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Objectives.: To contextualize sexual initiation and barriers to the use of contraceptives by adolescents as well as the acquisition of adequate knowledge regarding contraception and sexually transmitted diseases., Materials and Methods.: This quantitative and qualitative study evaluated adolescents living in three cities with high pregnancy rates in Peru: Iquitos, Huamanga, and Lima. Subjects were invited to participate in the study via Facebook. Questionnaires were then used to select adolescents who met the inclusion criteria, and interviews were conducted to obtain detailed data regarding the study topic., Results.: A total of 33 women and 23 men aged 18 to 19 years participated in the study. The age of onset of sexual activity ranged from 14 to 16 years; the main reasons for sexual initiation were sexual desire among men and pressure from the partner among women; in most cases, the sexual partner was an occasional companion for men and a boyfriend for women. The barriers related to the use of contraceptives were the financial stability of the partner, responsibility of the female partner when using contraceptives, limited capacity to negotiate choices, fear of abandonment by the male partner for demanding the use of contraceptives, and the reduction of sexual sensitivity with the use of condoms., Conclusions.: The barriers identified in this study limit the use of contraceptives and indicate the need to develop specific strategies to strengthen the interpersonal skills of adolescents and provide accurate information about the risks of unprotected sex.

This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.

This article describes the concept of global health security and its development over time. It emphasizes the need to control challenges against global health such as those produced by biologic agents both natural and intentional. It presents world initiatives that have developed during the last two decades and the contribution of Peru to the Global Health Security Agenda (GHSA) and the Monitoring and Evaluation Framework. In order to accelerate the implementation of the International Health Regulations Peru has played an important role to accelerate the implementation of International Health Regulations (IHR), participating with a group of countries, World Health Organization (WHO), and GHSA in the creation of the Joint External Evaluation Tool (JEE).

Objectives: Describe the availability of psychotropic medications for the treatment of mental disorders in the health care facilities of the Ministry of Health of Peru., Materials and Methods: Monthly inventory reports of the availability and consumption of medications in facilities of the Ministry of Health during 2011 were analyzed. Using a cross sectional design, the availability of seven classes of psychotropic medications was determined. Also, the level of care of the establishments and the level of decisional autonomy to purchase medications were determined., Results: Anti-anxiety medications were available in health facilities of all levels of care. Antidepressants and antipsychotics were available in about two thirds of hospitals and in less than 20% of health centers and small health clinics. The other four classes of psychotropic medications (lithium, hypnotics and sedatives, psychostimulants/ADHD, and anti-dementia drugs) were only available in hospitals and not in health centers and small health clinics. 5% of hospitals had a sufficient supply to meet the demand for the year., Conclusions: There is a significant gap in the availability of psychotropic medications in the health care facilities of the Ministry of Health of Peru. This was observed both in hospitals and in primary care facilities. Actions are needed in health policy and management, including more funding and greater mental health training for staff in primary care, among other initiatives.

Objectives: This study evaluated the association between having been a victim of physical violence during childhood and the acceptability, in later life, towards the use of physical punishment in child rearing., Materials and Methods: A secondary analysis was conducted of a study on violence in 6,399 people over 14 years of age living in the cities of Lima, Callao, Maynas, Arequipa, Cusco, Trujillo and Huamanga. Univariate and multivariate logistic regression models were used to estimate statistical associations., Results: The acceptability of the use of physical punishment in child rearing is higher in people who were victims of physical abuse during childhood compared with non-victimized people (OR = 1.8; 95% CI: 1.5-2 1; p <0.001) after adjusting for potential confounders., Conclusions: People exposed to physical violence during childhood are more likely to accept or justify violence in adulthood, which could help maintain this child rearing practice from one generation to the next. Initiatives aimed at preventing the use of physical punishment in child rearing should be implemented to reduce the tendency to reproduce the action of violence by victimized people.

Objectives: To determine the lifetime prevalence of 18 mental disorders and to establish the pattern that those disorders have with the age of onset in five cities of Peru., Materials and Methods: As part of the World Mental Health Survey, the study in Peru followed a probabilistic multistage sample of people between 18 and 65 years old in Lima, Chiclayo, Arequipa, Huancayo and Iquitos. The desktop version of the Composite International Diagnostic Interview (CIDI) was administered., Results: The lifetime prevalence of at least one mental disorder was 29% (SE 1.2), and the prevalence of at least two or three was 10.5% (SE 0.7) and 4% (SE 0.4), respectively. Anxiety disorders were more common with 14.9% (SE 0.9) prevalence, followed by mood disorders with 8.2% (SE 0.5), impulse control disorders with 8.1% (SE 0.8), and substance use disorders (5.8%; SE 0.3). The age of onset was earlier for anxiety disorders (15 years old) and for impulse control disorders (20 years old). Younger respondents were more likely to have a mental disorder., Conclusions: Almost a third of the adult population of five cities in Peru has had some psychiatric disorder at a given time in their lives, and comorbidity is common. Most disorders begin before age 30.

Objectives: To estimate the annual prevalence of eighteen mental disorders, their sociodemographic correlates and the frequency of use of mental health services by individuals aged 18 to 65 in five cities of Peru., Materials and Methods: The World Mental Health Survey in Peru used the Composite International Diagnostic Interview, which provides diagnoses according to DSM-IV and ICD-10 criteria. It was performed with a multistage probabilistic sample in Lima, Arequipa, Huancayo, Iquitos and Chiclayo between July 2004 and December 2005., Results: The prevalence of mental disorders in the last twelve months was 13.5%, the most frequent being anxiety (7.9%), mood (3.5%), impulse control (3.5%) and substance misuse (1.7%). The widowed, separated and divorced showed a greater risk of disorders in the last year than those who were married or partners living together. Only 32.8% of those who had severe mental health disorders in the last twelve months received any kind of treatment. Among those with moderate or mild disorders, 18.1% and 15.4% received treatment, respectively., Conclusions: More than 13 out of 100 Peruvians reported having a mental health disorder in the last year. The magnitude of mental health disorders and the gap in those receiving care highlights the urgent need to direct care and resources towards the detection and timely treatment of mental diseases in Peru.