[Association between exclusive breastfeeding and obesity in children: a cross-sectional study of three Latin American countries].

OBJECTIVE: To determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old. METHOD: Cross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression. RESULTS: The prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found. CONCLUSION: Exclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru

Emergency response times, response provider and patient satisfaction data for individuals in three Peruvian health care facilities

Questionnaire and results of a study of service quality and promptness of health care formulary used in study of patients involved in road traffic incidents in three different Peruvian cities between August – September 2009

Evaluation of interventions on road traffic injuries in Peru: a qualitative approach

<p>Abstract</p> <p>Background</p> <p>Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru.</p> <p>Methods</p> <p>We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention.</p> <p>Results</p> <p>Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks.</p> <p>Conclusions</p> <p>Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru.</p

Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.

BACKGROUND:The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth. METHODS AND FINDINGS:Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita. CONCLUSIONS:The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs

Evaluación situacional, estructura, dinámica y monitoreo de los sistemas de información en accidentes de tránsito en el Perú - 2009

Objective: A baseline assessment of the structure, dynamics, and monitoring capabilities of the information systems for road traffic injuries was conducted in three Peruvian cities: Lima, Huamanga and Pucallpa. Material and methods. 50 in-depth interviews were performed with key stakeholders, including managers and operators of information systems. The instrument was developed taking into account international standards and recommendations for information systems. Results. Six information systems were identified, some of which contain integrated operational systems enabling the recollection, processing, aggregation and data analysis following automated processes. These systems are considered valuable by different stakeholders because of their ability to present data in an organized manner. A low level of collaboration and exchange of information between institutions in the diverse aspects of data collection, processing and usage was observed. Officially, formal collaboration agreements between institutions do exist, potentially enabling more collaborative work. An interest was expressed in establishing an integrated information system due to the need for detailed and solid/trusted information that maximizes the use of existing resources. Conclusions. Current information systems for road traffic injuries have limitations. The actual use and utility of the information for decision-making for prevention of road traffic injuries nationwide is limited.Ojetivo: Con el objetivo de elaborar un diagnóstico situacional de las fuentes de información existentes relacionadas con el registro de accidentes de tránsito, así como conocer su estructura, dinámica y monitoreo, se realizó una investigación en las ciudades de Lima, Huamanga y Pucallpa. Materiales y métodos. Como población de estudio fueron considerados funcionarios y responsables de los sistemas de información de diversas instituciones. Se realizaron 50 entrevistas en profundidad. El instrumento usado tuvo en consideración estándares y recomendaciones internacionales de sistemas de información. Resultados. Se identificaron seis sistemas de información; algunos cuentan con sistemas operativos que permiten recolectar, procesar, consolidar y analizar los datos de forma automática. Estos sistemas son considerados valiosos por distintos actores, pues les permiten tener datos organizados. Se observó que existe un bajo nivel de colaboración e intercambio de datos entre las instituciones en las distintas fases del levantamiento y procesamiento de información, y el uso de los mismos. A nivel operativo existen alianzas formales entre las instituciones vinculadas con el tema que permitirían un trabajo conjunto. Existe un interés por parte de las instituciones de conformar un sistema integrado de información por la necesidad de contar con información con mayor detalle y fiable empleando la menor cantidad d e recursos. Conclusiones. Existen limitaciones en los sistemas de información en accidentes de tránsito existentes. La utilidad y uso de la información es limitada para la toma de decisiones en materia de prevención de los accidentes de tránsito a nivel nacional

Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) of crude and adjusted incidence, mortality y fatality rates of RTIs in Peru, 1973–2008.

<p>*Notes: Variables tested in the adjusted models: (1) Total population, (2) Vehicle density, (3) Road density, (4) Allowance of imported used vehicles allowed. SOAT and the Zero Tolerance Plan were not associated with incidence, mortality or fatality in multivariable models.</p