Agbeve Shanon, Burgess Elizabeth R, Joseph Mahalah, Wright Rosemary, Clarke Rachel, Oliveira Jessica B
Department of Medical Education, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Cureus. 2025 Apr 20;17(4):e82642. doi: 10.7759/cureus.82642. eCollection 2025 Apr.
Loreto, Peru, is a region marked by social inequalities, with about 55% of its one million inhabitants living in isolated river-edge communities. Indigenous populations face significant barriers to healthcare, education, and sanitation, resulting in high rates of infant mortality and maternal deaths. This study explores the demographic characteristics and social determinants of health in five communities along the Amazon River, with a focus on women's access to healthcare. Understanding these barriers can help develop interventions specific to the needs of these communities.
Secondary data from a 2023 survey conducted by the Herbert Florida International University Wertheim College of Medicine medical students and Project Amazonas were analyzed. The study was conducted in five remote river communities within the Tamshiyacu Tahuayo Regional Conservation Area: El Chino, El Charro, Esperanza, Buena Vista, and Huaysi. Participants (n = 32) were Spanish-speaking women aged 18-80 years residing in these communities. They were randomly selected during medical visits, where they provided consent to participate. The survey was administered verbally in Spanish by Spanish-speaking medical students. Additionally, the Project Amazonas representative verbally asked a series of demographic questions in Spanish to the community leader in each village. Descriptive statistics were used to summarize demographic characteristics, general pregnancy and labor attitudes and experiences, and contraceptive use.
The long travel distance via boat to healthcare facilities, poor infrastructure, and limited education all restrict access to maternal care. Only 42% of women received prenatal care at local health posts, and 40% delivered at home. Contraceptive use, particularly medroxyprogesterone acetate (Depo-Provera) injections, is prevalent at 71%, though unplanned pregnancies (28%) and child mortality remain common (19%).
Geographic isolation has a significant impact on healthcare access, with education and transportation emerging as critical factors in maternal health outcomes. The findings highlight the need for culturally sensitive interventions that address these root causes. Proposed sustainable solutions include basic medical training for community members, emergency plans, and improved transportation to reduce maternal health disparities in these communities.
秘鲁的洛雷托地区存在社会不平等现象，其100万居民中约55%生活在与世隔绝的河边社区。当地原住民在医疗、教育和卫生设施方面面临重大障碍，导致婴儿死亡率和孕产妇死亡率居高不下。本研究探讨了亚马逊河沿岸五个社区的人口特征和健康的社会决定因素，重点关注妇女获得医疗服务的情况。了解这些障碍有助于制定针对这些社区需求的干预措施。
对赫伯特·佛罗里达国际大学韦特海姆医学院的医学生和亚马逊项目在2023年进行的一项调查中的二手数据进行了分析。该研究在塔姆希亚库·塔瓦约地区保护区内的五个偏远河边社区开展，分别是埃尔奇诺、埃尔查罗、埃斯佩兰萨、布埃纳维斯塔和瓦伊西。参与者（n = 32）为居住在这些社区的18至80岁讲西班牙语的女性。她们在就医时被随机选中，并同意参与调查。调查由讲西班牙语的医学生用西班牙语进行口头询问。此外，亚马逊项目代表也用西班牙语向每个村庄的社区领袖口头询问了一系列人口统计学问题。描述性统计用于总结人口特征、一般怀孕和分娩态度及经历，以及避孕措施的使用情况。
乘船前往医疗设施的路途遥远、基础设施差以及教育有限，都限制了产妇护理服务的获取。只有42%的妇女在当地卫生站接受了产前护理，40%的产妇在家中分娩。避孕措施的使用很普遍，尤其是醋酸甲羟孕酮（Depo - Provera）注射，使用率达71%，不过意外怀孕（28%）和儿童死亡率仍然很常见（19%）。
地理隔离对医疗服务的获取有重大影响，教育和交通成为影响孕产妇健康结果的关键因素。研究结果凸显了采取针对这些根本原因的文化敏感型干预措施的必要性。提议的可持续解决方案包括为社区成员提供基础医疗培训、制定应急计划以及改善交通，以减少这些社区的孕产妇健康差距。
