Evidence map›Paper›PMID 39244218›Full record

ArticleBMJ global health2024

Pathways to strengthen the climate resilience of health systems in the Peruvian Amazon by working with Indigenous leaders, communities and health officers.

Claudia L Vidal-Cuellar, Victoria Chicmana-Zapata, Ingrid Arotoma-Rojas, Graciela Meza, James D Ford, Hugo Rodríguez Ferruchi, Elida De-La-Cruz, Guillermo Lancha-Rucoba, Diego B Borjas-Cavero, Sonia Loarte and 10 more

Abstract read
In one paragraph

Article in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Stroke and climate change: A World Stroke Organization scientific statement.International journal of stroke : official journal of the International Stroke Society · 2026
    Review
  2. Article
  3. Article
  4. Indigenous rights, health and traditional medicine systems.Bulletin of the World Health Organization · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Claudia L Vidal-CuellarUnidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru.
Victoria Chicmana-ZapataUnidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru.
Ingrid Arotoma-RojasThe Priestley Center for Climate Futures, University of Leeds, Leeds, UK.
Graciela MezaFaculty of Medicine, Universidad Nacional de la Amazonia Peruana, Iquitos, Peru.
James D FordThe Priestley Center for Climate Futures, University of Leeds, Leeds, UK.
Hugo Rodríguez FerruchiFaculty of Medicine, Universidad Nacional de la Amazonia Peruana, Iquitos, Peru.
Elida De-La-CruzOrganización de Mujeres Indígenas Amazónicas Asháninkas de la Selva Central (OMIAASEC), Satipo, Peru.
Guillermo Lancha-RucobaUnidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Yurimaguas, Peru.
Diego B Borjas-CaveroUnidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru.
Sonia LoarteDirección de Promoción de la Salud, Estado Peruano Ministerio de Salud, Lima, Peru.
Ofelia Alencastre MamaniDirección de Pueblos Indígenas u Originarios, Estado Peruano Ministerio de Salud, Lima, Peru.
Victoria I Peña PalmaDirección de Salud Mental, Estado Peruano Ministerio de Salud, Lima, Peru.
Maria G Coronel-AltamiranoDirección de Salud Mental, Estado Peruano Ministerio de Salud, Lima, Peru.
Ivonne BenitesDirección de Gestión de Riesgos y Desastres (DIGERD), Estado Peruano Ministerio de Salud, Lima, Peru.
Giovanna PinascoDirección de Gestión de Riesgos y Desastres (DIGERD), Estado Peruano Ministerio de Salud, Lima, Peru.
Rosa ValeraCoordinadora Regional Salud de Pueblos indígenas, Gerencia Regional de Salud Loreto, Iquitos, Peru.
Marco Maguiña HuamanEstrategia de Pueblos Indígenas u Originarios, Red de Salud de Satipo, Satipo, Peru.
Adolfo Urteaga-VillanuevaOficina de Emergencias y Desastres, Red de Salud de Satipo, Satipo, Peru.
César V MunaycoCentro Nacional de Epidemiología, Prevención y Control de Enfermedades (CDC), Estado Peruano Ministerio de Salud, Lima, Peru.
Carol Zavaleta-CortijoUnidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru carol.zavaleta.c@upch.pe.ORCID http://orcid.org/0000-0003-4969-8959

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundIndigenous knowledge and responses were implemented during the COVID-19 pandemic to protect health, showcasing how Indigenous communities participation in health systems could be a pathway to increase resilience to emergent hazards like climate change. This study aimed to inform efforts to enhance climate change resilience in a health context by: (1) examining if and how adaptation to climate change is taking place within health systems in the Peruvian Amazon, (2) understanding how Indigenous communities and leaders' responses to climatic hazards are being articulated within the official health system and (3) to provide recommendations to increase the climate change resilience of Amazon health systems.

methodsThis study was conducted among two Peruvian Amazon healthcare networks in Junin and Loreto regions. A mixed methodology design was performed using a cross-sectional survey (13 healthcare facilities), semistructured interviews (27 official health system participants and 17 Indigenous participants) and two in-person workshops to validate and select key priorities (32 participants). We used a climate-resilient health system framework linked to the WHO health systems building blocks.

resultsIndigenous and official health systems in the Peruvian Amazon are adapting to climate change. Indigenous responses included the use of Indigenous knowledge on weather variability, vegetal medicine to manage health risks and networks to share food and resources. Official health responses included strategies for climate change and response platforms that acted mainly after the occurrence of climate hazards. Key pathways to articulate Indigenous and official health systems encompass incorporating Indigenous representations in climate and health governance, training the health work force, improving service delivery and access, strengthening the evidence to support Indigenous responses and increasing the budget for climate emergency responses.

conclusionsKey resilience pathways call for a broader paradigm shift in health systems that recognises Indigenous resilience as valuable for health adaptation, moves towards a more participatory health system and broadens the vision of health as a dimension inherently tied to the environment.

Indexed as

Climate ChangeAdultCross-Sectional StudiesDelivery of Health CareFemaleHealth Services, IndigenousHumansIndians, South AmericanLeadershipMalePeruEnvironmental healthHealth policies and all other topicsHealth services researchHealth systems

Identifiers

PMID39244218
PMCPMC11733073

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.