Perception of Afro-Peruvians on primary healthcare in the first level of attention

Keywords: Primary Health Care, Perception, Health Service

Abstract

Objective: To describe perception of compliance with primary healthcare requisites in Afro-Peruvian population during the COVID-19 pandemic. Materials and Methods: This is an observational and cross-sectional study, which was performed in six Peruvian cities, which included adult Afro-Peruvian subjects who were selected using intentional sampling. An online survey was administered, using the Primary Care Assessment Tool (PCAT), which was harmonized for an Ibero-American context, assessing attributes of primary care, such as service accessibility, continuing care, community participation, and cultural suitability; and these characteristics were assessed using a descriptive analysis. Additionally, related factors, such as sociodemographic and clinical characteristics were assessed using hypothesis tests. Results: Most interviewed persons perceived compliance limitations with primary healthcare attributes (94.8%). Particularly, community participation and continued care were troublesome areas, reaching 92.3% and 92.1%, respectively. No significant correlation was found between compliance perception for primary healthcare and sociodemographic and clinical factors, with the exception of a history of having had COVID-19, in which less compliance with attributes of primary healthcare were also observed. Global reliability of PCAT was 0.93 using Cronbach alpha test. Conclusions: There is a generally low perception of primary healthcare services in Afro-Peruvian population. Further investigation is required for exploring the underlying causes for such perception, and efforts must be made for improving compliance with primary healthcare attributes that are perceived as insufficient, particularly accessibility and continued care.

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References

Rosas Prieto AM, Narciso Zarate V, Cuba Fuentes MS. Atributos de la Atención Primaria de Salud (A.P.S): Una visión desde la Medicina Familiar. Acta Méd Peru. 2013;30(1):42-7.

Benavides M, León J, Espezúa L, Wangeman A. Estudio Especializado sobre Población Afroperuana (EEPA) [Internet]. Lima: GRADE; 2015 [citado 3 de julio de 2023]. Disponible en: https://www.grade. org.pe/publicaciones/estudio-especializado-sobre-poblacion- afroperuana-eepa/

Benavides M, Sarmiento P, Valdivia N, Moreno M. ¡Aquí estamos! Niñas, niños y adolescentes afroperuanos. [Internet]. Perú: Centro de Desarrollo Étnico (CEDET); 2013 [citado 3 de julio de 2023]. 1-28 p. Disponible en: https://centroderecursos.cultura.pe/sites/ default/files/rb/pdf/Aqui-estamos-Ninas-ninos-adolescentes- afroperuanos%20RESUMEN-EJECUTIVO.pdf

Ministerio de Salud del Perú. Política Nacional Multisectorial de Salud al 2030 “Perú, País Saludable" [Internet]. DECRETO SUPREMO No 026-2020-SA Lima: MINSA; 2020 [citado 3 de julio de 2023]. Disponible en: https://cdn.www.gob.pe/uploads/document/ file/1272348/Pol%C3%ADtica%20Nacional%20Multisectorial%20 de%20Salud%20al%202030.pdf

Ministerio de Cultura del Perú. Orientaciones para la implementación de políticas públicas para la población afroperuana [Internet]. Lima: Ministerio de Cultura; 2014 [citado 3 de julio de 2023]. Disponible en: https://repositorio.cultura.gob.pe/bitstream/handle/CULTURA/79/ Orientaciones%20para%20la%20implementaci%c3%b3n%20 de%20pol%c3%adticas%20p%c3%bablicas%20para%20la%20 poblaci%c3%b3n%20afroperuana.pdf?sequence=1&isAllowed=y

Cuba Fuentes M, Jurado Gabriel EE. Attributes of Primary Care and patient satisfaction degree on a primary care facility. Rev Med Hered. 2011;22(1):4-9.

Lizana M, Flores EÁ, Carhuayo-Luján S. Evaluación de los atributos de atención primaria de salud en establecimientos del primer nivel atención de Ayacucho, Perú. Rev Med Hered. 2020;31(3):175-80.

Hennis AJM, Coates A, del Pino S, Ghidinelli M, de Leon RGP, Bolastig E, et al. COVID-19 and inequities in the Americas: lessons learned and implications for essential health services. Rev Panam Salud Publica. 2021;45:e130. doi: 10.26633/RPSP.2021.130.

Pasarín MI, Berra S, Rajmil L, Solans M, Borrell C, Starfield B. [An instrument to evaluate primary health care from the population perspective]. Aten Primaria. 2007;39(8):395-401. Spanish. doi: 10.1157/13108612.

Zuidgeest M. Measuring and improving the quality of care from the healthcare user perspective: the Consumer Quality Index. Het meten en verbeteren van de kwaliteit van zorg vanuit het zorggebruikers perspectief: de Consumer Quality Index [Doctoral Thesis]. Bergschenhoek, the Netherlands: GVO drukkers & vormgevers B.V./Ponsen & Looyen te Ede; 2011.

Instituto Nacional de Estadística e Informática (INEI). Encuesta Demográfica y de Salud Familiar (ENDES) 2017 [Internet]. Lima: INEI; 2017 [citado 3 de julio de 2023]. Disponible en: https://www.datosabiertos.gob.pe/dataset/encuesta- demogr%C3%A1fica-y-de-salud-familiar-endes-2017-instituto- nacional-de-estad%C3%ADstica-e

Ponzo J, Berra S, Giraldo-Osorio A, Pasarín MI, Leyns C, Álvarez CV, et al. Armonización iberoamericana de los instrumentos PCAT para la evaluación del primer nivel de atención. Rev Panam Salud Publica. 2018;42:e80. doi: 10.26633/RPSP.2018.80.

Centro de Investigación Epidemiológica y en Servicios de Salud. Colaboración IA-PCAT [Internet]. Córdova: Facultad de ciencias médicas, Universidad Nacional de Córdova; 2023 [citado 3 de julio de 2023]. Disponible en: https://ciess.sitios.fcm.unc.edu.ar/ia-pcat/

Fuentes-GarcíaA.GuíaderecomendaciónyusodeInstrumento Primary Care Asessment Tools (PCAT) versiones “Usuarios Adultos” y “Prestadores” para la Atención Primaria de Salud de Chile [Internet]. Santiago: Facultad de Medicina, Universidad de Chile; 2019 [citado 3 de julio de 2023]. Disponible en: https://www. researchgate.net/publication/336441884_Guia_PCAT_Chile_final/ citations

BresickG,SayedAR,leGrangeC,BhagwanS,MangaN,Hellenberg D. Western Cape Primary Care Assessment Tool (PCAT) study: Measuring primary care organisation and performance in the Western Cape Province, South Africa (2013). Afr J Prim Health Care

Fam Med. 2016;8(1):1057. doi: 10.4102/phcfm.v8i1.1057.

Bresick G, Pressentin KB von, Mash R. Evaluating the performance of South African primary care: a cross-sectional descriptive survey. South African Family Practice. 2019;61(3):109-116. doi: 10.1080/20786190.2019.1596666.

Hu R, Liao Y, Du Z, Hao Y, Liang H, Shi L. Types of health care facilities and the quality of primary care: a study of characteristics and experiences of Chinese patients in Guangdong Province, China. BMC Health Serv Res. 2016;16(a):335. doi: 10.1186/s12913-016- 1604-2.

Li L, Li L, Zhong C, Mei J, Liang Y, Kuang L. Effect of family practice contract services on the quality of primary care in Guangzhou, China: a cross-sectional study using PCAT-AE. BMJ Open. 2018;8(11):e021317. doi: 10.1136/bmjopen-2017-021317.

Franco-Giraldo Á. El rol de los profesionales de la salud en la atención primaria en salud (APS). Rev Fac Nac Salud Pública. 2015;33(3):414-24.

Shepherd SM, Willis-Esqueda C, Paradies Y, Sivasubramaniam D, Sherwood J, Brockie T. Racial and cultural minority experiences and perceptions of health care provision in a mid-western region. Int J Equity Health. 2018;17(1):1-10. doi: 10.1186/s12939-018-0744-x.

Afroperuanos y atención primaria de salud

Shi L, Starfield B, Xu J. Validating the Adult Primary Care Assessment Tool. J Fam Pract. 2001;50(2):161-175w.

Shieh CF. Assessing the quality of primary health care in a remote county of Taiwan [Thesis]. Baltimore: Johns Hopkins University; 2020.

DullieLW.Qualityofprimarycarefromthepatientperspectivein South West Malawi : Development and application of the Malawian Primary Care Assessment Tool (Pcat-Mw) [Doctoral thesis]. Bergen: The University of Bergen; 2020.

Wong SY, Kung K, Griffiths SM, Carthy T, Wong MC, Lo SV, et al. Comparison of primary care experiences among adults in general outpatient clinics and private general practice clinics in Hong Kong. BMC Public Health. 2010;10(1):397. doi: 10.1186/1471-2458-10- 397.

MacinkoJ,MullacheryPH.PrimarycareexperiencesamongBrazilian adults: Cross-sectional evidence from the 2019 National Health Survey. PLoS One. 2022;17(6):e0269686. doi: 10.1371/journal. pone.0269686.

D’Avila OP, Pinto LF da S, Hauser L, Gonçalves MR, Harzheim E. The use of the Primary Care Assessment Tool (PCAT): an integrative review and proposed update. Cien Saude Colet. 2017;22(3):855-65. doi: 10.1590/1413-81232017223.03312016.

Published
2024-06-30
How to Cite
1.
Contreras PJ, Urday-Fernande D, Izquierdo-Hernandez M, Chacon-Uscamaita PR, Cuba-Fuentes MS. Perception of Afro-Peruvians on primary healthcare in the first level of attention. Acta Med Peru [Internet]. 2024Jun.30 [cited 2024Oct.4];41(2):112-21. Available from: http://www.amp.cmp.org.pe/index.php/AMP/article/view/3016
Section
ORIGINAL ARTICLES