Determinantes socioculturales asociados a la neumonía en Puno, Perú: estudio cualitativo Sociocultural determinants associated to pneumonia in Puno, Peru: a qualitative study

Objective: To identify the sociocultural determinants of pneumonia through the perception of health workers and community in Puno, Peru. Methods: From June 8 to 11, 2009, we applied qualitative techniques including focus groups in administrative workers of the Regional Health Directorate of Puno, healthcare workers from a public hospital of the province of Juliaca, Puno, and schoolchildren between 8 and 9 years from a public school in the province of Juliaca. Projective techniques were also applied to the schoolchildren, who through free drawing expressed their feelings, opinions, reasons for behaviors and attitudes of both children and their parents, related to pneumonia. Focus groups were recorded and later transcribed; we also interviewed two relatives of a girl who died from pneumonia in the community of Uros, Puno, using a questionaire guide. Results: The determinants associated with pneumonia that were identified are lack of leadership and coordination of health workers in the care of patients with pneumonia, delayed in care and payments for health services, the influence of the mother-in-law who decides what to do with children with pneumonia, parents who medicate their children, children that stay alone at home uintil late at night and a delay in the attendance to the hospital; health workers recognized that attention in health services is limited and not of quality. Conclusions: The sociocultural determinants are lack of leadership and coordination of health teams, delays in care and payments for services, the mother-in law influence in decision making, self-medication and going to the hospital when the child is seriously ill.