Objetivos: Comparar indicadores materno-perinatales entre gestantes chilenas y peruanas en Santiagode Chile entre enero y julio del 2017. Materiales y métodos: Estudio transversal analítico en 1578 chilenasy 318 peruanas atendidas en un hospital clínico de Santiago. Se realizó un análisis comparativo delas variables materno-perinatales por nacionalidad. Se realizaron modelos logísticos crudos y ajustadoscon sus intervalos de confianza al 95% (IC 95%). Resultados: Las gestantes peruanas residían en promedio5,7 años en Chile, tenían más edad (28,1 ± 6,5 vs. 26,6 ± 6,5 años), menos desocupación (52,3% vs.60,6%), más probabilidad de ingreso tardío al control prenatal (CP) (OR: 2,17, IC 95%: 1,69-2,78) y detener anemia (OR: 3,45, IC 95%: 2,13-5,56) asociada al ingreso tardío a CP (OR ajustado: 0,43, IC95%:0,33-0,56). Las gestantes chilenas tuvieron una mayor probabilidad de obesidad al ingreso al CP (OR:2,48 IC 95%: 1,81-3,41) y al parto (OR: 2,03, 1,57-2,62). Así como, de diabetes gestacional (DG) (OR:2,12, IC 95%: 1,24-3,61), parto prematuro (OR: 2,82, IC 95%: 1,59-5,01) e hijos con bajo peso al nacer(BPN) (OR: 3,10, IC 95%: 1,51-6,33). En el modelo ajustado la obesidad se asoció en forma independientea la DG (OR ajustado: 3,8, IC 95%: 2,44-6,18) y al BPN (OR ajustado: 3,34, IC95%: 2,33-4,85). Conclusiones:El efecto del migrante sano se observa en gestantes inmigrantes peruanas, principalmente enresultados perinatales. Es necesario favorecer el ingreso precoz a la atención prenatal, prevenir la anemiay la obesidad, para evitar resultados materno-perinatales adversos en esta población.

Introduction The COVID- 19 pandemic discontinued sexual and reproductive health care in Chile and the world. The national focus on hospital care led primary care teams to respond in natural and diverse ways. Understanding the factors involved in this process may improve future responses from the judgment of good practices. Therefore, this study aimed to identify and systematize sexual and reproductive health initiatives raised by primary care teams in response to the COVID- 19 pandemic in Chile. Methods We systematically evaluated initiatives and practices in sexual and reproductive health in prima-ry care between June 2020 and November 2021. This study was developed in three methodological phases: a review of documents, a collection of experiences through an electronic instrument sent to the 29 health services in Chile, and in-depth interviews. According to best practice criteria, mapping and characterizing the initiatives and critical discourse analysis of narratives and interviews were carried out. Results Forty-one initiatives from 19 health services were identified, mainly from the South Central macro zone and urban areas. In these areas, care was recognized. These practices were relevant, aligned with their objectives, rapidly implemented, and used novel strategies through new technologies. However, these initiatives had little intercultural relevance or evaluation. Perceived success was related to motivation, leadership, and institutional and community resilience. The adaptability of initiatives emerged as a new need and criterion of analysis. Conclusion The lessons learned from these initiatives invite us to consider health care teams' mental health, their relationship with the community, the use of new technologies, the evaluation of practices considering satisfaction, cross- cutting approaches, and their adaptability. In all, these aspects may improve primary care response in sexual and reproductive health to new crises.

Introduction Healthcare systems are developed in imperfect scenarios, in which there are constant failures (uncertainty, information asymmetry, agency relationship problem, and supply-induced demand). These failures, based on the imperfection of the sector, determine the relationships and incentives between the actors. It is within this context that payment mechanisms regulate aspects of the system behavior and incentives, acting as instruments for the purchasing of health care from providers, mediated by health insurance on behalf of users. Objective To characterize the basic elements of most frequent payment mechanisms to help providers in their relationship with payers. Methods A review of the evidence was conducted in PubMed, Google, Google Scholar, and strategic snowball selection. Payment mechanisms consist of three classical microeconomics variables, fixed or variable: price, quantity, and expense. Time dimensions are used to analyze their attributes and effects. Different mechanisms emerge from the combination of these variables. Results Among the most used are: Fee-For-Service, Global Budget, Bundled Payments, Diagnosis-Related Groups, Per-capita, Performance Pay, and Risk-Sharing Agreements. A fourth has also gained importance: Financial Risk. Conclusions Payment mechanisms are essential to link health efforts with clinical practice. They make it possible to regulate relationships between insurers, providers, and users, which, depending on the architecture of the mechanism, can become beneficial or hinder the fulfillment of the objectives of the health system.

Objetivo. Se pretende explorar el impacto de las inequidades de género en la salud sexual y reproductiva, con foco principal en la salud materna y perinatal. Método. Se realizó una revisión narrativa de categoría experto, orientada a la revisión temática con enfoque problematizador. Se llevó a cabo una búsqueda principal en las bases de datos Pubmed y Scielo, con una búsqueda secundaria en Google Scholar y adición por técnica de bola de nieve. Se llevó a cabo un análisis con relación a categorías de impacto, según dimensiones ex priori, y con base en un enfoque tipo hermenéutico interpretativo. Resultados. Del análisis se desprendieron cuatro categorías que dan cuenta de respuestas generales al objetivo de la revisión: garantías de derechos reproductivos; discriminación nutricional de género e impacto materno-perinatal; subvaloración social explícita e impacto perinatal; y violencia de género y riesgo reproductivo y perinatal. Conclusiones. La salud de las mujeres, así como su salud reproductiva, materna y perinatal, se encuentran permeadas por la condición de género, generando un impacto en el desarrollo pleno de los derechos sexuales y reproductivos, como al acceso a calidad de vida que propenda a mantener su potencial saludable. Por tanto, los indicadores que expresan la calidad de dicha salud requieren incorporación prioritaria de la transversalización de enfoque de género y derechos.