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COVID-19: Original Article
Prevalence and factors associated with non-use of health services in the Peruvian population with COVID-19 symptomatology: a secondary analysis of the 2020 National Household Survey
Akram Hernández-Vásquez, Fabriccio J. Visconti-Lopez, Diego Azañedo
Epidemiol Health. 2021;43:e2021084.   Published online October 18, 2021
DOI: https://doi.org/10.4178/epih.e2021084
  • 7,672 View
  • 148 Download
  • 1 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The objective of this study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors in Peruvians with symptoms of coronavirus disease 2019 (COVID-19).
METHODS
A secondary analysis of the 2020 National Household Survey (ENAHO) was carried out. Participants over 18 years of age with any COVID-19 symptom (fever, cough, sensation of shortness of breath) in the last 4 weeks who did not visit health services were defined as exhibiting NUHS. Adjusted prevalence ratios (aPRs) were estimated to determine the factors associated with NUHS.
RESULTS
Data from 1,856 participants were analyzed; the prevalence of NUHS was 52.2% (95% confidence interval [CI], 48.0 to 56.5). Living in urban areas of the jungle (aPR, 1.61; 95% CI, 1.32 to 1.98; p<0.001) and rural areas of the jungle (aPR, 1.48; 95% CI, 1.15 to 1.90; p=0.002) was associated with a higher probability of NUHS than living in urban coastal areas. The factors associated with a lower probability of NUHS were being 50-59 years old (aPR, 0.72; 95% CI, 0.58 to 0.90) and 60 years and over (aPR, 0.74; 95% CI, 0.59 to 0.95), having a secondary educational level (aPR, 0.67; 95% CI, 0.48 to 0.93) or superior educational level (aPR, 0.67; 95% CI, 0.48 to 0.96), and having health insurance (aPR, 0.79; 95% CI, 0.68 to 0.92).
CONCLUSIONS
More than half of the participants with COVID-19 symptoms did not use health services, and NUHS was associated with the geographic and socio-demographic characteristics of the population. The formulation of health strategies and programs is required to increase the use of health services by people with COVID-19 symptoms.
Summary
Key Message
The objective of this study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors in Peruvians with symptoms of coronavirus disease 2019 (COVID-19) in 2020. In the study, more than half of the participants with COVID-19 symptoms did not use health services, and NUHS was associated with the geographic and socio-demographic characteristics of the population. The formulation of health strategies and programs is required to increase the use of health services by people with COVID-19 symptoms, in the country with the highest mortality rate by this disease.

Citations

Citations to this article as recorded by  
  • Staying in or out? COVID-19-induced healthcare utilization avoidance and associated socio-demographic factors in rural India
    Michael Safo Oduro, Prince Peprah, Anthony Kwame Morgan, Williams Agyemang-Duah
    BMC Public Health.2023;[Epub]     CrossRef
  • Chronic disease relapses: A cross-sectional study of the associated factors and socioeconomic inequalities during the COVID-19 pandemic in Peru
    Fabriccio J. Visconti-Lopez, Akram Hernández-Vásquez, Dustin M. Solorzano-Salazar, Diego Azañedo, Ramune Jacobsen
    PLOS ONE.2022; 17(9): e0274697.     CrossRef
  • COVID-19 and drivers of excess death rate in Peru: A longitudinal ecological study
    Kim N. Cajachagua-Torres, Hugo G. Quezada-Pinedo, Carlos A. Huayanay-Espinoza, Jordan A. Obeso-Manrique, Víctor A. Peña-Rodríguez, Elisa Vidal, Luis Huicho
    Heliyon.2022; 8(12): e11948.     CrossRef
Original Articles
Socio-demographic inequalities in the uptake of Papanicolaou tests in Peru: analysis of the 2015-2017 Demographic and Family Health Survey
Antonio Barrenechea-Pulache, Emmanuel Avila-Jove, Akram Hernández-Vásquez, Fernando M. Runzer-Colmenares
Epidemiol Health. 2020;42:e2020043.   Published online June 18, 2020
DOI: https://doi.org/10.4178/epih.e2020043
  • 12,609 View
  • 186 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted to analyze the inequalities in Papanicolaou test (also referred to as the Pap smear) uptake according to the socio-demographic characteristics of Peruvian women 30 years to 59 years of age using information from the 2015-2017 Demographic and Family Health Survey (ENDES, acronym in Spanish).
METHODS
This is an analytical, cross-sectional study based on information acquired from the 2015-2017 ENDES surveys. Socio-demographic characteristics were reported using absolute frequencies and weighted proportions with 95% confidence intervals, considering results with a p-value <0.05 as statistically significant. Concentration curves (CCs) and concentration indices (IndCs) were created based on the interaction of the wealth index and uptake of Pap smears, taking into account the different characteristics of the population studied for the measure of inequalities.
RESULTS
All the CCs were distributed below the line of equality. Similarly, all the IndCs were higher than zero, indicating inequality in the uptake of Pap smears, favoring those with a higher wealth index. The highest IndC values were obtained from women aged 50-59 (IndC, 0.293), those who lived in the jungle (IndC, 0.230), and those without health insurance (IndC, 0.173).
CONCLUSIONS
We found socio-demographic inequalities in the uptake of Pap smears in Peru, favoring women with a higher wealth index. More funding is needed to promote cervical cancer screening programs and to create systems that ensure equal access to healthcare in Peru.
Summary

Citations

Citations to this article as recorded by  
  • Reasons for never receiving a pap test among Brazilian women: National health survey
    Claudia Fernandes Rodrigues, José Victor Afonso Coutinho, Camila Drumond Muzi, Raphael Mendonça Guimarães
    Public Health Nursing.2021; 38(6): 963.     CrossRef
Associations between chronic conditions and oral health services utilization in older Peruvian adults: a pooled analysis of the Demographic and Health Survey 2015-2017
Diego Azañedo, Diego Chambergo-Michilot, Akram Hernández-Vásquez
Epidemiol Health. 2020;42:e2020023.   Published online April 9, 2020
DOI: https://doi.org/10.4178/epih.e2020023
  • 12,614 View
  • 268 Download
AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted to investigate the associations between chronic conditions (CCs) and oral health services utilization (OHSU) within the previous 6 months in older Peruvian adults (defined as those 60 years of age or more according to Peruvian law).
METHODS
An analytical cross-sectional study was performed based on the 2015-2017 Peruvian Demographic and Family Health Survey. Pooled data from 13,699 older adults were analyzed. A logistic regression model was used to analyze the associations between OHSU (dependent variable) and CCs (independent variables). Tobacco consumption, obesity, educational level, age, sex, welfare quintile, area of residence, having health insurance, and natural region of residence were included as covariates in the analysis.
RESULTS
The frequency of OHSU in older adults was 18.5% (95% confidence interval [CI], 17.8 to 19.3). The highest percentage point (%p) differences with regards to OHSU were found between the extreme categories of educational level (higher education vs. none or elementary school: +24.8%p) and welfare quintile (richest vs. poorest: +24.0%p). In the crude model, OHSU was associated with diabetes (odds ratio [OR], 1.46; 95% CI, 1.26 to 1.69), but this association disappeared after adjustment for covariates. Meanwhile, depression decreased the likelihood of OHSU (OR, 0.82; 95% CI, 0.72 to 0.95) in the adjusted model.
CONCLUSIONS
The frequency of OHSU was low in older Peruvian adults. Regarding CCs, we found that depression independently decreased the likelihood of OHSU in the adjusted model. Our results may be useful for the development of policies aimed at achieving greater OHSU in older adults with CCs, especially in those with depression.
Summary
Determinants of early initiation of breastfeeding in Peru: analysis of the 2018 Demographic and Family Health Survey
Akram Hernández-Vásquez, Horacio Chacón-Torrico
Epidemiol Health. 2019;41:e2019051.   Published online December 25, 2019
DOI: https://doi.org/10.4178/epih.e2019051
  • 12,755 View
  • 281 Download
  • 7 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Early initiation of breastfeeding (EIBF) is one of the most cost-effective strategies to reduce neonatal mortality. We sought to determine the prevalence and determinants of EIBF in Peru.
METHODS
We performed a cross-sectional analytical study of the 2018 Peruvian Demographic and Family Health Survey as a secondary data source. In total, 19,595 children born during the 5 years prior to the survey were included in the study. The dependent variable (EIBF status), socio-demographic variables, and pregnancy-related variables were analyzed using a multivariate logistic regression model to identify the determinants of EIBF.
RESULTS
The prevalence of EIBF in the study population was 49.7%. Cesarean deliveries were associated with a lower likelihood of EIBF (adjusted odds ratio [aOR], 0.06; 95% confidence interval [CI], 0.05 to 0.07) than were vaginal deliveries. Newborns born at public health centers (aOR, 1.37; 95% CI, 1.15 to 1.65) had a higher rate of EIBF than those not born at public or private health centers. Women from the jungle region (aOR, 2.51; 95% CI, 2.17 to 2.89) had higher odds of providing EIBF than those from the coast. Mothers with more than a secondary education (aOR, 0.65; 95% CI, 0.55 to 0.76) were less likely to breastfeed during the first hour of the newborn’s life than women with primary or no education.
CONCLUSIONS
More than half of Peruvian children do not breastfeed during the first hour after birth. The major determinants of EIBF status were the delivery mode and the region of maternal residence. Strategies are needed to promote early breastfeeding practices.
Summary

Citations

Citations to this article as recorded by  
  • Sociodemographic determinants associated with breastfeeding in term infants with low birth weight in Latin American countries
    Carlos Javier Avendaño-Vásquez, Magda Liliana Villamizar-Osorio, Claudia Jazmin Niño-Peñaranda, Judith Medellín-Olaya, Nadia Carolina Reina-Gamba
    World Journal of Clinical Pediatrics.2024;[Epub]     CrossRef
  • Prevalence of essential newborn care in home and facility births in the Peruvian Amazon: analysis of census data from programme evaluation in three remote districts of the Loreto region
    Stefan Reinders, Magaly M. Blas, Melissa Neuman, Luis Huicho, Carine Ronsmans
    The Lancet Regional Health - Americas.2023; 18: 100404.     CrossRef
  • Factors associated with breastfeeding initiation time in a Baby-Friendly Hospital
    Siddika Songül Yalçin
    Revista de Salud Pública.2023; 25(1): 1.     CrossRef
  • Strong Negative Association between Cesarean Delivery and Early Initiation of Breastfeeding Practices among Vietnamese Mothers—A Secondary Analysis of the Viet Nam Sustainable Development Goal Indicators on Children and Women Survey
    Tam Thi Thanh Nguyen, Kimihiro Nishino, Lan Thi Huong Le, Souphalak Inthaphatha, Eiko Yamamoto
    Nutrients.2023; 15(21): 4501.     CrossRef
  • The effect of skin-to-skin contact on early initiation of breastfeeding among women in Vietnam
    Hoang Thi Nam Giang, Le Tho Minh Hieu, Do Thi Thuy Duy, Mai Thi Phuong, Tran Dinh Trung
    Pediatrics & Neonatology.2023;[Epub]     CrossRef
  • Effects of maternal education on early initiation and exclusive breastfeeding practices in sub-Saharan Africa: a secondary analysis of Demographic and Health Surveys from 2015 to 2019
    Wako Golicha Wako, Zelalem Wayessa, Anteneh Fikrie
    BMJ Open.2022; 12(3): e054302.     CrossRef
  • Timing of Breastfeeding Initiation Mediates the Association between Delivery Mode, Source of Breastfeeding Education, and Postpartum Depression Symptoms
    Xinran Shen, Shunna Lin, Hui Li, Nubiya Amaerjiang, Wen Shu, Menglong Li, Huidi Xiao, Sofia Segura-Pérez, Rafael Pérez-Escamilla, Xin Fan, Yifei Hu
    Nutrients.2022; 14(14): 2959.     CrossRef
  • Determinants of early initiation of breast feeding among mothers of children aged less than 24 months in Ethiopia: A community-based cross-sectional study
    Sewunet Sako, Girma Gilano, Be'emnet Tekabe, Sintayehu Abebe
    BMJ Open.2022; 12(10): e062905.     CrossRef
  • Socioeconomic determinants and inequalities in exclusive breastfeeding among children in Peru
    Akram Hernández-Vásquez, Rodrigo Vargas-Fernández
    Frontiers in Nutrition.2022;[Epub]     CrossRef
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