Support Systems and Limitations in Therapeutic Abortion Care by the Gynecologist-Obstetrician of Public Hospitals in Peru.

OBJECTIVE: To identify the barriers to provide to women and adequately train physicians on therapeutic abortions in public hospitals in Peru. METHODS: Descriptive cross-sectional survey-based study. We invited 400 obstetrics and gynecology specialists from 7 academic public hospitals in Lima and 8 from other regions of Peru. Expert judges validated the survey. RESULTS: We collected survey results from 160 participants that met the inclusion criteria. Of those, 63.7% stated that the hospital where they work does not offer abortion training. Most of the participants consider that the position of the Peruvian government regarding therapeutic abortion is indifferent or deficient. The major limitations to provide therapeutic abortions included Peruvian law (53.8%), hospital policies (18.8%), and lack of experts (10.6%). CONCLUSION: Most surveyed physicians supported therapeutic abortions and showed interest in improving their skills. However, not all hospitals offer training and education. The limited knowledge of the physicians regarding the law and institutional policies, as well as fear of ethical, legal, and religious repercussions, were the main barriers for providing abortions.

OBJETIVO: Identificar as barreiras para oferecer às mulheres e capacitar adequadamente os médicos sobre abortos terapêuticos nos hospitais públicos do Peru. MéTODOS: Estudo descritivo transversal baseado em inquérito. Convidamos 400 especialistas em obstetrícia e ginecologia de 7 hospitais públicos acadêmicos de Lima e 8 de outras regiões do Peru. Juízes especialistas validaram a pesquisa. RESULTADOS: Coletamos os resultados da pesquisa de 160 participantes que atenderam aos critérios de inclusão. Destes, 63,7% afirmaram que o hospital onde trabalham não oferece treinamento sobre aborto. A maioria dos participantes considera que a posição do governo peruano em relação ao aborto terapêutico é indiferente ou deficiente. As principais limitações para fornecer abortos terapêuticos incluem a lei peruana (53,8%), políticas hospitalares (18,8%) e falta de especialistas (10,6%). CONCLUSãO: A maioria dos médicos pesquisados apoiava o aborto terapêutico e demonstrava interesse em aprimorar suas habilidades. No entanto, nem todos os hospitais oferecem treinamento e educação. O conhecimento limitado dos médicos sobre a lei e as políticas institucionais, além do medo de repercussões éticas, legais e religiosas, foram as principais barreiras para a realização do aborto.

Support Systems and Limitations in Therapeutic Abortion Care by the Gynecologist-Obstetrician of Public Hospitals in Peru / Sistemas de apoio e limitações na atenção ao aborto terapêutico pelo ginecologista-obstetra de hospitais públicos do Peru

Abstract Objective To identify the barriers to provide to women and adequately train physicians on therapeutic abortions in public hospitals in Peru. Methods Descriptive cross-sectional survey-based study. We invited 400 obstetrics and gynecology specialists from 7 academic public hospitals in Lima and 8 from other regions of Peru. Expert judges validated the survey. Results We collected survey results from 160 participants that met the inclusion criteria. Of those, 63.7% stated that the hospital where they work does not offer abortion training. Most of the participants consider that the position of the Peruvian government regarding therapeutic abortion is indifferent or deficient. The major limitations to provide therapeutic abortions included Peruvian law (53.8%), hospital policies (18.8%), and lack of experts (10.6%). Conclusion Most surveyed physicians supported therapeutic abortions and showed interest in improving their skills. However, not all hospitals offer training and education. The limited knowledge of the physicians regarding the law and institutional policies, as well as fear of ethical, legal, and religious repercussions, were the main barriers for providing abortions.

Resumo Objetivo Identificar as barreiras para oferecer às mulheres e capacitar adequadamente os médicos sobre abortos terapêuticos nos hospitais públicos do Peru. Métodos Estudo descritivo transversal baseado em inquérito. Convidamos 400 especialistas em obstetrícia e ginecologia de 7 hospitais públicos acadêmicos de Lima e 8 de outras regiões do Peru. Juízes especialistas validaram a pesquisa. Resultados Coletamos os resultados da pesquisa de 160 participantes que atenderam aos critérios de inclusão. Destes, 63,7% afirmaram que o hospital onde trabalham não oferece treinamento sobre aborto. A maioria dos participantes considera que a posição do governo peruano em relação ao aborto terapêutico é indiferente ou deficiente. As principais limitações para fornecer abortos terapêuticos incluem a lei peruana (53,8%), políticas hospitalares (18,8%) e falta de especialistas (10,6%). Conclusão A maioria dos médicos pesquisados apoiava o aborto terapêutico e demonstrava interesse em aprimorar suas habilidades. No entanto, nem todos os hospitais oferecem treinamento e educação. O conhecimento limitado dos médicos sobre a lei e as políticas institucionais, além do medo de repercussões éticas, legais e religiosas, foram as principais barreiras para a realização do aborto.

Utilización de tecnología, información, comunicación y aula virtual en la enseñanza de la asignatura de Gerencia en Salud para los médicos residentes de la Facultad de Medicina de la Universidad Nacional Mayor de San Marcos, 2015 / Use of technology, information, communication and virtual classroom teaching course in the Health Management education for medical residents of the Faculty of Medicine, Universidad Nacional Mayor de San Marcos, 2015

Introducción. A partir del año 2005 se inició la incorporación de la formación por competencias en los diversos planes de estudio de los programas de formación médica, incluyendo siete competencias que requieren los médicos residentes. Los temas de gerencia y administración fueron dos de las competencias que parecían recibir poco desarrollo y atención. Objetivo. Describir y analizar el uso de tecnología, información, comunicación y aula virtual para la enseñanza de Gerencia en Salud. Diseño. Estudio cuantitativo de nivel descriptivo, prospectivo y de corte transversal. Lugar. Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes. 91 médicos residentes matriculados en la asignatura de Gerencia en Salud. Intervenciones. Se seleccionó una muestra no probabilista por conveniencia y se implementó un aula virtual de código abierto. El índice de confiabilidad del instrumento correspondió a 0,93. Se aplicó el cuestionario bajo la modalidad online. Resultados. La principal fuente de adquisición de conocimientos y habilidades fue de forma autodidacta. El 83,9% recomendaría la implementación y uso del aula virtual para el desarrollo de otros cursos del Programa de Segunda Especialización en Medicina Humana. El 90% consideró importante el uso del aula virtual durante su formación como médico especialista. Conclusiones. Se considera importante la implementación del aula virtual y su utilidad para la formación de médico especialista.

Introduction. Since 2005 the Faculty of Medicine of the Universidad Nacional de San Marcos incorporated a competency-based training in the various curricula of medical training programs, including seven skills required by medical residents. The management and administration subjects were so me of those skills that seemed to receive less development and attention. Objective. To describe and analyze the use of technology, information, communication and virtual classroom in the health management education. Design. Quantitative, descriptive, prospective and cross-sectional study. Setting. Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Participants. 91 medical residents enrolled in health management. Interventions. A non-probabilistic sample was selected by convenience. An open source virtual classroom was implemented. The reliability index of the instrument was to 0.93. The questionnaire was applied in online mode. Results. The main source of acquiring knowledge and skills were on their own; 83.9% would recommend the implementation and use of the virtual classroom for the development of other courses in the Second Specialization Program in Human Medicine. And 90% considered important to use the virtual classroom during their specialist training. Conclusions. The implementation of the virtual classroom and its usefulness for specialist medical training is considered.