PubMed · 5889220
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J M Stycos, A G Feldt, G C Myers. 1964. The Cornell International Population Program.. https://pubmed.ncbi.nlm.nih.gov/5889220/
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Central America is an area with a growing human immunodeficiency virus (HIV) epidemic, but with marked limitations in its health care infrastructure. Estimated adult HIV infection rates range from 0.20% in Nicaragua to 2.01% in Belize. Hospitals and clinicians with experience in HIV care exist mainly, if not only, in capital cities and principal economic centers. Nationally sponsored social security systems in each country consistently offer a wider range of services than do ministry of health systems. Estimated access to the social security system ranges from 0% in Belize and 10% of the population in Honduras to 95% in Costa Rica. Combination antiretroviral therapy is not available through the ministries of health and zidovudine is only sporadically available for prevention of perinatal transmission. Combination therapy is available through the social security system in the countries of Guatemala, Panama, and Costa Rica only. A wide variety of antiretroviral agents are available through private pharmacies in all countries except Belize. With the exception of Costa Ricans, most people with HIV infection in Central America have limited access to HIV-specific health services and limited or no access to antiretroviral agents.
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Within the ongoing strategy of the Workers' Health program at the Pan American Health Organization on strengthening surveillance in the field of workers' health in the Americas (the Region), a project was conducted in July 1999 in Washington, D.C. The objectives of the project were to discuss the problems found in the surveillance of workers' health, to develop a methodology and use it to prioritize and select the top three occupational sentinel health events for incorporation into the surveillance systems in the Region, and to develop the initial protocols for establishing the surveillance systems for the three chosen occupational sentinel health events. The Pan American Health Organization invited 24 occupational health experts from the Region to participate in the project. Over an intensive 3-day period, the experts heard reports of workplace surveillance activities in the various countries in the Region; developed prioritization methods; identified and prioritized a list of occupational sentinel health events; and developed three surveillance protocols, one each for occupational fatal injuries, pesticide poisoning, and low back pain. The results on the prioritization of occupational sentinel health events and the development of surveillance protocols are reported in this article.