Resumo: Este artigo recupera a perspectiva dos supervisores escolares sobre os regulamentos acadêmicos produzidos no contexto da pandemia para acompanhar e sustentar as trajetórias escolares no nível secundário. Em particular, examina os resultados de uma pesquisa sobre as interpretações e traduções feitas por um grupo de supervisores com relação a esses regulamentos e as condições que, de sua perspectiva, dificultam sua recepção e apropriação por parte de diretores e professores de escolas secundárias. Os dados empíricos são provenientes de entrevistas semiestruturadas com oito supervisores que trabalham em diferentes regiões educacionais da Província de Chaco (Argentina). As entrevistas foram realizadas entre março e junho de 2021, durante o período de distanciamento social, preventivo e obrigatório (DISPO). O estudo mostra que, dentro da burocracia educacional, os supervisores de nível secundário são atores-chave, pois, a partir da tradução dos regulamentos acadêmicos, avaliam modos de trabalho com as equipes diretivas para orientá-las na interpretação desses regulamentos e na transmissão que poderiam propor às suas escolas e professores

Resumen: Este artículo recupera la mirada de los supervisores escolares en torno a las regulaciones académicas que se produjeron en el contexto de pandemia para acompañar y sostener las trayectorias escolares en el nivel secundario. En particular, examina resultados de investigación referidos a las interpretaciones y traducciones realizadas por un grupo de supervisores respecto de tales normativas y las condiciones que, desde su perspectiva, obstaculizan su recepción y apropiación por parte de directivos y docentes de escuelas secundarias. Los datos empíricos proceden de entrevistas semiestructuradas realizadas a ocho supervisores que se desempeñan en diferentes regiones educativas de la provincia del Chaco (Argentina). Estas se efectuaron entre los meses de marzo y junio de 2021, durante el período de distanciamiento social, preventivo y obligatorio (DISPO). El trabajo da cuenta de que, dentro de la burocracia educativa, los supervisores del nivel secundario se constituyen en actores clave, dado que a partir de un trabajo de traducción de las normativas académicas evalúan modos de trabajo con los equipos directivos para orientarlos en la interpretación que realizan de estas normativas y en la transmisión que podrían plantear hacia sus escuelas y docentes

Abstract: This article explores the perspective of school supervisors regarding the academic regulations that emerged in the context of the pandemic to support and sustain secondary school trajectories. Specifically, it examines research findings related to the interpretations and translations made by a group of supervisors regarding these regulations and the conditions that, from their viewpoint, hinder their reception and adoption by school principals and teachers in secondary schools. The empirical data were collected through semi-structured interviews conducted with eight supervisors working in different educational regions of the Province of Chaco, Argentina. These interviews took place between March and June 2021, during the period of social distancing and mandatory preventive measures (DISPO). The study highlights that within the educational bureaucracy, secondary school supervisors play a pivotal role. They engage in the translation of academic regulations and assess ways of working with school leadership teams to guide them in their interpretation of these regulations and in the communication they could facilitate to their schools and teachers.

Resumen El objetivo del presente artículo es realizar una revisión sistematizada sobre las técnicas usadas para la recolección de datos sobre la percepción de estudiantes de Instituciones de Educación Superior con respecto a la violencia de género en los espacios universitarios. Dicha revisión se llevó a cabo sobre trabajos que abordan esta temática, utilizando la metodología de la Declaración PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) con el fin de documentar la búsqueda en las bases de datos SCOPUS, ProQuest y WorldCat, con los descriptores: espacios públicos intrauniversitarios, espacios universitarios y violencia de género en universidades. Se delimitó la búsqueda a artículos de los últimos tres años, de acceso abierto y escritos en español. Se obtuvieron 2 313 resultados, de los cuales se eligieron 34 publicaciones. Se encontró que la metodología de análisis más utilizada fue la cualitativa (58.8%), mientras que 35.2% fue de tipo cuantitativo y 5.8% mixta. Asimismo, 50% de los estudios encontrados se realizaron en IES mexicanas. Se concluye que la percepción de seguridad de estudiantes en los espacios universitarios está relacionada con la socialización del miedo en los espacios públicos y con la violencia de género.

Abstract The objective of this article is to carry out a systematic review of the techniques used to collect data on the perception of students from Higher Education Institutions regarding gender violence in university spaces. This review was carried out on works that address this topic, using the PRISMA 2020 Declaration (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology in order to document the search in the SCOPUS, ProQuest, and WorldCat databases, with the descriptors: intra-university public spaces, university spaces, and gender violence in universities. The search was limited to articles from the last three years, open access, and written in Spanish. 2,313 results were obtained, of which 34 publications were chosen. It was found that the most used analysis methodology was qualitative (58.8%), while 35.2% was quantitative and 5.8% mixed. Likewise, 50% of the studies found were carried out in Mexican HEIs. It is concluded that the perception of security of students in university spaces is related to the socialization of fear in public spaces and gender violence.

Resumen: Desde una perspectiva sociocultural, caracterizamos prácticas de escritura, lectura y entornos de realización de primeras publicaciones de autoras(es) noveles, con al menos una publicación. Realizamos entrevistas semiestructuradas a 11 investigadoras(es) recientemente doctorados de diferentes instituciones. Analizamos y describimos las prácticas letradas orientadas a publicar, el apoyo de mentoras(es) y los géneros de publicación, interpretándolos como parte de la experiencia autoral y disciplinar, a través de una trayectoria académica, antes y después del doctorado. Estas autoras(es) siguieron distintas vías para desarrollar su escritura disciplinar y aprender a publicar. Considerando el número de sus publicaciones y las formas de autoría reportadas, describimos tres momentos de su desarrollo autoral: principiantes, aprendices y practicantes. Mostramos que la mayoría sostiene colaboraciones y trabaja en coautoría.

Abstract: From a sociocultural perspective, we characterize the writing, reading practices, and early publishing environments of new authors, with at least one publication. We carried out semi-structured interviews with eleven researchers who had recently received doctoral degrees from various institutions. Subsequently, we analyzed and described literacy practices aimed at publishing, the support of mentors, and publication genres, interpreting them as part of the authors' disciplinary experience during their academic trajectory, before and after receiving their doctoral degree. The authors under study followed different paths for developing their disciplinary writing and learning to publish. Considering the number of their publications and the reported forms of authorship, we describe three moments in their development as authors: beginners, apprentices, and practitioners. We show that most of them produce co-authored collaborations and work.

BACKGROUND Vaccine development is a laborious craftwork in which at least two main components must be defined: a highly immunogenic antigen and a suitable delivery method. Hence, the interplay of these elements could elicit the required immune response to cope with the targeted pathogen with a long-lasting protective capacity. OBJECTIVES Here we evaluate the properties of Escherichia coli spherical proteoliposomes - known as outer membrane vesicles (OMVs) - as particles with natural adjuvant capacities and as antigen-carrier structures to assemble an innovative prophylactic vaccine for Chagas disease. METHODS To achieve this, genetic manipulation was carried out on E. coli using an engineered plasmid containing the Tc24 Trypanosoma cruzi antigen. The goal was to induce the release of OMVs displaying the parasite protein on their surface. FINDINGS As a proof of principle, we observed that native OMVs - as well as those carrying the T. cruzi antigen - were able to trigger a slight, but functional humoral response at low immunization doses. Of note, compared to the non-immunized group, native OMVs-vaccinated animals survived the lethal challenge and showed minor parasitemia values, suggesting a possible involvement of innate trained immunity mechanism. MAIN CONCLUSION These results open the range for further research on the design of new carrier strategies focused on innate immunity activation as an additional immunization target and venture to seek for alternative forms in which OMVs could be used for optimizing vaccine development.

RESUMEN Objetivo: Determinar el impacto del gasto público en educación en el trabajo infantil en Cajamarca y Huancavelica, periodo 2012-2020. Método: La investigación fue de tipo cuantitativo no experimental y transversal, de alcance explicativo. La población estuvo compuesta por los datos de las series estadísticas del gasto público en educación, tanto para primaria y secundaria, y por la tasa de niños, niñas y adolescentes de los departamentos de Cajamarca y Huancavelica, los cuales fueron obtenidos del Instituto Nacional de Estadística e Informática y de la plataforma de Estadística de Calidad Educativa (Ministerio de Educación). Resultados: El impacto del gasto total, en soles, en educación por alumno es menos de 0,0078%, siendo claro al coincidir la teoría económica de educación con la evidencia estadística y econométrica hallada con el método de efectos fijos. Se evidencia que Huancavelica posee condiciones adversas al bienestar económico, puesto que tiene características propias que aumentan el nivel de trabajo infantil a diferencia de Cajamarca. Conclusión: El gasto público en educación tanto para el nivel primario como secundario tiene un impacto negativo en el trabajo infantil.

ABSTRACT Objective: Determine the impact of public spending on education on child labor in Cajamarca and Huancavelica, 2012-2020 period. Method: The research was of a quantitative, non-experimental and cross-sectional type; with an explanatory scope; the population was based on the data from the statistical series of public spending on education for both primary and secondary education along with the rate of boys, girls and teenagers in the departments of Cajamarca and Huancavelica, which were obtained from the National Institute of Statistics and Informatics and the platform of Educational Quality Statistics (Peru’s Ministry of Education). Results: The impact of total spending on education in soles per student is less than 0,0078%; being clear when the economic theory of education coincides with the statistical and econometric evidence found with the fixed effects method. It is evidenced that Huancavelica has adverse conditions to the economic well-being, since it has its own characteristics that increase the level of child labor, unlike Cajamarca. Conclusion: Public spending on education for both primary and secondary levels have a negative impact on child labor.

Resumo Descrever uma visão geral da prestação de serviços de saúde no México e analisar geoespacialmente a atual distribuição e acessibilidade das unidades de APS para contribuir com novas abordagens para melhorar o planejamento da saúde no México. Realizamos uma análise espacial de dados oficiais para analisar as distâncias atuais das unidades de saúde à população, para determinar as áreas descobertas de prestação de serviços de saúde em 3 estados selecionados usando uma classificação de indicadores. Estimamos a cobertura da área de serviço das unidades de APS com redes viárias de 3 estados do México (Chiapas, Guerrero e Oaxaca). Nossas estimativas fornecem uma visão geral do acesso espacial à saúde da população mexicana nos três estados mais pobres do México. Não consideramos seguridade social nem prestadores privados. O acesso geoespacial às unidades de saúde é fundamental para alcançar a cobertura universal de saúde e uma cobertura eficaz. Países, como o México, devem medir isso para identificar áreas não merecidas com falta de acesso geoespacial à saúde para resolvê-lo. Os governos devem gerar políticas e mecanismos para distribuir efetivamente novas instalações de saúde para aumentar o acesso geoespacial efetivo à saúde, bem como para evitar instalações de saúde não planejadas.

Abstract To describe a general overview of health services delivery in Mexico and geospatially analyze the current distribution and accessibility of Primary Health Care (PHC) facilities to contribute to new approaches to improve healthcare planning in Mexico. We performed a spatial analysis of official data to analyze current distances from health facilities to population, to determine the underserved areas of health services delivery in three selected states using a ranking of indicators. We estimated service area coverage of PHC facilities with road networks of three Mexican states (Chiapas, Guerrero, and Oaxaca). Our estimations provide an overview of spatial access to healthcare of the Mexican population in Mexico’s three most impoverished states. We did not consider social security nor private providers. Geospatial access to health facilities is critical to achieving PHC and adequate coverage. Countries like Mexico must measure this to identify underserved areas with a lack of geospatial access to healthcare to solve it. This type of analysis provides critical information to help decision-makers decide where to build new health facilities to increase effective geospatial access to care and to achieve Universal Health Coverage.

Resumo Descrever uma visão geral da prestação de serviços de saúde no México e analisar geoespacialmente a atual distribuição e acessibilidade das unidades de APS para contribuir com novas abordagens para melhorar o planejamento da saúde no México. Realizamos uma análise espacial de dados oficiais para analisar as distâncias atuais das unidades de saúde à população, para determinar as áreas descobertas de prestação de serviços de saúde em 3 estados selecionados usando uma classificação de indicadores. Estimamos a cobertura da área de serviço das unidades de APS com redes viárias de 3 estados do México (Chiapas, Guerrero e Oaxaca). Nossas estimativas fornecem uma visão geral do acesso espacial à saúde da população mexicana nos três estados mais pobres do México. Não consideramos seguridade social nem prestadores privados. O acesso geoespacial às unidades de saúde é fundamental para alcançar a cobertura universal de saúde e uma cobertura eficaz. Países, como o México, devem medir isso para identificar áreas não merecidas com falta de acesso geoespacial à saúde para resolvê-lo. Os governos devem gerar políticas e mecanismos para distribuir efetivamente novas instalações de saúde para aumentar o acesso geoespacial efetivo à saúde, bem como para evitar instalações de saúde não planejadas.

Abstract To describe a general overview of health services delivery in Mexico and geospatially analyze the current distribution and accessibility of Primary Health Care (PHC) facilities to contribute to new approaches to improve healthcare planning in Mexico. We performed a spatial analysis of official data to analyze current distances from health facilities to population, to determine the underserved areas of health services delivery in three selected states using a ranking of indicators. We estimated service area coverage of PHC facilities with road networks of three Mexican states (Chiapas, Guerrero, and Oaxaca). Our estimations provide an overview of spatial access to healthcare of the Mexican population in Mexico’s three most impoverished states. We did not consider social security nor private providers. Geospatial access to health facilities is critical to achieving PHC and adequate coverage. Countries like Mexico must measure this to identify underserved areas with a lack of geospatial access to healthcare to solve it. This type of analysis provides critical information to help decision-makers decide where to build new health facilities to increase effective geospatial access to care and to achieve Universal Health Coverage.

The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of 2 manuscripts. This second part is a guideline that details these recommendations through screening strategies, prophylactic therapies and vaccines indications for bacterial, mycobacterial, viral, fungal and parasitic infections, both for adults and children.

Resumen La incorporación de terapias biológicas ha significado un gran avance en el manejo de diversas patologías de origen autoinmune, neoplásico u otros. Si bien su uso ha implicado mejoras significativas en el pronóstico de estas enfermedades, no está exento de complicaciones, entre éstas, las infecciosas. El objetivo de este consenso fue evaluar el perfil de seguridad, desde la mirada infectológica, de las terapias biológicas de uso más frecuente y dar recomendaciones para la prevención de infecciones en pacientes tratados con ellas, basándose en la evidencia de mayor calidad disponible para los biológicos seleccionados. El consenso cuenta de dos manuscritos. Esta segunda parte corresponde a la guía clínica que detalla estas recomendaciones mediante estrategias de cribado, terapias profilácticas e indicación de vacunas, según corresponde, para infecciones bacterianas, y por micobacterias en particular, virus, hongos y parásitos, tanto para adultos como para niños.

The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of two manuscripts. This first part details the risks of developing infectious complications depending on the type of biological used for a certain pathology. This evaluation included a broad search in MEDLINE and Epistemonikos of systematic reviews and meta-analyzes of controlled clinical trials and casecontrol examining post-treatment infections with anti-TNF alpha, anti-CD20, anti-CD52, CTLA4-Ig and anti-integrins. The research was complemented by a review of: multicentre cohorts of biological users, the MMWR of the CDC, Atlanta, U.S.A., and national registers and scientific societies in which infectious complications derived from the use of biological therapies were mentioned.

Resumen La incorporación de terapias biológicas ha significado un gran avance en el manejo de diversas patologías de origen autoinmune, neoplásico u otros. Si bien su uso ha implicado mejoras significativas en el pronóstico de estas enfermedades, no está exento de complicaciones, entre estas, las infecciosas. El objetivo de este consenso fue evaluar el perfil de seguridad, desde la mirada infectológica, de las terapias biológicas de uso más frecuente y dar recomendaciones para la prevención de infecciones en pacientes tratados con ellas, basándose en la evidencia de mayor calidad disponible para los biológicos seleccionados. El consenso cuenta de dos manuscritos. Esta primera parte detalla los riesgos de desarrollar complicaciones infecciosas dependiendo del tipo de biológico utilizado para determinada patología. La revisión incluyó búsqueda amplia en MEDLINE y Epistemonikos de revisiones sistemáticas y meta-análisis de estudios clínicos controlados y caso/control que examinaban infecciones posteriores al tratamiento con anti-TNF alfa, anti-CD20, anti-CD52, CTLA4-Ig y anti-integrinas. Esta búsqueda se complementó con revisión de cohortes multicéntricas de usuarios de biológicos, del MMWR del CDC, Atlanta, E.U.A. y de registros nacionales y/o de sociedades científicas en la que se hiciera mención a complicaciones infecciosas derivadas del uso de biológicos.

BACKGROUND TcP21 is a ubiquitous secreted protein of Trypanosoma cruzi and its recombinant form (rP21) promotes parasite cell invasion and acts as a phagocytosis inducer by activating actin polymerisation in the host cell. OBJECTIVE Our goal was to evaluate if the additional supplementation of rP21 during a prime/boost/challenge scheme with T. cruzi TCC attenuated parasites could modify the well-known protective behavior conferred by these parasites. METHODS The humoral immune response was evaluated through the assessment of total anti-T. cruzi antibodies as well as IgG subtypes. IFN-γ, TNF-α and IL-10 were measured in supernatants of splenic cells stimulated with total parasite homogenate or rP21. FINDINGS Our results demonstrated that, when comparing TCC+rP21 vs. TCC vaccinated animals, the levels of IFN-γ were significantly higher in the former group, while the levels of IL-10 and TNF-α were significantly lower. Further, the measurement of parasite load after lethal challenge showed an exacerbated infection and parasite load in heart and skeletal muscle after pre-treatment with rP21, suggesting the important role of this protein during parasite natural invasion process. MAIN CONCLUSION Our results demonstrated that rP21 may have adjuvant capacity able to modify the cytokine immune profile elicited by attenuated parasites.

Abstract The article describes and systematizes the modifications to the norms that protect the environment and the objects that compose it in the last decade in Chile. This analysis allows to conclude that, while there have been important advances in the criminal protection of biodiversity and in some other specific aspects, this is not observed regarding the penal regulation of the phenomenon of serious environmental pollution, the mockery of the administrative system of protection of the environment and punishment of legal persons responsible for environmental crime. It is argued that the origin of these differences seems to be in the disagreement regarding the legitimacy, necessity and form of regulating the crimes of contamination. Given this differences, the text proposes to advance in the protection of the environment by perfecting the criminal figures already existing in our system, as a way to fill the legislative vacuum detected.

Resumen El artículo describe y sistematiza las modificaciones a las normas que protegen el medio ambiente y los objetos que lo componen en la última década en Chile. Este análisis permite concluir que, mientras han existido importantes avances en la protección penal de la biodiversidad y en algunos otros aspectos puntuales, ello no se observa en lo referido a la regulación penal del fenómeno de la grave contaminación ambiental, la burla del sistema administrativo de protección del medio ambiente y la sanción de las personas jurídicas responsables de los delitos ambientales. Se sostiene que el origen de estas diferencias parece encontrarse en el desacuerdo respecto de la necesidad y forma de regular los delitos de contaminación. Atendidas estas diferencias, el texto propone avanzar en la protección del medio ambiente perfeccionando las figuras penales ya existentes en nuestro ordenamiento, como vía para llenar el vacío legislativo detectado.

ABSTRACT Introduction: Births in ethnic populations in Latin America are still being attended by traditional midwifes. The conceptual and theoretical outlook to this practice varies among different actors, influencing on proposed policies and interventions for this group. Objectives: To analyze the political overview of traditional midwives through a critic intercultural scope. Data sources: In this descriptive study, a review of academic documents, technical documents and regulations was made, identifying conceptual, approach and political topics related to traditional midwives. The data was summarized in a matrix and analyzed through the method of consecutive approximations. Methodological triangulation was made among researchers, disciplines, techniques and information sources on the topic. Data synthesis: The academic community makes a distinction among traditional midwives and professional midwives. International organizations promote professional midwifery just for difficult geographical access locations. Latin-American governments have different positions from the hegemonic overview of the biomedical model in health toward midwifery. Conclusions: Traditional midwives remain in an ambiguous political arena undermining their role, generating a loss of the cultural heritage of the countries as they are not being recognized, not being linked to the health system as service providers, but being community actors that inform, educate and refer to the health services the maternal and neonatal cases.

RESUMEN Introducción: Los partos de los pueblos étnicos en América Latina, siguen siendo atendidos por parteras tradicionales. La mirada conceptual y teórica de esta práctica varía entre los diferentes actores, lo que influye en las políticas e intervenciones propuestas para este gremio. Objetivo: Analizar desde una postura intercultural crítica, el panorama político que enfrentan las parteras tradicionales en América Latina. Fuente de datos: Este es un estudio de revisión de artículos académicos, documentos técnicos y normativos, que se clasificaron en temas conceptuales, de enfoques y políticos relacionados con las parteras tradicionales. Los datos se consolidaron en matrices y se analizaron a partir del método de aproximaciones sucesivas. Se realizó una triangulación entre investigadores y teórica sobre el tema. Síntesis de los datos: el sector académico realiza una diferenciación entre parteras tradicionales y parteras profesionales. Los organismos Internacionales envían a la partería tradicional solo a lugares de difícil acceso geográfico. Los Gobiernos de América Latina presentan diversas posturas desde la mirada hegemónica del modelo biomédico de salud frente a la partería tradicional. Conclusiones: Las parteras tradicionales siguen en un terreno políticamente ambiguo que debilita su rol, lo que genera la pérdida del patrimonio cultural de los países ante su no reconocimiento, no vinculación a los sistemas de salud como prestadoras de servicio y sí como actores comunitarios encargados de informar, educar, y remitir a los prestadores de servicios de salud los casos de salud materna y neonatal.

ABSTRACT Introduction: Births in ethnic populations in Latin America are still being attended by traditional midwifes. The conceptual and theoretical outlook to this practice varies among different actors, influencing on proposed policies and interventions for this group. Objectives: To analyze the political overview of traditional midwives through a critic intercultural scope. Data sources: In this descriptive study, a review of academic documents, technical documents and regulations was made, identifying conceptual, approach and political topics related to traditional midwives. The data was summarized in a matrix and analyzed through the method of consecutive approximations. Methodological triangulation was made among researchers, disciplines, techniques and information sources on the topic. Data synthesis: The academic community makes a distinction among traditional midwives and professional midwives. International organizations promote professional midwifery just for difficult geographical access locations. Latin-American governments have different positions from the hegemonic overview of the biomedical model in health toward midwifery. Conclusions: Traditional midwives remain in an ambiguous political arena undermining their role, generating a loss of the cultural heritage of the countries as they are not being recognized, not being linked to the health system as service providers, but being community actors that inform, educate and refer to the health services the maternal and neonatal cases.

RESUMEN Introducción: Los partos de los pueblos étnicos en América Latina, siguen siendo atendidos por parteras tradicionales. La mirada conceptual y teórica de esta práctica varía entre los diferentes actores, lo que influye en las políticas e intervenciones propuestas para este gremio. Objetivo: Analizar desde una postura intercultural crítica, el panorama político que enfrentan las parteras tradicionales en América Latina. Fuente de datos: Este es un estudio de revisión de artículos académicos, documentos técnicos y normativos, que se clasificaron en temas conceptuales, de enfoques y políticos relacionados con las parteras tradicionales. Los datos se consolidaron en matrices y se analizaron a partir del método de aproximaciones sucesivas. Se realizó una triangulación entre investigadores y teórica sobre el tema. Síntesis de los datos: el sector académico realiza una diferenciación entre parteras tradicionales y parteras profesionales. Los organismos Internacionales envían a la partería tradicional solo a lugares de difícil acceso geográfico. Los Gobiernos de América Latina presentan diversas posturas desde la mirada hegemónica del modelo biomédico de salud frente a la partería tradicional. Conclusiones: Las parteras tradicionales siguen en un terreno políticamente ambiguo que debilita su rol, lo que genera la pérdida del patrimonio cultural de los países ante su no reconocimiento, no vinculación a los sistemas de salud como prestadoras de servicio y sí como actores comunitarios encargados de informar, educar, y remitir a los prestadores de servicios de salud los casos de salud materna y neonatal.