Evidence map›Paper›PMID 39987126›Full record

ArticleBMC health services research2025

Healthcare facility readiness and availability for hypertension and type 2 diabetes care in Puno, Peru: a cross-sectional survey of healthcare facilities.

Katherine E Lord, Parker K Acevedo, Lindsay J Underhill, Gonzalo Cuentas, Sonia Paredes, Juan C Mendoza, Percy Herrera, Victoria B Chou, Victor G Dávila-Román, Stella M Hartinger and 1 more

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Treatment of Hypertensive Crisis in Primary Care Health Facilities in Peru, 2019-2024.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Article
  4. Article
  5. Article
  6. ANDES trial and integration of the HEARTS model in Puno, Peru.Revista panamericana de salud publica = Pan American journal of public health · 2025
    Article
  7. 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

11 authors.

Katherine E LordDivision of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E Monument St, Room 555, Baltimore, MD, USA.
Parker K AcevedoDivision of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E Monument St, Room 555, Baltimore, MD, USA.
Lindsay J UnderhillDepartment of Medicine, Institute for Public Health and Cardiovascular Division, Global Health Center, Washington University in St. Louis, St. Louis, MO, USA.
Gonzalo CuentasHospital Base III, EsSalud, Puno, Perú.
Sonia ParedesDirección Regional de Salud, Ministerio de Salud, Puno, Perú.
Juan C MendozaDirección Regional de Salud, Ministerio de Salud, Puno, Perú.
Percy HerreraDirección de Prevención y Control de Enfermedades No Transmisibles, Ministerio de Salud, Raras y Huerfanas, Lima, Perú.
Victoria B ChouDepartment of International Health, Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Victor G Dávila-RománDepartment of Medicine, Institute for Public Health and Cardiovascular Division, Global Health Center, Washington University in St. Louis, St. Louis, MO, USA.
Stella M HartingerFacultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Perú.
William CheckleyDivision of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E Monument St, Room 555, Baltimore, MD, USA. wcheckl1@jhmi.edu.

Funding

Addressing HyperteNsion and Diabetes through Community-Engaged Systems in Puno Peru (ANDES study)UH3HL152371 · NHLBI · UNIVERSIDAD PERUANA CAYETANO HEREDIA · PI William Checkley, Victor G. Davila-Roman · 2023 to 2026
$4.9M
Addressing HyperteNsion and Diabetes through Community-Engaged Systems in Puno, Peru (ANDES study)UG3HL152371 · NHLBI · UNIVERSIDAD PERUANA CAYETANO HEREDIA · PI CHECKLEY, WILLIAM, DAVILA-ROMAN, VICTOR G. · 2020 to 2021
$1.3M
Research training in chronic, non-communicable respiratory diseases in PeruD43TW011502 · FIC · JOHNS HOPKINS UNIVERSITY · PI CHECKLEY, WILLIAM, HARTINGER, STELLA MARIA · 2019 to 2023
$1.2M
FIC NIH HHS D43 TW011502FIC NIH HHS D43TW011502NHLBI NIH HHS UG3 HL152371NHLBI NIH HHS UH3 HL152371
6 · The paper itself

Abstract

backgroundNon-communicable diseases are a rapidly growing cause of mortality and morbidity in Peru, accounting for 73% of total deaths. There is limited research on health system readiness to manage this rising burden. Our study characterized the readiness of healthcare facilities to manage patients with hypertension and/or type 2 diabetes (T2D) across two public healthcare systems in Puno, a largely rural and low-income department in Peru.

methodsWe adapted the World Health Organization Service Availability and Readiness Assessment to characterize resources and services for hypertension and T2D care. We administered the survey to personnel at healthcare facilities in Puno. Service readiness scores were calculated based on tracer items necessary for hypertension or T2D care. Facilities with ≥ 70% of tracer items were considered ready to manage each disease.

resultsBetween June 2022 and June 2023, we surveyed 85% (414/488) of Puno's government-run healthcare facilities. Overall, only 28% and 29% were considered ready to manage hypertension and T2D, respectively. Despite larger annual cumulative case volumes at health posts and low-level health centers, lower-level facilities were significantly less likely to be ready to manage hypertension (OR = 0.20, 95% CI 0.11-0.36) or T2D (OR = 0.03, 95% CI 0.01-0.06). Areas of concern included an overreliance on aneroid blood pressure monitors, their infrequent calibration, and limited hemoglobin A1c and urine testing. Additionally, only 66% and 48% of providers self-reported that they could diagnose hypertension and T2D, respectively. There was also low essential medication availability including insulin (7.2%) and fixed-dose combinations (0.5%) and a scarcity of trained healthcare professionals, particularly community health workers at health posts (49.8% had none).

conclusionsHealthcare facilities were largely unprepared to manage hypertension and T2D, underscoring the critical need for health system strengthening to address disparities in non-communicable disease management across Puno.

Indexed as

Diabetes Mellitus, Type 2Health FacilitiesHealth Services AccessibilityHypertensionCross-Sectional StudiesFemaleHumansMalePeruDiabetesHealthcare facilityHypertensionPeruService readiness

Identifiers

PMID39987126
PMCPMC11846368

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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.