Indigenous communities’ responses to the COVID-19 pandemic and consequences for maternal and neonatal health in remote Peruvian Amazon: a qualitative study based on routine programme supervision

Abstract

AimTo explore indigenous communities’ responses to the COVID-19 pandemic and its consequences for maternal and neonatal health (MNH) care in the Peruvian Amazon.MethodsMamás del Río is a community-based, MNH programme with comprehensive supervision covering monthly meetings with community health workers (CHW), community leaders and health facilities. With the onset of the lockdown, supervisors made telephone calls to discuss measures against COVID-19, governmental support, CHW activities in communities and provision of MNH care and COVID-19 preparedness at facilities. As part of the programme’s ongoing mixed methods evaluation, we analysed written summaries of supervisor calls collected during the first 2 months of Peru’s lockdown.ResultsBetween March and May 2020, supervisors held two rounds of calls with CHWs and leaders of 68 communities and staff from 17 facilities. Most communities banned entry of foreigners, but about half tolerated residents travelling to regional towns for trade and social support. While social events were forbidden, strict home isolation was only practised in a third of communities as conflicting with daily routine. By the end of April, first clusters of suspected cases were reported in communities. COVID-19 test kits, training and medical face masks were not available in most rural facilities. Six out of seven facilities suspended routine antenatal and postnatal consultations while two-thirds of CHWs resumed home visits to pregnant women and newborns.ConclusionsHome isolation was hardly feasible in the rural Amazon context and community isolation was undermined by lack of external supplies and social support. With sustained community transmission, promotion of basic hygiene and mask use becomes essential. To avoid devastating effects on MNH, routine services at facilities need to be urgently re-established alongside COVID-19 preparedness plans. Community-based MNH programmes could offset detrimental indirect effects of the pandemic and provide an opportunity for local COVID-19 prevention and containment.

Indigenous Knowledge of Medicine for COVID-19 or Related Disease in Benishangul Gumuz Regional State: Phenomenological Design

“…This finding is consistent with the study done in Remote Peruvian Amazon revealed that almost all communities instigated rules prohibiting entry of non-residents, including family members, social isolation, exit restriction, social distance within the community and avoid physical contact for the purpose of prevention mechanism of COVID – 19 infection. 14 Similarly, a different qualitative research reviews supported this finding. 15 …”

Seroprevalence and lethality by SARS-CoV-2 in indigenous populations of Latin America and the Caribbean: a systematic review

“…However, in countries such as Bolivia ( Fondo para el Desarrollo de los Pueblos Indígenas de América Latina y el Caribe, 2020a ), Peru ( Centro Nacional de Epidemiología Prevención y Control de Enfermedades, 2021 ), Ecuador ( Castro, 2020 ), Venezuela ( Pan American Health Organization, 2021b ), and Colombia ( Organización Panamericana de la Salud, 2020 ), cases of COVID-19 have been reported in the indigenous populations. During the COVID-19 pandemic, a deficit of diagnostic tests, lack of masks, and the suspension of health programs in indigenous communities have been described ( Reinders et al, 2020 ), being a situation that could lead to a decline in health care in these communities as well as an underestimation of the prevalence of COVID-19 in indigenous populations. Thus, health care for this historically vulnerable group should be prioritized during times of crisis.…”

“…Furthermore, in Peru, it has been described that the majority of the communities of the rural districts Nauta, Parinari, and Sequena prohibited the entry of people not belonging to the community. However, half of these communities did allow residents to travel to the cities for commercial and social reasons, and the prohibition of social events was only abided by a third of the communities since the control measure, decreed by the Peruvian government, competes with their daily routine ( Reinders et al, 2020 ). Although it is described that the measures taken by governments to control the spread of COVID-19 towards indigenous communities have been deficient ( Fondo para el Desarrollo de los Pueblos Indígenas de América Latina y el Caribe, 2020b ), it should be emphasized that mistrust in authority and disbelief in the existence and severity of the pandemic likely influenced outcomes ( Fondo para el Desarrollo de los Pueblos Indígenas de América Latina y el Caribe, 2020b ; Meneses-Navarro et al, 2020 ).…”

Social innovation in health: a critical but overlooked component of the COVID-19 pandemic response

“…Empowered with a tablet application, the community health workers conduct home visits to pregnant women and their families, deliver health educational content and gather data to share with local government. 5 During COVID-19 travel restrictions, the communities in the implementation area became isolated and health facilities suspended routine services. The programme rapidly adapted to meet the needs of local people, including delivery of materials and equipment for basic COVID-19 prevention, managing misconceptions through phone supervisions, developing video training for community health workers about COVID-19 and continuing home visits for people with COVID-19 symptoms.…”