Indigenous communities face the greatest gaps in access to healthcare and social protection, especially in rural and remote areas of the Amazon. Since 2015, I have led the Mamás del Río (Mothers of the River) program, which initially focused on improving maternal and child health by empowering Community Health Workers (CHWs) with information and communication technologies. Currently, the program has evolved into a platform called Ikara, which means "indigenous healing song." This platform seeks to increase knowledge in Indigenous, rural, and Amazonian health in diverse areas such as mental health, sexual and reproductive health, community empowerment, climate change, and environmental pollution.

To design Mothers of the River, we conducted research to understand the cultural practices surrounding pregnancy, childbirth, and newborn care among the Kukama-Kukamiria women of Loreto. We found that home births are extremely common, that women value and prefer home births because they are intimate, familiar, and affordable, and that they also face cultural and structural barriers to accessing prenatal care and childbirth in health facilities. This research helped design culturally relevant educational content adapted to the needs and realities of the communities.

This study was complemented by additional research that demonstrated the feasibility of using cell phones to collect health information by indigenous CHWs in Loreto. These studies laid the foundation for the structure of the Mamás del Río program, which is based on home visits conducted by CHWs using digital tablets.

Then, the Our Stories project developed an innovative educational strategy in which the communities themselves developed digital stories that reflected their life lessons, addressing sensitive issues such as the risks of failing to recognize maternal danger signs, lack of access to health facilities, the effects of teenage pregnancy, and domestic violence. Some of these stories were entered into tablets and shared by the CHWs during their home visits, achieving great acceptance among the population.

During the implementation of Mamás del Río (Mothers of the River), the COVID-19 pandemic occurred, and the CHWs exemplified resilience, expanding their roles and leading local responses with limited resources. The Hear My Voice project provided them with participatory tools such as Photovoice, which helped them document challenges and solutions through the use of photography. This allowed the CHWs to raise their voices in front of public policymakers.

Finally, in a study evaluating the impact of the Mamás del Río program in Loreto, we analyzed how the program impacted essential newborn care practices during home births. We observed that almost all key indicators related to thermal care of the baby, breastfeeding, and umbilical cord care improved significantly, and these gains were maintained even during the COVID-19 pandemic. Furthermore, more women began choosing to give birth in health facilities.

We saw Mamás del Río grow and expand to the border with Colombia, with the Mamás de la Frontera (Mothers of the Board) program operating in 38 communities in four districts on the Colombian-Peruvian border along the Putumayo River. In this program, the CHWs work to promote not only health but also social protection for the communities. The CHWs improve maternal and child health, vaccination, access to contraception, national identity documents, and government social programs such as JUNTOS. They also promote the population's health-seeking efforts at fixed health facilities and mobile social action platforms, which are boats from the Ministry of Development and Social Inclusion that transport various Peruvian government services. At Ikara, we have generated new lines of work that allow us to identify the most effective strategies to prevent teenage pregnancy, understand the mental health of indigenous women, and empower communities. Through these interventions, we seek not only to reduce health inequities, but also to strengthen local capacities and promote a more inclusive and culturally adapted care model.

The epidemiology of infectious diseases seeks to understand how infections spread, who is most vulnerable, and what measures can be taken to prevent their transmission. In this field, I have conducted pioneering research that helps us better understand diseases such as chlamydia, human papillomavirus (HPV), and human T-cell lymphotropic virus (HTLV).

At the University of Washington, we conducted a study that determined that pregnant women infected with Chlamydia trachomatis have an increased risk of premature birth and premature rupture of membranes, highlighting the importance of screening and treatment for this infection during pregnancy to prevent maternal and neonatal morbidity.

In Ucayali, in the Peruvian Amazon, we studied the relationship between HTLV and HPV in Shipibo-Konibo women, finding a high prevalence of both viruses and underscoring the need for prevention and control programs for these infections. Furthermore, the study revealed that women with HTLV had a higher prevalence of HPV, meaning the two viruses were associated, emphasizing the importance of education and screening in these communities.

In Lima, we investigated HPV prevalence in female sex workers and conducted a study evaluating an alternative HPV vaccination schedule in this population. We also investigated HPV prevalence among men who have sex with men (MSM), finding high infection rates, especially among those living with HIV. These findings highlight the urgent need for prevention interventions such as vaccination.

Dedicating attention to the epidemiology of infectious diseases has improved our understanding and identified the best prevention strategies for these diseases, reminding us of the importance of equitable access to health care.

Technology has transformed public health, so we explored how to use the internet and mobile phones to prevent HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) in Peru, at a time when this was an innovative approach to reaching this population.

Imagine Juan, a young man who spends much of his time online. He belongs to a population at high risk for HIV. My team and I saw an opportunity in this challenge, using ads in the same digital spaces Juan used to reach him with prevention messages and offer free HIV and syphilis testing. These ads attracted many users like Juan, and while not all of them went to clinics to get tested, those who did discovered conditions that needed immediate attention, such as HIV and syphilis. With this research, we demonstrate that the internet can connect hard-to-reach populations with necessary health services.

Additionally, we designed motivational videos that addressed the emotional and psychological barriers many men face when considering HIV testing, leading more MSM to express their intention to get tested and attend clinics. An online survey revealed that fear and misinformation were the main barriers. Based on this knowledge, specific interventions were designed to reduce fear and increase awareness about the importance of early HIV diagnosis. To design these interventions, we conducted focus groups that helped create effective messages that ensured the confidentiality and safety of testing and avoided stigmatization.

Through this research, we have demonstrated how ICTs can transform HIV and STI prevention, making public health more accessible and effective for those who need it most. Thanks to these innovative strategies, people like Juan gained greater access to tools to protect their health.

Informatics plays an essential role in improving public health worldwide. Over the years, I have worked on several projects that seek to train professionals from different fields to address global health challenges more effectively, using technology and data. Initiatives such as the QUIPU Center and the Kuskaya Program have been key in this process.

With the QUIPU Center, we conducted a pioneering assessment of health informatics training needs in Latin America. We identified key training areas such as mobile health, which is medical and public health practices supported by mobile devices, information security, and how to represent data in an understandable way. This assessment allowed us to create a curriculum tailored to the needs of the region and organize the first International Expert Workshop on Biomedical Informatics in March 2010, where experiences and knowledge were shared with professionals from across Latin America.

The Kuskaya Program, developed in partnership with the University of Washington from 2014 to 2018, had an innovative approach. We trained 33 fellows from Peru and the United States, many of whom came from disciplines outside of health, such as engineering, architecture, or computer science. The program taught researchers to work together to solve public health and global health problems collaboratively, using technological tools. This interdisciplinary approach has served as a model for other global health training programs.

As a result of these efforts, we were able to institutionalize the first master's and diploma program in biomedical informatics at the Cayetano Heredia University of Peru. This program has trained professionals from several countries in the region, preparing new leaders in global health and demonstrating the importance of continuing education in this field.

Cervical cancer is the leading cause of cancer death in women in Peru. Research in this field seeks to identify the burden of this disease in different population groups and save lives. Through several studies, I have contributed to a better understanding of this problem and proposed accessible and effective solutions.

One of my main efforts has been to analyze inequities in cervical cancer care among Indigenous Peruvian women. This study revealed that rural women, especially those who speak Indigenous languages, face significant barriers to accessing early detection testing and specialized treatment, underscoring the need for inclusive policies and equitable access to health services.

We also explored the psychosocial barriers faced by cancer survivors in the Andes, identifying individual, interpersonal, and institutional challenges that limit access to quality care, highlighting the importance of patient-centered policies.

Additionally, we have assessed the burden of human papillomavirus (HPV) infection in Indigenous women in Ucayali through the AINBO study, and in Lima, we have analyzed this burden in sex workers through the Girasol study. This study showed that 7 out of 10 sex workers had HPV, and almost half had high-risk types, reinforcing the urgency of vaccination campaigns and early screening. In this particularly vulnerable group, we evaluated an alternative HPV vaccination schedule and found that it works just as well as the traditional one and can be administered during routine medical visits, protecting more women. These efforts, along with our participation in a Lancet review where we described the incidence, mortality, survival, and consequences of breast and cervical cancer at the global and regional levels, reflect our commitment to addressing disparities and promoting cervical cancer prevention, saving lives and empowering the most vulnerable communities.