Browsing by Author "Verhoeven, Veronique"

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Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals
(2022) Neira Molina, Vivian Alejandra; Ortiz Segarra, José Ignacio; Vega Crespo, Bernardo José; Andrade Galarza, Andrés Fernando; Guerra Astudillo, Gabriela; Ortiz Mejía, José Stalin; Flores Salinas, María Antonieta; Mora Bravo, Lorena Viviana; Verhoeven, Veronique; Gama, Ana; Dias, Sonia; Verberckmoes, Bo; Vermandere, Heleen; Michelsen, Kristien; Degomme, Olivier
Background: Cervical cancer screening is a cost-effective method responsible for reducing cervical cancer-related mortality by 70% in countries that have achieved high coverage through nationwide screening strategies. However, there are disparities in access to screening. In Ecuador, although cervical cancer is the second most common cancer in women, only 58.4% of women of reproductive age have ever been screened for cervical cancer. Methodology: A qualitative study was performed to understand the current barriers to screening and to identify strategies that could increase uptake in Azuay province, Ecuador. Seven focus group discussions (FGDs) were conducted with under-screened women and health professionals (HPs). The FGDs were recorded and transcribed. Content analysis was done using the socio-ecological framework to categorize and analyse the data. Results: Overall, 28 women and 27 HPs participated in the study. The two groups perceived different barriers to cervical cancer screening. The HPs considered barriers to be mainly at the policy level (lack of a structured screening plan; lack of health promotion) and the individual level (lack of risk perception; personal beliefs). The women identified barriers mainly at organizational level, such as long waiting times, lack of access to health centres, and inadequate patient–physician communication. Both groups mentioned facilitators at policy level, such as national campaigns promoting cervical cancer screening, and at community and individual level, including health literacy and women’s empowerment. Conclusions: The women considered access to health services the main barrier to screening, while the HPs identified a lack of investment in screening programmes and cultural patterns at the community level as major obstacles. To take an integrated approach to cervical cancer prevention, the perspectives of both groups should be taken into account. Additionally, new strategies and technologies, such as self-administered human papillomavirus (HPV) testing and community participation, should be implemented to increase access to cervical cancer screening
Intelligent System to Provide Support in the Analysis of Colposcopy Images Based on Artificial Vision and Deep Learning: A First Approach for Rural Environments in Ecuador
(Springer, 2023) Loja Morocho, Andres Fernando; Robles Bykbaev, Vladimir; Verhoeven, Veronique; Vega Crespo, Bernardo José; Rocano Portoviejo, Jessica Noemi
Perceptions of Ecuadorian indigenous healers on their relationship with the formal health care system: barriers and opportunities
(2021) Bautista Valarezo, Estefanía; Duque, Víctor; Verhoeven, Veronique; Mejia Chicaiza, Jorge Victoriano; Hendrickx, Kristin; Maldonado Rengel, Ruth Elizabeth; Michels, Nele RM
The new paradigm of intercultural policies focuses on rethinking the common public culture. In Ecuador, the “Buen Vivir” plan seeks to incorporate the ancestral medical knowledge, experience and beliefs of traditional healers into the formal health services. This study explores views on the formal health system from the perspective of the healers belonging to the Kichwa and Shuar ethnicities in the South of Ecuador.
Rol del auto muestreo para el diagnóstico del virus del papiloma humano
(Universidad Técnica de Ambato, 2022) Viñansaca Atancuri, Lourdes Catalina; Verhoeven, Veronique; Parrón Carreño, Tesifón; Morales Díaz, María Angélica; Dávila Sacoto, Santiago Arturo; Ortiz Segarra, José Ignacio; Mejía Chicaiza, Jorge Victoriano; López Sigüenza, Diana; Espinoza González, María Elena; Neira Molina, Vivian Alejandra; Vega Crespo, Bernardo José; Mora Bravo, Lorena Viviana; Vega Crespo, Bernardo José
Introducción: Durante el año 2020, se reportaron 604127 nuevos casos de cáncer de cuello uterino (CC) y 341831 muertes por ésta causa a nivel mundial. En el mismo año, se identificaron 1534 nuevos casos y 813 muertes por CC en Ecuador. El programa nacional de prevención del CC, centra sus esfuerzos principalmente en la citología vaginal y la vacunación para adolescentes en el sistema de atención primaría, sin embargo, solamente el 58,4% de las mujeres en edad reproductiva se ha realizado una prueba de tamizaje a lo largo de su vida en el país. Se han identificado diferentes barreras para el acceso al tamizaje del CC, entre ellas: tiempos de espera prolongados, dolor, vergüenza, desconocimiento y falta de percepción de riesgo entre las más importantes. Las técnicas de auto muestreo, han incrementado las coberturas y han alcanzando a mujeres que tradicionalmente no accedían a las pruebas de detección precoz. Objetivos: Identificar la aceptabilidad de las pruebas de auto muestreo en mujeres de zona rural. Comparar la sensibilidad, especificidad de las pruebas de orina y auto toma con la toma tradicional con espéculo, para el diagnostico de el VPH. Método: La presenta investigación forma parte del proyecto “Haciendo accesible la detección del cáncer de cuello uterino a través del auto muestreo: un paso hacia la igualdad en salud mediante el empoderamiento de las mujeres en un contexto intercultural, financiado por el VLIR UOS” (CAMIE). En su fase cualitativa realizo un estudio, fenomenológico, mediante grupos focales de discusión (GFD) con mujeres de zona rural de la parroquial El Valle del cantón Cuenca. Los grupos focales fueron grabados y trascritos, su análisis se realizó utilizando en programa Nvivo. En su fase cuantitativa, se realizó una invitación a participar en el estudio, a las mujeres que acudían al servicio de salud, mismas que luego de firmar el consentimiento informado, procedieron a la recolección de orina, muestreo por auto toma y toma tradicional con espéculo. Las muestras fueron procesadas en el departamento de biología molecular de la Universidad de Cuenca. Principales resultados: Cualitativos: Un total de 47 mujeres participaron en 7 GFD. La participantes consideran la técnica de toma de Papanicolaou es dolorosa, invasiva y vergonzosa; en tanto que los métodos de auto toma, tienen ventajas como la privacidad, ahorran tiempo de espera, son más cómodos y menos dolorosos. Cuantitativos: Se procesaron las muestras de orina, auto toma y toma normal para el diagnóstico de VPH de 120 participantes. La toma con espéculo, fue usada como prueba de oro. La sensibilidad y especificidad fue de 89% y 95% para la prueba de orina; 94% y 92% para la prueba de auto toma. Conclusiones: Las pruebas de auto muestreo, constituyen una estrategia válida y aceptada para el tamizaje primario del VPH a nivel comunitario. La aplicación de estas técnicas sumadas a estrategias educativas permitirá romper barreras en el acceso a la detección oportuna del CC
Seroprevalence of sars-cov-2 infection and adherence to preventive measures in cuenca, ecuador, october 2020, a cross-sectional study
(2021) Colebunders, Robert; Acurio Páez, Fausto David; Vega Crespo, Bernardo José; Orellana Vintimilla, Daniel Augusto; Charry Ramírez, José Ricardo; Gómez, Andrea; Obimpeh, Michael; Verhoeven, Veronique
A door-to-door survey was organised in Cuenca, Ecuador, to determine the prevalence ofCOVID-19 infection and adherence of the population to COVID-19 preventive measures. A total of2457 persons participated in the study; 584 (23.7%) reported having experienced at least one flu-likesymptom since the onset of the pandemic. The maximum SARS-CoV-2 seroprevalence in Cuenca was13.2% (CI: 12–14.6%) (IgM or IgG positive). Considering PCR confirmed infections, the prevalencewas 11% (CI: 10–12.4%). There was no significant difference in seroprevalence between rural andurban areas. Participants aged 35–49 years old, living with a COVID-19 positive person, at leastsix people in a household, physical contact with someone outside the household, a contact with aperson outside the home with flu-like symptoms, using public transport, and not having enoughresources for living, significantly increased the odds for SARS-CoV-2 seropositivity. Overall, therewas good adherence to COVID-19 preventive measures. Having known someone who tested positivefor COVID-19, having a primary or secondary level of education, and having enough resources forliving, significantly increased the odds for higher adherence. In conclusion, despite good overalladherence of the population of Cuenca with COVID-19 preventive measures, our study suggests highongoing COVID-19 transmission in Cuenca, particularly in certain parishes. Prevention should notonly focus on behavioural change, but on intensified testing strategies in demographical risk groups
Towards an indigenous definition of health: an explorative study to understand the indigenous ecuadorian people's health and illness concepts
(2020) Bautista Valarezo, Maria Noela; Duque, Víctor; Verdugo Sanchez, Adriana Elizabeth; Davalos Batallas, Viviana Del carmen; Nele , Michels; Hendrickx, Kristin; Verhoeven, Veronique
Abstract Backgrounds An intercultural society facilitates equitable and respectful interrelations. Knowing and understanding each other’s sociocultural and linguitic contexts is a prerequisite for an intercultural society. This study explores the concepts of health and illness among healers of indigenous ethnicities in Southern Ecuador. Methods A qualitative observational study with eleven focus groups was conducted in three locations in Southern Ecuador; a total of 110 participants the Shuar, Kichwa and Mestizo ethnic groups were included. A phenomenological and hermeneutic analysis was conducted. Results Fourteen main subtopics around of two predefined themes, i.e., “Health” and “Illness” were identified: 1) four bodies, 2) religiosity, 3) health as a good diet, 4) health as god’s blessing or a gift, 5) health as balance/ harmony, 6) health as community and social welfare, 7) health as potentiality or a skill, 8) health as peacefulness, 9) heath as individual will, 10) illness as an imbalance, 11) illness as bad energy, 12) illness as a bad diet, 13) illness as suffering or worry, and 14) illness from God, Nature and People illness. By analysing all the topics’ and subtopics’ narratives, a health and illness definition was developed. The principal evidence for this new framework is the presence of interculturality as a horizontal axis in health. The indigenous perspective of health and illness focus on a balance between 4 bodies: the physical, spiritual, social and mental bodies. Additionally, “good health” is obtained through of the good diet and balanced/harmony. Conclusion Indigenous healers in Southern Ecuador have views on health and illness that differ from the Western biomedical model of care. These different views must be recognized and valued in order to build an intercultural (health) system that empowers both ancestral and modern medical knowledge and healing.