semi-structured, qualitative interviews their experience of participation in broader epidemic control efforts. Complementary interviews held with two nephrology teams and a senior representative of the grassroots-level National Health Forum operating in the same area, provided necessary contrast. Interview questions were informed by reference to the Adaptation and Development after Persecution and Trauma (ADAPT) model [ 1 ] as applicable in post-conflict environments like El Salvador to analyze contextual factors influencing community participation. Findings: Farmers are scarcely involved in wider MeN prevention efforts in El Salvador despite greater National Health System emphasis on encouraging community participation since the approval of the 2009 Health Reform [2]. This study found that widespread insecurity due to gang warfare, declining family and social networks due to high murder rates and international migration, and unresolved sense of injustice over unremitting poverty are among major factors with potential destructive effect on farmer participation. Conclusions: Health system-led MeN prevention responses need to encompass attention to persisting social vulnerabilities in economically and socially marginalized communities in order to enhance farmer participation in this effort. This paper concludes with some recommendations on how this can be done.
机译：目标：本文重点介绍并讨论了影响萨尔瓦多农民参与国家卫生系统主导的萨尔瓦多预防MeN的努力的主要因素，并提出了一些建议，以加强他们的参与。方法：该研究于2018年6月在萨尔瓦多进行，涉及10个终身受益农民，这些农民居住在Chalatenango和Usulutan部门的五个受MeN影响的社区中，这些社区不受MeN或MeN的控制，以通过半结构化，定性的理解采访他们参与更广泛的流行病控制工作的经验。与两个肾脏科团队和同一地区的基层全国卫生论坛的高级代表进行的补充访谈提供了必要的对比。采访中的问题是通过参考“迫害和创伤后适应与发展”（ADAPT）模型[1]得出的，该模型适用于像萨尔瓦多这样的冲突后环境，以分析影响社区参与的背景因素。调查结果：自2009年卫生改革批准以来，尽管国家卫生系统更加重视鼓励社区参与，但农民几乎没有参与萨尔瓦多的广泛的MeN预防工作。这项研究发现，由于帮派战争而造成的广泛不安全感，由于高谋杀率和国际移民而导致的家庭和社会网络的减少以及对持续贫困的不公正感是造成农民参与潜在破坏性影响的主要因素。结论：卫生系统主导的MeN预防对策需要包括对经济和社会边缘化社区中持续存在的社会脆弱性的关注，以增强农民的参与力度。本文最后提出了有关如何完成此操作的一些建议。

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