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Item type:Publication, Effect of salt substitution on community-wide blood pressure and hypertension incidence(Nature Research, 2020-03-01)Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped-wedge cluster randomized trial (NCT01960972). The regular salt in enrolled households was retrieved and replaced, free of charge, with a combination of 75% NaCl and 25% KCl. A total of 2,376 participants were enrolled in 6 villages in Tumbes, Peru. The fully adjusted intention-to-treat analysis showed an average reduction of 1.29 mm Hg (95% confidence interval (95% CI) (−2.17, −0.41)) in systolic and 0.76 mm Hg (95% CI (−1.39, −0.13)) in diastolic blood pressure. Among participants without hypertension at baseline, in the time- and cluster-adjusted model, the use of the salt substitute was associated with a 51% (95% CI (29%, 66%)) reduced risk of developing hypertension compared with the control group. In 24-h urine samples, there was no evidence of differences in sodium levels (mean difference 0.01; 95% CI (0.25, −0.23)), but potassium levels were higher at the end of the study than at baseline (mean difference 0.63; 95% CI (0.78, 0.47)). Our results support a case for implementing a pragmatic, population-wide, salt-substitution strategy for reducing blood pressure and hypertension incidence. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ensuring sexual and reproductive healthcare services amidst a pandemic: Experiences from health workers in Lima, Peru(Public Library of Science, 2024-06-28)Nowadays there is an emerging interest on health system resilience capacity during emergencies as the one created by the COVID-19 Pandemic. This article contributes to this emerging field of studies by analysing the impact of the state´s policy responses COVID-19 (as lockdowns) on the Peruvian health system, specifically on the delivery of non-covid services, sexual and reproductive health services, and describe the strategies deployed by health workers to adapt to the COVID-19 crisis in Peru, a country that have been dramatically impacted by the pandemic. The article, based on the analysis of depth interviews with 11 health workers and one health supervisor working at sexual and reproductive health services at public health services Lima during 2020 and 2021, describe how pre-existing conditions of the health system (as poor infrastructure and deficit of human resources) magnified the negative effects of the measures taken to control de pandemic, undermining the “resilience” of the health system. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gender, health-seeking, and tuberculosis: Negotiating responsibility in urban Peru(Society for Applied Anthropology, 2026-01-01)Tuberculosis (TB) remains a persistent public health concern in Peru, particularly in densely populated urban districts marked by poverty, informal labor, and overcrowded housing. Drawing on 25 semi-structured interviews with adult residents insured under the public health system (Seguro Integral de Salud) in San Juan de Lurigancho, Lima, this article examines how gender norms shape everyday understandings of TB, health-seeking practices, and moral responsibilities for care. Rather than focusing on individuals currently undergoing treatment, the study explores how TB is understood through the experiences of relatives, neighbors, coworkers, and illness trajectories within participants' social networks. Findings show that masculinities and femininities organize distinct moral economies of risk and care. Men's narratives emphasize endurance, work obligations, and the minimization of symptoms, often delaying engagement with health services, while women's accounts foreground caregiving responsibilities and the coordination of care within households. These gendered practices intersect with structural constraints, making self-medication and delayed consultation pragmatic responses to precarious everyday conditions rather than signs of neglect. By situating TB within everyday life and gendered moral expectations, this study contributes to debates on health, gender, and urban inequality. It argues for gender-sensitive public health strategies that engage with local moral worlds beyond purely informational models.1