Indigenous communities of Peru: Level of accessibility to health facilities

Hernández-Vasquéz, Akram; Bendezú-Quispe, Guido; Turpo-Cayo, Efrain Y.

doi:10.1016/j.jtumed.2022.02.006

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…Data collected by the National Institute of Statistics and Informatics (INEI) from Peruvian nationwide surveys from 2007 to 2016 show a consistent pattern in which populations in the Andean and Amazonian regions have lower incomes and higher poverty than those living on the coast [ 25 , 26 ]. Moreover, the Andean and Amazonian regions are mainly rural, and their inhabitants tend to have less access to healthcare not only because of their distant and complex geographical location, but also because of pronounced socio-cultural barriers [ 27 ]. All of these factors may have influenced both access to healthcare and the quality of care they received.…”

Section: Discussionmentioning

confidence: 99%

Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

Amanzo-Vargas,

Arellano-Veintemilla,

González-Lagos

et al. 2023

Pathogens

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Background and aims: In Peru, the estimated prevalence of human immunodeficiency virus (HIV) and human T-lymphotropic virus-1 (HTLV-1) co-infection has been reported to be as high as 18%. Despite the endemicity of HTLV-1 in Peru, few studies have assessed the impact of HIV/HTLV-1 co-infection. Our study compared socio-demographic and clinical characteristics, and mortality rates between HIV-infected and HIV/HTLV-1 co-infected patients. Methods: We reviewed the medical records of patients aged 18 years and older belonging to the HIV and HTLV-1 cohorts in Lima during a 30-year period: 1989–2019. Each HIV/HTLV-1 co-infected patient was randomly matched with two HIV-infected patients with similar characteristics (same sex, age ± 5 years, and same year of HIV diagnosis). Allegedly co-infected patients without a confirmatory diagnosis of HIV and HTLV-1 were excluded. Most of the patients in the HIV-infected group did not have a negative test result for HTLV-1 infection, so we used two probabilistic sensitivity analysis models to correct for potential HTLV-1 exposure misclassification bias in the group of HIV-infected patients. Results: Of 162 patients enrolled, 54 were HIV/HTLV-1 co-infected and 108 were HIV-infected. The median age was 42 years (IQR = 34–51 years) and the majority were male (61.1%), single (44.4%), heterosexual (71%), born in Lima (58%), educated at the secondary school level (55.6%), and receiving antiretroviral treatment (91.4%). HIV/HTLV-1 co-infection was associated with an increased risk of death (HR: 11.8; 95% CI: 1.55–89.00; p = 0.017) while antiretroviral treatment was associated with a decreased risk of death (HR: 0.03; 95% CI: 0.003–0.25; p = 0.001). The overall mortality rate was 13.6 per 100 persons and the survival time for co-infected patients (median = 14.19 years) was significantly shorter than that of HIV-infected patients (median = 23.83 years) (p < 0.001). Conclusions: HIV/HTLV-1 co-infected patients had a significantly shorter survival time compared to HIV-infected patients, suggesting that the immune alterations caused by HTLV-1 in CD4 cell count may have contributed to late initiation of antiretroviral treatment and prophylaxis against opportunistic infections over the decades, and thus reducing their benefits in these patients.

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Section: Discussionmentioning

confidence: 99%

Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

Amanzo-Vargas,

Arellano-Veintemilla,

González-Lagos

et al. 2023

Pathogens

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“…In fact, the official report of the Ministry of Health confirms our findings and indicates that the lowest vaccination coverage is found in the departments of Madre de Dios and Amazonas [ 14 ]. Particularly, in the jungle, there are barriers of geographical access, rurality, the presence of ethnic minorities and multiple native languages, and a lack of adequate means of information about vaccines [ 38 , 39 ], which limit optimal vaccination coverage against COVID-19 in the region.…”

Section: Discussionmentioning

confidence: 99%

Geographic and Socioeconomic Determinants of Full Coverage COVID-19 Vaccination in Peru: Findings from a National Population-Based Study

2023

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Despite the fact that vaccination coverage against COVID-19 has made great progress in Peru, there is still a quarter of the population that has not been fully vaccinated. This study aims to determine the factors associated with complete vaccination in Peruvian adults. An analysis of the National Household Survey 2022 in Peru was performed. Prevalence ratios with their 95% confidence intervals (95% CI) were estimated to assess the factors associated with vaccination with three or more doses of the COVID-19 vaccine. A total of 58,471 participants were included in the study and 75.8% of the surveyed population were found to have received full vaccination. Significant differences in complete coverage were observed according to sex, age, educational level, ethnicity, poverty status, and geographic location. In the adjusted analysis, individuals aged 60 years or older, those with higher educational attainment, the non-poor, and those living in urban areas were more likely to be fully vaccinated. Native individuals and people who live in households without media are less likely to be fully covered. These results highlight the importance of considering demographic and socioeconomic factors when analyzing COVID-19 vaccination coverage. Additional strategies are needed to address vaccination gaps and ensure better vaccination coverage.

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“…El sector salud es uno de los sectores que requiere una mayor importancia por parte de las autoridades (Sunción, 2021) debido a la problemática que se presenta día a día en las diferentes instituciones de atención, ya sea por causa administrativas o asistenciales (Aliaga, 2021). Ante lo mencionado, una de las principales políticas que deben ser promovidas por el estado es la atención a las mujeres embarazadas (Jimeno, 2022) sobre todo a la de edad avanzada, quienes por diferentes factores se ven en la necesidad de aplazar su maternidad (Hernández, 2022). El aplazamiento de la maternidad es considerado como un fenómeno común en el mundo, el cual se debe a factores de educación, cultura, sociales y económicos (Ayala, 2022;Jimeno-Orozco et al, 2022).…”

Section: Introductionunclassified

“…En efecto, en Latinoamérica, los factores económicos y otros factores han dificultado la accesibilidad (Jimeno-Orozco et al, 2022;Zhang et al, 2021) y en el Perú, la accesibilidad, entre la distancia, los horarios de atención y el tiempo de espera, son considerados por las gestantes como barreras principales de acceso para la atención pre y post natal (Hernández-Vásquez, 2022). Por ello, es necesario fortalecer a los servicios para que aseguren una adecuada y oportuna atención, mediante subsidios estatales que evite poner en riesgo la integridad de las gestantes y su niño (Jimeno-Orozco et al, 2022).…”

Section: Introductionunclassified

Incidencia de la Gestión pública en la calidad de servicio y accesibilidad de gestantes añosas de un centro materno en Chiclayo. Perú

Ucañay Dávila,

Veramendi Vernazza

2023

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En la medida que las autoridades y funcionarios del sector salud desarrollen una gestión pública basada en la identificación de intervenciones efectivas, para establecer metas y estrategias de mejora de coberturas y evaluar las que impiden que las intervenciones y servicios lleguen a los grupos más vulnerables, como son las gestantes añosas, será más viable fortalecer un sistema de salud efectivo, equitativo y eficiente con miras al mejoramiento de los procesos de las instituciones de salud como los centros maternos. Por esta preocupación, se realizó esta investigación con la finalidad de dar a conocer si la gestión pública incide en la calidad de servicio y la accesibilidad en gestantes añosas, se pretende que los resultados sean útiles para la toma de decisiones y futuras acciones. Es así que este estudio es realizado en Chiclayo el año 2023, de enfoque cuantitativo, transversal y correlacional-causal, con una muestra de 250 gestantes de 36 a 40 años, de muestreo no probabilístico y por conveniencia. El levantamiento de los datos fue realizado con 3 cuestionarios: Gestión pública, calidad de servicio y accesibilidad, los cuales fueron validados por juicio de expertos y se halló su confiabilidad con una prueba piloto a 30 embarazadas añosas. El análisis inferencial fue con el análisis multivariado de correlación canónica no lineal y la regresión logística ordinal. Dados los resultados, se evidenció que con un ajuste máximo del 56.4% se afirma que existe incidencia significativa de la gestión pública en la calidad de servicio y accesibilidad a gestantes añosas de un centro materno en Chiclayo. Esto indica que existe dependencia de la calidad de servicio y accesibilidad frente a la gestión pública.

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Indigenous communities of Peru: Level of accessibility to health facilities

Cited by 5 publications

References 16 publications

Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

Geographic and Socioeconomic Determinants of Full Coverage COVID-19 Vaccination in Peru: Findings from a National Population-Based Study

Incidencia de la Gestión pública en la calidad de servicio y accesibilidad de gestantes añosas de un centro materno en Chiclayo. Perú

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