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Minsalud emite pautas para cuidado menstrual en las cárceles: Resolución 1235 de 2024
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El pasado 10 de julio, el Ministerio de Salud con la Resolución 1235 de 2024 adoptó las orientaciones técnicas para suministrar productos para la promoción de la salud y el cuidado menstrual de mujeres y personas menstruantes privadas de la libertad. Cabe señalar que, la medida hace parte de los deberes legales establecidos en la Ley 2261 de 2022.
La Ley 2261 de 2022 establece la entrega gratuita, oportuna y suficiente de artículos de higiene y salud menstrual a mujeres y personas menstruantes privadas de la libertad. Según el artículo 2 de esta ley, el Gobierno Nacional, a través del Ministerio de Justicia y del Derecho, debe garantizar la distribución de estos artículos, definiendo en sus parágrafos las condiciones mínimas para su entrega.
Además de esta norma, la cartera sanitaria ha adoptado la Estrategia Intersectorial para la Promoción de la Salud y Cuidado Menstrual 2023 — 2031. La iniciativa reconoce que la salud y el cuidado menstrual son conceptos amplios que han evolucionado desde un enfoque meramente biológico e higiénico hacia una perspectiva integral. Este nuevo enfoque busca garantizar los derechos humanos de niñas y mujeres en toda su diversidad, incluyendo dignidad, igualdad de género, autonomía y no discriminación, además de asegurar el acceso a servicios de salud, educación, trabajo, agua y saneamiento.
Aspectos fundamentales de la resolución sobre cuidado menstrual:
Enmarcado en lo anterior, la Resolución 1235 de 2024 se rige por una serie de principios orientadores, incorporados en la Constitución Política. Éstos comprenden la dignidad humana, igualdad, no discriminación, privacidad y demás garantías aplicables que forman parte del catálogo de derechos y libertades. Al respecto, el Ministerio de Salud destaca que las orientaciones deberán adaptarse a cada mujer o persona con capacidad de menstruar, considerando su edad, nivel educativo, etnia, identidad de género o condición de discapacidad, y cumpliendo con los estándares de calidad en oportunidad, disponibilidad, accesibilidad, seguridad, integralidad, pertinencia, aceptabilidad centrada en la persona, satisfacción, eficacia y continuidad.
Por la naturaleza de las orientaciones y la población a la que está dirigida, la Resolución 1235 de 2024 será de aplicación obligatoria para el Instituto Nacional Penitenciario y Carcelario -INPEC, la Unidad de Servicios Penitenciarios y Carcelarios —USPEC, el Instituto Colombiano de Bienestar Familiar —ICBF y las Entidades Territoriales. En la normativa, el Ministerio de Salud hace la salvedad que las funciones dependen de las competencias y responsabilidades de cada uno.
Para el diseño de las orientaciones técnicas, la autoridad en salud adopta el concepto de UNICEF y los cuatro pilares sobre cuidado menstrual. “1) apoyo social a las personas que menstrúan; 2)/a educación integral en salud menstrual; 3) servicios sanitarios, y 4) insumos para la gestión del sangrado menstrual (2). Todos ellos igual de relevantes para alcanzar la salud y cuidado menstrual, evidenciando la necesidad de realizar acciones intersectoriales y comunitarias, acompañadas de normativa nacional, así como, de actividades centrales, departamentales, municipales y locales para abordar el tema”.
Acciones de promoción de salud y cuidado menstrual a cargo del INPEC:
- Asegurar el abastecimiento, provisión y entrega efectiva y oportuna de toallas sanitarias desechables para el cuidado menstrual.
- Articular con los prestadores de servicios de salud de los centros carcelarios y penitenciarios y las entidades territoriales de salud, las intervenciones individuales y colectivas dirigidas a la promoción y mantenimiento de la salud, con énfasis en salud sexual y reproductiva, y salud mental.
- Desarrollar capacidades en el talento humano de los centros penitenciarios y carcelarios, para el reconocimiento, garantía y respeto por los derechos sexuales y derechos reproductivos dé las personas privadas de la libertad.
- Promover la detección de mujeres y personas menstruantes con anormalidades del sangrado (abundante, prolongado e irregular) a través de la educación e información de éstas y su entorno de cuidado, para actuar con actividades que permitan la corrección del problema y atenuar el impacto que esto representa: en la salud, incidencia de anemia, alteración de calidad de vida y uso de productos para el cuidado menstrual.
La valoración de las necesidades y características de la gestión de la menstruación de las mujeres y personas menstruantes privadas de la libertad se aplicará de la siguiente manera: al ingreso del establecimiento de reclusión del orden nacional y durante la realización del Examen Médico de Ingreso (EMI). Para el caso de las mujeres o personas menstruantes recluidas, se hará una evaluación inicial mediante un instrumento que permita identificar alteraciones en salud menstrual y determinar la necesidad individual de productos para la promoción de la salud y el cuidado menstrual. Esta población será valorada anualmente según su cobertura en salud.
Adicionalmente, se deben evaluar las necesidades en salud y cuidado menstrual, definiendo el tipo de producto y cantidad de acuerdo con las necesidades de cada persona que menstrua.
Según la disponibilidad de talento humano en los centros penitenciarios y carcelarios, la valoración para el suministro de productos podrá estar a cargo de un profesional de enfermería, un médico general, un especialista en medicina familiar o ginecología en casos especiales. Una vez estos profesionales determinen la cantidad de producto a entregar, el proceso de entrega podrá ser realizado por un auxiliar de enfermería o un auxiliar en salud pública. De forma excepcional, otro personal capacitado podrá apoyar en esta tarea.
El talento humano debe contar con conocimientos sobre el ciclo menstrual y sus alteraciones, así como habilidades para informar y educar sobre los derechos sexuales y reproductivos. Por lo tanto, se requiere una capacitación específica que incluya conceptos generales de salud y cuidado menstrual, derechos sexuales y reproductivos, con un enfoque de género y diferencial en las poblaciones de los centros penitenciarios y carcelarios.
Deberes a cargo de las Entidades Territoriales para garantizar el cuidado menstrual de personas privadas de la libertad:
- Asegurar el abastecimiento, provisión y entrega efectiva y oportuna de los productos para el cuidado y gestión menstrual a cada mujer y persona menstruante. Incluidas las mujeres y personas menstruantes que se encuentre en los centros de detención transitoria.
- Articular con los prestadores de servicios de salud de los centros carcelarios y las entidades territoriales de salud, las intervenciones individuales y colectivas dirigidas a la promoción y mantenimiento de la salud, con énfasis en salud sexual y reproductiva, y salud mental.
- Cumplir con los criterios de calidad y seguridad para la atención en salud y suministro de productos e insumos para la salud de las mujeres y personas menstruantes privadas de la libertad en los centros carcelarios en Colombia. Incluyendo garantía en saneamiento básico e infraestructura para el uso y desecho de productos para el cuidado menstrual.
- Promover la detección de mujeres y personas menstruantes con anormalidades del sangrado (abundante, prolongado e irregular) a través de la educación e información de éstas y su entorno de cuidado, para actuar con actividades que permitan la corrección del problema y atenuar el impacto que esto representa: en la salud, incidencia de anemia, alteración de calidad de vida y uso de productos para el cuidado menstrual.
- A las mujeres y personas menstruantes que se encuentran recluidas en los establecimientos carcelarios con anterioridad a la expedición de las presentes orientaciones, la Entidad Territorial definirá el mecanismo para la valoración de necesidades y características de la gestión menstrual, a fin de determinar la necesidad individual de productos para la promoción de la salud y el cuidado menstrual.
Para conocer en detalle los lineamientos de la Resolución 1235 de 2024 sobre cuidado menstrual, lo invitamos a leer o descargar el documento:
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