The use of a Toolkit for health needs assessment on neural tube defects in Argentina

• Autores: Groisman, Boris; Liascovich, Rosa; Barbero, Pablo; Alberg, Corinna; Moorthie, Sowmiya; Nacul, Luis; Sagoo, Gurdeep S
• Año de publicación: 2013
• Idioma: inglés
• Tipo de recurso: artículo
• Fuente: Journal of community genetics 2013; 4(1):77-86.
• Materia: Tubo Neural; Argentina
• Institución: Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"

Fil: Groisman, Boris. ANLIS Dr.C.G.Malbrán. Centro Nacional de Genética Médica; Argentina.
Fil: Liascovich, Rosa. ANLIS Dr.C.G.Malbrán. Centro Nacional de Genética Médica; Argentina.
Fil: Barbero, Pablo. ANLIS Dr.C.G.Malbrán. Centro Nacional de Genética Médica; Argentina.
Fil: Alberg, Corinna. PHG Foundation, 2 Worts Causeway, Cambridge, CB1 8RN; Reino Unido.
Fil: Moorthie, Sowmiya. PHG Foundation, 2 Worts Causeway, Cambridge, CB1 8RN; Reino Unido.
Fil: Nacul, Luis. PHG Foundation, 2 Worts Causeway, Cambridge, CB1 8RN; Reino Unido.
Fil: Sagoo, Gurdeep S. PHG Foundation, 2 Worts Causeway, Cambridge, CB1 8RN; Reino Unido.
Health needs assessment (HNA) is a commonly used process for those working in public health. The PHG Foundation has developed a Toolkit to provide users with a stepwise approach for undertaking a HNA on birth defects. We report the findings from using the Toolkit to examine needs in relation to policies and programs, services, and interventions for neural tube defects (NTDs) in Argentina. The trend over the last few decades is one of decline in infant mortality from nutritional and infectious causes, thus further increasing the relative importance of birth defects. The observed prevalence of NTDs is consistent with that reported internationally. Since 2002 folic acid fortification (FAF) has been mandatory by law, and different studies have shown at least a 50 % decrease in the birth prevalence of NTDs after FAF. In Argentina, there is inequity between the public and non-public health sectors. The birth prevalence of NTDs seems lower in the non-public sector, possibly as a result of better nutritional status of women, higher access to folic acid supplementation, and earlier prenatal diagnosis followed by termination of pregnancy (ToP) in non-public hospitals. Although illegal, ToP is believed to be widespread, with better access for people of higher socioeconomic status. Through the process of HNA, we identified several unmet needs regarding registration of cases, public and professional education, legislation, and organization of care pathways. In our experience, the Toolkit brought together people working on the same issue, and it engaged and motivated experts and stakeholders to work together to tackle the problem.