Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon

Tiana Bressan; Andrea Valdivia-Gago; Rosa M. Silvera-Ccallo; Alejandro Llanos-Cuentas; Daniel F. Condor; Pierre G. Padilla-Huamantinco; Stalin Vilcarromero; J. Jaime Miranda; Carol Zavaleta-Cortijo

doi:10.1186/s12939-022-01773-7

Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon

Tiana Bressan, Andrea Valdivia-Gago, Rosa M. Silvera-Ccallo, Alejandro Llanos-Cuentas, Daniel F. Condor, Pierre G. Padilla-Huamantinco, Stalin Vilcarromero, J. Jaime Miranda, Carol Zavaleta-Cortijo

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Biomedical technologies have the potential to be advantageous in remote communities. However, information about barriers faced by users of technology in general and in remote Indigenous communities is scarce. The purpose of this study was to characterize the leading challenges faced by researchers who have used biomedical technologies in the Peruvian Amazon. Methods: This exploratory, qualitative study with a phenomenological approach depicts the lived experience of participants who were researchers with experience working with biomedical technologies in the Peruvian Amazon in the past five years. Analysis was based on three core themes: design, implementation, and acceptability. Sub-themes included environment, community, and culture. Of the 24 potential participants identified and contacted, 14 agreed to participate, and 13 met inclusion criteria and completed semi-structured interviews. Results were sent to each participant with the opportunity to provide feedback and partake in a 30-minute validation meeting. Five participants consented to a follow-up meeting to validate the results and provide further understanding. Results: Participants recognized significant challenges, including technologies designed out-of-context, difficulty transporting the technologies through the Amazon, the impact of the physical environment (e.g., humidity, flooding), and limited existing infrastructure, such as electricity and appropriately trained health personnel. Participants also identified cultural factors, including the need to address past experiences with technology and health interventions, understand and appropriately communicate community benefits, and understand the effect of demographics (e.g., age, education) on the acceptance and uptake of technology. Complementary challenges, such as corruption in authority and waste disposal, and recommendations for technological and health interventions such as co-design were also identified. Conclusions: This study proposes that technological and health interventions without efforts to respect local cultures and health priorities, or understand and anticipate contextual challenges, will not meet its goal of improving access to healthcare in remote Amazon communities. Furthermore, the implications of corruption on health services, and improper waste disposal on the environment may lead to more detrimental health inequities.

Original language	English
Article number	183
Journal	International Journal for Equity in Health
Volume	21
Issue number	1
DOIs	https://doi.org/10.1186/s12939-022-01773-7
State	Published - Dec 2022
Externally published	Yes

Bibliographical note

Funding Information:
Funding for the research included the University of Guelph President’s Scholarship stipend for summer research assistantship and the Summerlee Humanitarian Scholarship for TB to travel to Peru and to continue this research. CZ-C was supported by the National Institute for Health Research (NIHR) (using the UK’s Official Development Assistance (ODA) Funding) and Wellcome 218743_Z_19_Z under the NIHR-Wellcome Partnership for Global Health Research. The views expressed are those of the authors and not necessarily those of Wellcome, the NIHR or the Department of Health and Social Care. We acknowledge the Indigenous Health and Adaptation to Climate Change (IHACC) program for funding the manuscript submission cost and confirm that there was no influence on the design, collection, analysis, or interpretation of data and writing of the manuscript. JJM acknowledges having received support from the Alliance for Health Policy and Systems Research (HQHSR1206660), Bloomberg Philanthropies (grant 46129, via University of North Carolina at Chapel Hill School of Public Health), FONDECYT via CIENCIACTIVA/CONCYTEC, British Council, British Embassy and the Newton-Paulet Fund (223-2018, 224-2018), DFID/MRC/Wellcome Global Health Trials (MR/M007405/1), Fogarty International Center (R21TW009982, D71TW010877, R21TW011740), Grand Challenges Canada (0335-04), International Development Research Center Canada (IDRC 106887, 108167), Inter-American Institute for Global Change Research (IAI CRN3036), National Cancer Institute (1P20CA217231), National Heart, Lung and Blood Institute (HHSN268200900033C, 5U01HL114180, 1UM1HL134590), National Institute of Mental Health (1U19MH098780), Swiss National Science Foundation (40P740-160366), UKRI BBSRC (BB/T009004/1), UKRI EPSRC (EP/V043102/1), UKRI MRC (MR/P008984/1, MR/P024408/1, MR/P02386X/1), Wellcome (074833/Z/04/Z, 093541/Z/10/Z, 103994/Z/14/Z, 107435/Z/15/Z, 205177/Z/16/Z, 214185/Z/18/Z, 218743/Z/19/Z) and the World Diabetes Foundation (WDF15-1224).

Publisher Copyright:
© 2022, The Author(s).

Keywords

Amazon
Biomedical engineering
Challenges
Healthcare access
Peru
Technology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12939-022-01773-7

Cite this

Bressan, T., Valdivia-Gago, A., Silvera-Ccallo, R. M., Llanos-Cuentas, A., Condor, D. F., Padilla-Huamantinco, P. G., Vilcarromero, S., Miranda, J. J., & Zavaleta-Cortijo, C. (2022). Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon. International Journal for Equity in Health, 21(1), [183]. https://doi.org/10.1186/s12939-022-01773-7

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abstract = "Background: Biomedical technologies have the potential to be advantageous in remote communities. However, information about barriers faced by users of technology in general and in remote Indigenous communities is scarce. The purpose of this study was to characterize the leading challenges faced by researchers who have used biomedical technologies in the Peruvian Amazon. Methods: This exploratory, qualitative study with a phenomenological approach depicts the lived experience of participants who were researchers with experience working with biomedical technologies in the Peruvian Amazon in the past five years. Analysis was based on three core themes: design, implementation, and acceptability. Sub-themes included environment, community, and culture. Of the 24 potential participants identified and contacted, 14 agreed to participate, and 13 met inclusion criteria and completed semi-structured interviews. Results were sent to each participant with the opportunity to provide feedback and partake in a 30-minute validation meeting. Five participants consented to a follow-up meeting to validate the results and provide further understanding. Results: Participants recognized significant challenges, including technologies designed out-of-context, difficulty transporting the technologies through the Amazon, the impact of the physical environment (e.g., humidity, flooding), and limited existing infrastructure, such as electricity and appropriately trained health personnel. Participants also identified cultural factors, including the need to address past experiences with technology and health interventions, understand and appropriately communicate community benefits, and understand the effect of demographics (e.g., age, education) on the acceptance and uptake of technology. Complementary challenges, such as corruption in authority and waste disposal, and recommendations for technological and health interventions such as co-design were also identified. Conclusions: This study proposes that technological and health interventions without efforts to respect local cultures and health priorities, or understand and anticipate contextual challenges, will not meet its goal of improving access to healthcare in remote Amazon communities. Furthermore, the implications of corruption on health services, and improper waste disposal on the environment may lead to more detrimental health inequities.",

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Bressan, T, Valdivia-Gago, A, Silvera-Ccallo, RM, Llanos-Cuentas, A, Condor, DF, Padilla-Huamantinco, PG, Vilcarromero, S, Miranda, JJ & Zavaleta-Cortijo, C 2022, 'Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon', International Journal for Equity in Health, vol. 21, no. 1, 183. https://doi.org/10.1186/s12939-022-01773-7

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AU - Bressan, Tiana

AU - Valdivia-Gago, Andrea

AU - Silvera-Ccallo, Rosa M.

AU - Llanos-Cuentas, Alejandro

AU - Condor, Daniel F.

AU - Padilla-Huamantinco, Pierre G.

AU - Vilcarromero, Stalin

AU - Miranda, J. Jaime

AU - Zavaleta-Cortijo, Carol

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Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon

Abstract

Bibliographical note

Keywords

UN SDGs

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