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Intervenciones multisectoriales y comunitarias basadas en equidad para la reducción del embarazo adolescente: scoping review
Equity-based multisectoral and community-based interventions to reduce teenage pregnancy: scoping review
DOI:
https://doi.org/10.15446/rsap.v26n1.110395Palabras clave:
Embarazo en adolescencia, determinantes sociales de la salud, efectividad, ciencia de la implementación (es)Teenage pregnancy, social determinants of health, social change, implementation science (en)
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Objetivos Identificar y describir la evidencia científica disponible sobre intervenciones multisectoriales que reduzcan el embarazo en adolescentes en poblaciones que viven en condiciones de vulnerabilidad, y describir barreras y facilitadores para su implementación en aquellas que cuenten con efectividad.
Métodos Revisión sistemática de alcance de literatura realizada en las bases Cochrane Library, NICE, Pubmed, Scholar Google, BVS OPS, Scielo y PROQUEST. Se seleccionaron estudios experimentales y observacionales que dieran cuenta de intervenciones de base comunitaria, realizadas fuera de servicios clínicos, cuyo propósito fuera reducir de manera directa el embarazo adolescente.
Resultados Se analizaron 32 estudios con efectividad en la reducción de embarazo adolescente, de los cuales 17 eran provenientes de países de ingresos medios y bajos de África, Asia y América Latina y el Caribe; los restantes incluyeron población vulnerable de países de ingresos medios-altos. Se realizó una descripción narrativa de las principales características de dichas intervenciones y algunas consideraciones con respecto a la implementación de estas iniciativas. Adicionalmente, se vinculan los componentes de las intervenciones exitosas con los aspectos reportados en la literatura con relación a los determinantes sociales del embrazo adolescente.
Conclusiones Es relevante que las intervenciones para reducir el embarazo en adolescentes consideren desde su diseño el modelo de determinantes sociales. Esto permitirá hacer un seguimiento adecuado al impacto que estas logran sobre las inequidades.
Objetive To systematically identify and describe the existing scientific evidence concerning multisectoral interventions aimed at reducing adolescent pregnancy rates among populations living in vulnerable conditions, and to provide a comprehensive description of the barriers and facilitators that may influence the successful implementation of these effective interventions.
Methods A scoping review of the literature was conducted in the Cochrane Library, NICE, Pubmed, Scholar Google, VHL OPS, Scielo, PROQUEST databases. Experimental and observational studies that reported on community-based interventions, performed outside clinical services, whose purpose was to directly reduce adolescent pregnancy were selected.
Results A total of 32 studies demonstrating effectiveness in reducing adolescent pregnancy rates were included. 17 were from low-middle income countries and the remaining studies focused on vulnerable populations in middle and high-income countries. We provide a narrative description of the characteristics of these interventions and some essential considerations regarding the implementation of them. Additionally, we linked the successful intervention components and the reported aspects in the literature concerning the social determinants of adolescent pregnancy.
Conclusions Our findings highlight the crucial significance of integrating the social determinants model into the design and implementation of interventions aimed at reducing adolescent pregnancy rates. This ensures that these interventions are better equipped to monitor and evaluate their impact on reducing inequalities among vulnerable populations.
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