The document summarizes key findings from 34 qualitative interviews with pregnant women and community members in Carabayllo, Peru that identified several barriers to adequate prenatal care. Barriers included limited health facilities and personnel, serious economic burdens, low literacy and lack of educational opportunities, extremely poor living conditions, low nutrient intake, and lack of family/social support and psychosocial stress. The WARMI-SMS study aims to improve prenatal care experiences through culturally relevant text messaging providing health information to expecting mothers in the resource-poor community. Next steps include incorporating interview findings into text messages, conducting focus groups to develop the message format and content, and preparing an intervention proposal.

1. BRUNETTE, M. | UMASS LOWELL
DE LEON, M. | UMASS LOWELL
PAULINO, O. | UMASS LOWELL
RESULTS
A total of 34 key informant interviews were conducted in June and July, 2015. Our qualitative analyses revealed several
barriers to adequate prenatal care that potentially reduces the chances of healthier pregnancies for women in Carabayllo:
Limited numbers of health care facilities and trained personnel
“En el centro de salud … por paciente te atienden 10 minutos … tratan de acabar lo más rápido posible … no toman
atención a las preguntas que una paciente les hace”
"At the healthcare center…each patient is seen for 10 minutes… they try to finish as quickly as possible ... they do not pay
attention to the questions you make”
Serious economic burdens
“Tienes que buscar en mercado lo que es un poco cómodo … a veces no alcanza (…) tienes que pagar agua, tienes que
pagar luz, comprar gas, para todo”
" (At the grocerie store) You have to search for things that are a little inexpensive … salary goes to pay for water, electricity,
buy gas… for everything"
Low literacy levels
“¿Y hasta que año estudiaste?; gestante: “Hasta 4. Hasta que aprendí a firmar mi nombre.”
“Until which grade did you study?”; pregnant woman: “Until 4th grade… until I learned how write my signature”
Lack of access to educational opportunities
“Desde de que tenía los 16 años fui a trabajar, para estudiar, comprar mis útiles…Y de ahí a cuando mis padres ya no
podían hacerme estudiar … ya no pude estudiar.”
" I have worked since I was 16 years old so that I could attend school and buy my own school supplies… when my
parents could no longer support me … I could not continue.”
Extremely poor living conditions (access to safe water and sanitation services)
“De la vecina … me da agua y presta su baño”
“I get water from my neighbor, and she also allows me to use her bathroom”
Low nutrient intake
“cuando hay plata si puedes comer, variar tu comida… pero cuando no hay, tienes que comer lo que te dan”
“When there is money you can eat and vary the types of food… but when there is no money you eat what you can get”
Lack of family/social support and psychosocial stress
“el apoyo de mi familia ahorita si me preocupa un poco…mi mamá tiene a mi hermana menor y yo no la puedo preocupar”
“Support from my family worries me a little…my mother has to take care of my little sister and I can’t make her feel
overwhelmed”
METHODOLOGY
•! Through our very own semi-structured key informant interviews of pregnant women, their relatives and partners, community members,
and healthcare professionals in Carabayllo, we identified barriers and facilitators for adequate prenatal care among this vulnerable
population.
•! The US-Peru research team developed questions related to housing and living conditions, economic factors, employment conditions,
family/social support, educational factors, quality of health services, as well as individual health, nutrition, and prenatal cares practices
of expecting mothers. Questions regarding use of mobile devices and access to the Internet were also included
PROJECT SUMMARY: WARMI-SMS is a study anchored in the Community-Based Participatory Research
(CBPR) approach that aims to improve the prenatal care experiences among women in resource-poor
communities. Working hand in hand with healthcare workers in Carabayllo, a marginalized and socially
excluded district in the northern part of Lima, WARMI-SMS explores how to design an effective, culturally-
relevant text messaging system (SMS) to provide health information to expecting mothers.
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WE ANTICIPATE GAINING KNOWLEDGE ABOUT THE SOCIO-TECHNICAL PROCESSES THAT WOULD IMPEDE OR FACILITATE EFFECTIVE
SOLUTIONS WITHIN THE LARGER HEALTH IT ECOSYSTEM OF THESE IMPOVERISHED COMMUNITIES
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Carabayllo:
A marginal urban
area in Lima, PERU
PAGOTO, S. | UMASS MEDICAL SCHOOL
LEMON, S. | UMASS MEDICAL SCHOOL
BORG, A. | UMASS MEDICAL SCHOOL
CONTRERAS, C. | SOCIOS EN SALUD PERU
TINTAYA, C. | SOCIOS EN SALUD PERU
GONZALEZ, L. | SOCIOS EN SALUD PERU
Socios
en Salud
Conducting key informant interviews at
participant home (Carabayllo, July 2015)
First US-Perú research retreat
(Carabayllo, November 2014)
NEXT STEPS…
•! Incorporate results from this
assessment phase into a set
of text messages (SMS’s)
•! Conduct a series of focus
groups among pregnant
women to gather their
preferences for messages
format, content, frequency
and other human factors
aspects relevant to any
socio-technical
development.
•! Prepare/submit an
intervention proposal to NIH
Fogarty Program
Second US-Perú research retreat
(Socios en Salud Headquarters – Lima, July 2015)
Living conditions in Carabayllo, Lima
Living conditions in Carabayllo, Lima