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Bressan T, Valdivia-Gago A, Silvera-Ccallo RM, Llanos-Cuentas A, Condor DF, Padilla-Huamantinco PG, Vilcarromero S, Miranda JJ, Zavaleta-Cortijo C. Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon. Int J Equity Health 2022; 21:183. [PMID: 36536404 PMCID: PMC9762865 DOI: 10.1186/s12939-022-01773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Biomedical technologies have the potential to be advantageous in remote communities. However, information about barriers faced by users of technology in general and in remote Indigenous communities is scarce. The purpose of this study was to characterize the leading challenges faced by researchers who have used biomedical technologies in the Peruvian Amazon. METHODS This exploratory, qualitative study with a phenomenological approach depicts the lived experience of participants who were researchers with experience working with biomedical technologies in the Peruvian Amazon in the past five years. Analysis was based on three core themes: design, implementation, and acceptability. Sub-themes included environment, community, and culture. Of the 24 potential participants identified and contacted, 14 agreed to participate, and 13 met inclusion criteria and completed semi-structured interviews. Results were sent to each participant with the opportunity to provide feedback and partake in a 30-minute validation meeting. Five participants consented to a follow-up meeting to validate the results and provide further understanding. RESULTS Participants recognized significant challenges, including technologies designed out-of-context, difficulty transporting the technologies through the Amazon, the impact of the physical environment (e.g., humidity, flooding), and limited existing infrastructure, such as electricity and appropriately trained health personnel. Participants also identified cultural factors, including the need to address past experiences with technology and health interventions, understand and appropriately communicate community benefits, and understand the effect of demographics (e.g., age, education) on the acceptance and uptake of technology. Complementary challenges, such as corruption in authority and waste disposal, and recommendations for technological and health interventions such as co-design were also identified. CONCLUSIONS This study proposes that technological and health interventions without efforts to respect local cultures and health priorities, or understand and anticipate contextual challenges, will not meet its goal of improving access to healthcare in remote Amazon communities. Furthermore, the implications of corruption on health services, and improper waste disposal on the environment may lead to more detrimental health inequities.
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Affiliation(s)
- Tiana Bressan
- School of Engineering, University of Guelph, 50 Stone Rd E, Guelph, ON N1G 2W1 Canada
| | - Andrea Valdivia-Gago
- Escuela de Nutrición, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Rosa M. Silvera-Ccallo
- Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Alejandro Llanos-Cuentas
- Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
- Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Daniel F. Condor
- School of Nursing, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
- Biomedical Informatics in Global Health Unit, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
- CuidART-e Research Group, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Pierre G. Padilla-Huamantinco
- Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102
- Health Innovation Lab, Institute of Tropical Medicine Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine, and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile Av Vicuña Mackenna 4860
| | - Stalin Vilcarromero
- Hospital Nacional Edgardo Rebagliati Martins (HNERM), EsSalud, Lima, Peru Av. Edgardo Rebagliati 490, 15072
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Carol Zavaleta-Cortijo
- Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
- Unidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
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Courses on Basic Occupational Safety and Health: A Train-the-Trainer Educational Program for Rural Areas of Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061842. [PMID: 32178363 PMCID: PMC7143534 DOI: 10.3390/ijerph17061842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 02/29/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022]
Abstract
Integrating basic occupational health services into primary care is encouraged by the Pan American Health Organization. However, concrete initiatives are still scarce. We aimed to develop a training program focusing on prevention of occupational risks for primary healthcare professionals. This train-the-trainer program was piloted at four universities in Chile and Peru. Occupational health or primary healthcare lecturers formed a team with representative(s) of one rural primary healthcare center connected to their university (Nparticipants = 15). Training started with a workshop on participatory diagnosis of working conditions. Once teams had conducted the participatory diagnosis in the rural communities, they designed in a second course an active teaching intervention. The intervention was targeted at the main occupational health problem of the community. After implementation of the intervention, teams evaluated the program. Evaluation results were very positive with an overall score of 9.7 out of 10. Teams reported that the methodology enabled them to visualize hazardous working conditions. They also stated that the training improved their abilities for problem analysis and preventive actions. Aspects like time constraints and difficult geographical access were mentioned as challenges. In summary, addressing occupational health in primary care through targeted training modules is feasible, but long-term health outcomes need to be evaluated.
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