REȚEA NAȚIONALĂ DE PROMOVARE A SĂNĂTĂȚII REPRODUCERII PRIN POLITICI PUBLICE INTEGRATE – PARTENERIATUL PUBLIC-PRIVAT PENTRU ŞANSĂ LA VIAŢĂ, BRAȘOV 19 – 21 IUNIE 2019.

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Rețeaua RENASC reprezintă un element inovativ creat în cadrul unui proiect finanțat prin fonduri europene – Parteneriatul Public – Privat adresat specialiștilor în domeniul sănătății reproducerii, ce poate fi consultat de ministere și foruri de decizie printr-o platformă informatică – instrument de cercetare și consultare în plolitici publice de sănătate.

Alături de o echipă multidisciplinară, implicată activ în proiectele și nevoile comunității la nivel național, în perioada 19 – 21 iunie, în inima Transilvaniei, Municipiul Brașov, a avut loc atelierul de lucru cu membrii Rețelei Tematice Naționale RENASC – Rețea Națională pentru Sănătatea Reproducerii.  Aceasta  urmează dezbaterile publice avute în cele 8 regiuni de dezvoltare, în decursul a 7 luni de implementare a proiectului cu titlul “RENASC – Rețea Națională de promovare a Sănătății reproducerii prin politici publice integrate”, Cod SIPOCA 226/SMIS/110651, proiect cu acoperire națională cofinanțat de Uniunea Europeană din Fondul Social European prin Programul Operațional Capacitate Administrativă 2014 – 2020.

Evenimentele Rețelei RENASC s-au adresat specialiștilor în domeniul Sănătății Reproducerii, și au avut ca scop consultarea profesioniștilor din teren, referitor la politicile publice existente în domeniul sănătăţii reproducerii, cu scopul de a formula de propuneri alternative la politicile publice referitoare la domeniile sănătății reproducerii.

În ideea de a îmbunătății sănătatea reproducerii sub toate aspectele ei, aspecte care vizează măsuri care să vină în sprijinul îmbunătățirii calității vieții  mamei și copilului, parteneriatul RENASC a reunit actori relevanți din domeniul sănătății reproducerii, membrii/reprezentanți ai ONG-urilor, personal medical din domeniu, reprezentanți ai serviciilor educaționale, autorităților publice, societății civile, experți în sănătate publică, asistenți medicali și membrii ai mediului academic. Împreună, lucrand interdisciplinar la un plan de măsuri pentru creșterea accesului la servicii de planificare familială au colectat și propus soluții inovative, in urma celor 8 evenimente de dezvoltare a Rețelei RENASC și 5 seminarii de lucru care au avut loc în Brașov, Buzău, Cluj, Constanța, Dolj, Iași, Prahova și Municipiul București. Actorii relevanți, ce constituie grupul țintă al proiectului, sunt profesioniști care înțeleg și se confruntă cu realităţile din sistemul de sănătate,  pot integra aceste inițiative în propuneri legislative benefice sistemului, fie că este vorba de legislație națională, norme de aplicare la nivel local sau înfrățirea unor domenii prioritare, cum ar fi educația şi sănătatea.

Mulțumiri deosebite tuturor specialiștilor prezenți, echipelor Direcțiilor de Sănătate Publică și spitalelor județene, obstetricieni, moașe, asistenți medicali comunitari, asistenți sociali, psihologi școlari, reprezentanți ai ONG-urilor în domeniu, experți în sănătate publică și reprezentanți ai Ministerului Sănătății, tuturor experților în domeniul sănătății reproducerii și membrilor echipei de implementare a proiectului, pentru prezentarea situației serviciilor  din domeniul Sănătății Reproducerii și datelor la nivelul fiecărui județ. Discuții foarte productive au avut loc în identificarea de probleme, propunerea de soluții alternative și de armonizare legislativă a politicilor publice în domeniul de referință al proiectului.

Cu ocazia acestor dezbateri, s-a evidenţiat şi evoluția indicatorilor relvanți pentru sănătatea reproducerii în ultimii 10 ani (2005-2016). Punctul de plecare l-a reprezentat prezentarea rezultatelor „Studiului Sănătăţii reproducerii în România 2016”, prezentare susţinută de experții cercetători Prof. Dr. Matei Dumitru, CS I Dr. Michaela Nanu și  CS I Soc. Dr. Ecaterina Stativă, din Institutul Național pentru Sănătatea Mamei și Copilului „Alessandrescu-Rusescu”, partener în cadrul proiectului,studiu reprezentativ, realizat la nivel național, pe un eșantion de5051 femei între 15 și 45 ani.

Urmare acestui atelier, s-au conturat  principalele aspecte la care specialiștii au propus abordări de intervenție multidisciplinare. Rezultatele consultărilor la nivel național, prezentate de d-na Dr. Marina Oţelea, președinte al Asociației SAMAS, partener al proiectului, au reflectat probleme, obstacole și propuneri formulate care acoperă trei perioade ale asistenței:

  1. Intervenții în perioada pre-concepțională:

Precoce: igiena și educația sexuală în procesul de educație formală(începând de la gradiniță) – susținut de toți participanții);

În perioda fertilă: igienă, tratamentul bolilor cu transmitere sexuală, promovarea unui stil de viață sănătos: nutriție, renunțarea la consumul de alcool, tutun, droguri.

  1. Asistența garantată de stat în timpul sarcinii

Medicală: acces crescut la servicii cu atenție specială grupurilor vulnerabile, sporirea numărarului  de investigații la gravida, posibilitatea de intervenție în urgență;

Socială: suport logistic, psihologic, financiar;

  1. Asistența post natală a MAMEI ȘI A COPILULUI:

Medicală: servicii de screening, acces la servicii de îngrijire postnatală, posibilitatea de intervenție în urgență;

Socială: suport logistic, psihologic, financiar;

Educație pentru sănătate.

Dintre concluziile rezultate și propunerile formulate se numără:

În educație și formare:

  • Crearea unui standard (curriculă, mod de prezentare) pentru orele de educație pentru sănătate;
  • Derularea unor campanii de informare la nivel național prin mass media (în special TV) pentru o informare corectă a populației;
  • Reorganizarea rețelei de planificare familială (creșterea numărului de persoane cu competențe în domeniul planificării familiale) și redefinirea competențelor medicilor, moașelor și asistentelor care lucrează în aceste cabinete (de ex. posibilitate de implantare a steriletelor);
  • Transmiterea către Ministerul Sănătății a propunerii de selecție a unor inițiative independente a mai multor ONG-uri referitoare la programe de educație pentru părinți; (aceste programe putând fi selecționate de comisiile Ministerului Sănătății și acreditate pentru a putea fi furnizate direct părinților);
  • Elaborarea de programe de formare continuă pentru asistenţii medicali de obstetrică ginecologie privind situaţiile de urgenţă obstetricale şi pediatrice.

Asistență medicală:

  • Alocarea unui număr sporit de cadre medicale (asistente sociale, asistente medicale, moașe) pentru mediile defavorizate;
  • Modernizarea secţiilor de obstetrică ginecologie/neonatologie şi dotarea cu echipamente corespunzătoare;
  • Decontarea de către sistemul de asigurări de sănătate a cheltuielilor cu consilierea (consiliere antifumat în sarcină), nutriția etc.
  • Introducerea de programe de gimnastică medicală pre și post natală;
  • Participarea lărgită la programele de screening pentru mame (infecția HPV, ex. Papanicolau) – campanii de informăre pentru creșterea accesibilității;
  • Social
  • Asigurarea suportului social pentru copii abandonați.

Din analiza realizată prin intermediul chestionarelor online, adresate actorilor relevanți în politicile publice de sănătate, în număr de aproximativ 180, cel mai mare procent privind disfuncționalitățile raportate în serviciile de sănătate se concentrează pe planificarea familială (opțiuni reproductive) unde peste 28% consideră că acest pilon înregistrează cele mai mari probleme.

Educaţia sexuală și educația pentru sănătate se situează pe un loc de frunte în clasamentul politicilor asociate sănătății reproducerii din România, țară în care educaţia sexuală nu este obligatorie şi este furnizată neuniform în şcoli, mai ales din cauza opoziției profesorilor, părinților și problemelor de natură religioasă.

În opinia specialistilor, a actorilor relevanți, politicile de sănătate nu răspund nevoilor grupurilor defavorizate, nu există metodologii de abordare a acestei populații țintă.

Pentru îmbunătățirea asistenței în domeniul sănătății reproducerii actorii relevanți au propus:

  • Implicarea sistematică în elaborarea, implementarea şi evaluarea strategiilor şi politicilor privind dezvoltarea serviciilor de sanatate a reproducerii, a tuturor factorilor interesaţi.
  • Dezvoltarea şi implementarea de ghiduri pentru personalul medical privitoare la diferite aspecte ale sănătății reproducerii cu referire specială la opţiunile de contracepţie modernă, bazate pe date ştiinţifice şi standardele elaborate de Organizaţia Mondială a Sănătăţii (OMS);
  • Dezvoltarea şi implementarea de programe de formare adresate absolvenţilor şcolilor şi universităţilor medicale, bazate pe ultimele dovezi ştiinţifice pe plan național și internațional;

În centrul discuțiilor dintre specialiști, s-a aflat și platforma informatică RENASC, instrument de cercetare în politici de sănătate, care va putea fi accesată online de către actorii relevanți și care va oferi un cadru de evaluare, monitorizare și promovare a politicilor publice în domeniul sănătății reproducerii. Platforma va avea componente de cercetare, forum și discuții de feedback cu persoane resursă în domeniu, dar și bibliotecă virtuală. Site-ul de acces către platformă este www.portal.insmc.ro, sau prin pagina proiectului www.renasc.partnet.ro.

Prezentările, problemele identificate cât și rezultatele preliminare ale întâlnirii sunt puse la dispoziție pentru toți experții și membrii rețelei RENASC, prin intermediul platformei pentru actorii relevanți și beneficiari ai sănătății reproducerii și poate fi accesată prin crearea unui cont de beneficiar/actor relevant pe platforma gestionată de Institutului Național pentru Sănătatea Mamei și Copilului „Alessandrescu-Rusescu” București.

Proiectul se află la începutul fazei a doua de implementare, fază în care vor fi organizate cursuri inovative referitoare la promovare și lobby, strategii și politici publice, comunicare și advocacy, care toate au ca scop creșterea capacității ONG-urilor de a formula politici publice în domeniu. Rezultatele întâlnirilor se vor concretiza prin alegerea domeniului prioritar pentru elaborarea unei  politici publice și elaborarea unui plan  de măsuri în domeniul prioritar identificat pentru îmbunătățirea asistenței în domeniul sănătății reproducerii.

Tot în această etapă, activitatea va fi axată pe formularea unei propuneri de îmbunătățire a unei politici publice în domeniul sănătății reproducerii, promovarea ei în toate regiunile, dar și dezvoltarea și promovarea platformei informatice RENASC și a rețelei de actori relevanți.

GALERIE FOTO

 

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