Evidence map›Paper›PMID 41658230›Full record

ArticleBMJ public health2026

Characterising access to healthcare and the health status of women domestic workers in Peru: a respondent-driven sampling study.

Archna Gupta, Christopher Meaney, Karina M Romero, David Vera-Tudela, Maria Kathia Cardenas, María Sofía Cuba-Fuentes, Andrew D Pinto, Ayu Pinky Hapsari, Michael Anthony Rotondi, Janeth Tenorio-Mucha

Abstract read
In one paragraph

Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

10 authors.

Archna GuptaUpstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0001-5915-7609
Christopher MeaneyDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Karina M RomeroUniversidad Peruana Cayetano Heredia, Lima, Peru.
David Vera-TudelaUniversidad Peruana Cayetano Heredia, Lima, Peru.
Maria Kathia CardenasCRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima District, Peru.
María Sofía Cuba-FuentesCenter for Research in Primary Health Care, Universidad Peruana Cayetano Heredia, Lima, Peru.
Andrew D PintoUpstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.
Ayu Pinky HapsariUpstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.
Michael Anthony RotondiSchool of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
Janeth Tenorio-MuchaCRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima District, Peru.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Domestic workers (DWs) worldwide face precarious and informal working conditions, including unstable employment, extended hours and insufficient labour protections, impacting their health. This study examines the health and healthcare access of women DWs in Peru, focusing on differences related to formal and informal employment. Methods: This participatory action research surveyed women DWs in Lima, La Libertad and Piura, Peru, from September 2023 to March 2024 using respondent-driven sampling (RDS). We gathered sociodemographic, healthcare access and health status data and reported counts and percentages with RDS-II estimators (95% CI). We compared health status and healthcare access by formal and informal employment using bootstrap RDS methods. Results: The study analysed data from 456 DWs. Most were between 19 and 45 years old (60.0%, 95% CI 50.1% to 70.0%), resided in Lima (69.8%, 95% CI 57.5% to 82.0%) and self-identified as Mestizo (54.8%, 95% CI 45.0% to 64.7%). Most respondents were precariously employed as informal DWs (90.5%, 95% CI 87.5% to 93.6%). A higher percentage of informal workers reported difficulty obtaining workplace permission for healthcare visits (32.2%, 95% CI 21.3% to 43.1% vs 21.2%, 95% CI 4.3% to 28.2%; p=0.187) and spent over 100 PEN (US$28) out of pocket on medical visits in the past year (21.2%, 95% CI 14.1% to 28.4% versus 10.5%, 95% CI 0.0% to 32.5%; p=0.249). Despite access to public health insurance, a higher percentage of informal workers visited private healthcare facilities (14.4%, 95% CI 8.3% to 20.5%) than formal workers (4.7%, 95% CI 1.5% to 7.8%) (p=0.084). A higher percentage of informal workers reported a diagnosis of depression (9.7%, 95% CI 5.1% to 14.4% vs 1.6%, 95% CI 0.0% to 4.4%; p=0.052) and anxiety (12.3%, 95% CI 6.1% to 18.5% vs 3.5%, 95% CI 0.0% to 9.1%; p=0.322). Obesity (43.0%) and depressive symptoms (41.4%) were prevalent across the DW population, regardless of employment status. Conclusions: Informal employment among women DWs in Peru may be linked to greater health challenges and barriers to care, despite public health insurance coverage. Addressing these inequities requires stronger labour protections.

Indexed as

Health Services AccessibilityPublic HealthSociodemographic Factors

Identifiers

PMID41658230
PMCPMC12878187

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.