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    El Estado peruano frente a la Covid-19. Lecciones de la región Ayacucho
    (Pontificia Universidad Católica del Perú, 2023-04)
    Tras la pandemia de la Covid-2019 se evidenciaron diferentes problemáticas; entre estas está la capacidad de infraestructura del sistema de salud peruano, pese a ser un país catalogado como de ingreso medio alto, con casi el 100% de sus habitantes inscritos en un seguro de salud; también se notó la falta de recursos humanos, así como problemas derivados de la estructura del sistema de salud (por ejemplo, el fraccionamiento). Debido a ello, la respuesta estatal frente a la pandemia se vio debilitada, incluyendo la vacunación. Pese a estas limitaciones, la sociedad peruana, y el sistema de salud respondieron a la pandemia, y esta respuesta evitó, sin duda, muchas muertes.
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    Fortalecer el sistema de salud público para la equidad en salud: una necesidad impostergable
    (Pontificia Universidad Católica del Perú. Centro de Investigaciones Sociológicas, Económicas, Políticas y Antropológicas (CISEPA), 2020-12)
    El documento es resultado de meses de trabajo y discusión académica, los cuales surgen de reconocer la necesidad de repensar y analizar qué es lo que ha venido fallando a nivel del diseño institucional del sistema de salud para fortalecer la respuesta al COVID 19. En los pasados meses, un equipo convocado por el Centro de Investigaciones Sociológicas, Económicas, Políticas y Antropológicas de la PUCP (CISEPA) y Hanns-Seidel-Stiftung, ha venido trabajando en este material con el objetivo de generar una serie de recomendaciones para el fortalecimiento del sistema de salud, y contribuir al debate en salud de nuestro país.
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    Judicial lawfare: analysis of legal arguments against abortion rights in Peruvian courts
    (Fundacao Getulio Vargas, Escola de Direito de Sao Paulo, 2021-01-01)
    This article analyzes the puzzling case of Peru, a country highlighted as an example of the internationalization of sexual and reproductive health and rights norms through supranational litigation, but where these legal victories have not prompted an expansion of abortion rights. Through the analysis of three judicial cases, with a focus on the legal arguments and strategies, the article argues that two features of the abortion legal mobilization in Peru are key to understand the lack of more positive developments: 1) formalistic feature of Peruvian Courts, that offers little space toward recognizing additional grounds for abortion, as has been the case in other Latin American countries; 2) innovative capacity of anti-abortion legal mobilization, that have forced to create a tacit alliance between the movement toward the recognition of abortion rights and the State, to defend the (restricted) abortion rights in the country.
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    Quality of stroke guidelines in low- and middle-income countries: a systematic review
    (World Health Organization, 2021-09-01)
    Objective To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries. Methods We systematically searched medical databases and websites of medical societies and contacted international organizations. Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation). We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of guidelines and plans for dissemination to target audiences. Findings We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries. Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development; breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines encompassed detailed implementation plans and socioeconomic considerations. Conclusion Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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    When winning in the courts is not enough: abortion and the limits of legal mobilization without grassroots involvement in Peru
    (Cambridge University Press, 2022-01-01)
    Peru is often cited as an example of the internationalization of sexual and reproductive health and rights (SRHR) norms through supra-national litigation. Yet the impact to petitioners and other similarly situated women in Peruvian society has fallen far short of expectations. This chapter analyzes the actors behind progressive litigation in Peru, as well as their strategies and those of anti-abortion advocates. It shows that the professionalization, specialization, and detachment from grassroots movements of Peruvian feminist NGOs limit their capacity to build a broader network of political support and thus leverage the opportunities presented by successful litigation. By contrast, anti-abortion organizations are closely connected to grassroots organizations and have developed links to political organizations that allow them to deploy different strategies to stall efforts at expanding the right to abortion.
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    The Devasting Effects of the COVID-19 Pandemic on Peru: The Undermining Role of Vertical Health Policies in Health Systems
    (Oxford University Press, 2025-01-01)
    Why does a state like Peru, dedicated to fulfilling development goals and sustained good macroeconomic performance, appear incapable of dealing with the COVID-19 pandemic? Using the case of maternal mortality, this chapter argues that the tremendous impact of the pandemic is rooted in the adoption of health policy reforms that prioritized targets, vertical programmes, and an empty understanding of health coverage over quality, the need for social change, and the strengthening of the system as a whole. This approach to health policy is part of the global indicator culture of international development. It oversimplifies complex health problems such as the high number of maternal deaths, narrowing it to focusing on certain indicators without analysing their feasibility. This approach to policy-making is a form of exercising state power and structural violence that has created a weak health system that cannot rapidly restructure and deliver care to pregnant women in remote areas.
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    Stressors, mental health and coping amongst forcibly displaced youth since the advent of COVID-19: A systematic review
    (SAGE Publications Ltd, 2025-12-01)
    Mental health is a key issue for forcibly displaced youth. The evidence base on the mental health of youth forcibly displaced since the start of the pandemic is undefined, as well as sources of stressors and coping approaches. This systematic review aims to identify literature on the mental health of forcibly displaced youth in low- and middle-income settings, with focus on displacement since the advent of the COVID-19 pandemic. Objectives are to examine (1) sources of stress, (2) prevalence and covariates of common mental disorders (CMDs) and (3) coping approaches. Six databases were searched in February 2023. Search terms focused on CMDs, stress and forcibly displaced populations. Articles based on data collected after the onset of the COVID-19 pandemic focused on forcibly displaced persons aged 10-29 were included. Quantitative observation and intervention studies reporting CMD prevalences and related concepts were included, as were qualitative studies about stressors and/or coping approaches. Prevalences of CMDs and covariates were tabulated. Inductive thematic coding was conducted on qualitative data on stressors and coping. Interpretation of coping data was guided by a taxonomy including problem solving, support seeking, distraction/avoidance and positive cognitive restructuring. Twenty-one articles were included. Economic issues were the most prominent source of stress and led to subsequent stressors. Depression and anxiety symptom prevalence ranged from 6.2% to 77.4% and 17.2%–32.8% respectively. Problem-solving and support seeking were the most common coping approaches. Supporting the mental health and coping approaches of this marginalised group is critical to recovery in the post-COVID era.
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