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Author: search.filters.author.Archna Gupta

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    Assessing health disparities faced by female paid domestic workers in Peru before, during, and after the COVID-19 pandemic
    (BioMed Central Ltd, 2025-12-01)
    BACKGROUND: Female paid domestic workers are among the most vulnerable occupational groups globally, often lacking formal social protection and limited labour rights. The COVID-19 pandemic may have exacerbated these vulnerabilities, yet quantitative evidence from low and middle income countries is scarce. This study examines health disparities in Peru between female paid domestic workers and females employed in the formal service sector before, during, and after the pandemic. METHODS: We used pooled cross sectional data from the Peruvian National Household Survey (ENAHO, 2018-2023). The primary outcomes were self reported illness symptoms and healthcare seeking behaviour. We compared female paid domestic workers to female formal workers in other service occupations-including both personal and nonpersonal services-across three time periods: prepandemic (January 2018 - February 2020), pandemic (March 2020 - October 2022), and postpandemic (November 2022 - December 2023). Analyses involved comparing differences in proportions and conducting Wald tests. We also stratified results by key social determinants of health, including education, ethnicity, age, income, chronic disease status, household head status, and access to labour rights. RESULTS: Female paid domestic workers reported more illness symptoms and sought less healthcare than females working in nonpersonal service roles, especially during the pandemic. The difference in proportions - 5.9 percentage points (pp.) for illness symptoms and 16.5 pp. for healthcare-seeking behaviour- became smaller after one year. There were no significant differences when comparing female paid domestic workers to other personal service workers. Stratified results indicated that outcome differences between female paid domestic workers and female working in non-personal services were wider among household heads, those with chronic conditions, and those with limited access to labour rights. Post-pandemic disparities were especially pronounced among younger females, low-wage earners, and those with less education. CONCLUSION: In Peru, female paid domestic workers experienced persistent health disadvantages before, during, and after the COVID-19 pandemic when compared with females with formal employment. Addressing these disparities requires comprehensive policies that promote formalization and social security coverage to advance progress on Sustainable Development Goal 3.
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    Addressing the challenges and constraints of social protection policies for Peruvian women domestic workers: The ANITA project study protocol
    (BMJ Publishing Group, 2025-03-06)
    INTRODUCTION: Domestic workers (DWs) are vulnerable to precarious or informal working conditions with limited access to social protection policies such as employer-paid health insurance or retirement pensions. This study aims to examine the working conditions, health status and access to healthcare for women DWs in Peru and propose recommendations to improve their access to social protection policies. METHODS AND ANALYSIS: The project uses a participatory action research approach by engaging three committees: a DW co-researcher committee, an advisory committee and a steering committee. The first two include former or current DWs, while the third includes policymakers and academics. We use a sequential mixed-methods design organised in four phases: (1) secondary data analysis (n=4216): using two Peruvian national surveys to characterise working conditions, health status and access to healthcare; (2) face-to-face survey (n=448): with DWs in three cities, using respondent-driven sampling to further characterise working and health conditions and to identify factors that influence knowledge of and access to social protection policies; (3) qualitative interviews (n=30-46): with DWs, leaders of DW organisations, employers and policymakers to gather different perspectives on the facilitators and barriers to access to social protection policies; and (4) deliberative dialogues (n=14-26): with DW, leaders of DW organisations, employers, policymakers and academics to identify key barriers to the implementation of social protection policies and to develop recommendations for overcoming these barriers. ETHICS AND DISSEMINATION: Phase 1 and Phase 2 received ethical clearance from Universidad Peruana Cayetano Heredia in Peru and Unity Health Toronto in Canada. Phase 3 and Phase 4 received ethical clearance from PRISMA Charitable Association in Peru and Unity Health Toronto in Canada. To mobilise knowledge, in collaboration with the committees, we will co-generate policy briefs and audiovisual materials to disseminate the results from this project to different audiences and sectors.
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