Role and working conditions of nurses in public health in Mexico and Peru: a binational qualitative study.

AIM: This exploratory study conducted in Mexico and Peru investigated nurses' perceptions about their role in public health and working conditions. BACKGROUND: Health reform efforts in many countries are redefining the role of health professionals in public health. Little is known about the role of nurses working in public health contexts in Latin America. METHOD: Fourteen focus groups were conducted in Mexico and Peru with 82 nurses working in government-sponsored community health centres. Data were analysed using a content analysis technique. FINDINGS: Themes identified were: nurses' job descriptions in public health settings; organisational factors influencing the nurses' work, and influence of academic and social image factors. CONCLUSION: Management barriers and limited training influences the role and working conditions of public health nurses in Mexico and Peru. IMPLICATIONS FOR NURSING MANAGEMENT: The professional role of nurses working in public health in Latin America is not well defined because of the health-care system infrastructure and the lack of a clear public health nurse job description. Further research is needed to better understand the role of public health nurses and strengthen their training, particularly in relation to nursing management encompassing abilities for decision-making processes and public health program planning and evaluation.

Personal and social determinants of health services utilization by Mexican older people.

BACKGROUND: Increased healthcare needs among older individuals around the world demands a better understanding of factors influencing healthcare service utilization patterns. OBJECTIVE: To examine personal and social correlates to health services utilization among Mexican older persons. DESIGN AND METHODS: This was a cross-sectional study conducted between 2004 and 2006 with 2030 Mexican adults 60 years and older and based on a health services utilization framework. A two-stage cluster sampling with probability proportionate to size was used. Participants were randomly selected and recruited in four metropolitan areas in Northeastern Mexico. Chi-square and Pearson's chi-squared tests and logistic regression were used for data analyses. RESULTS: Significantly more women than men had lost a spouse and were illiterate. Also, females reported significantly poorer health, higher nutritional risk and lower ability to perform activities of daily and instrumental living than males. Predictors of healthcare utilization were: Having a caregiver during an illness; perceiving to have a health problem; being able to afford food, and having children. CONCLUSIONS: Predisposing, enabling and need factors are strong predictors of health services utilization among Mexican older persons. In addition, gender differences exist among this population in relation to health status, but not to health services demands.