Effects of ethnicity on the quality of family planning services in Lima, Peru

Materials and methods In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo (mixed ethnoracial ancestry) profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian FP clinical guidelines. Providers and data analysts were kept blinded to the allocation. The trial was registered with ClinicalTrials.gov NCT01885858.