Segregación ocupacional femenina: el pegamento que enmascara la discriminación salarial en una universidad colombiana / Female occupational segregation: the glue that masks wage discrimination in a public university in Colombia

Resumen Esta investigación tiene como objetivo capturar la segregación ocupacional y la discriminación salarial por género en la Universidad del Cauca, ubicada en el suroccidente colombiano, durante cuatro momentos en el tiempo (2005, 2010, 2015 y 2020). La metodología es cuantitativa e implementa en el primer caso el Índice de Karmel y MacLachlan (KM) y la descomposición de Kitagawa-Oaxaca-Blinder (KOB) en el segundo. Se utiliza información de datos panel en la descomposición KOB, lo que permite evaluar la evolución de la segregación en el tiempo. Las variables incluyen el género, el salario, la edad, los años de experiencia, el nivel de formación, los cargos administrativos, la unidad académica, entre otros. La información fue suministrada por la Vicerrectoría académica de la Universidad de forma totalmente anonimizada. Los resultados muestran evidencia de segregación ocupacional y discriminación salarial por género; a pesar de que en los últimos años ambas brechas se están cerrando levemente, el problema permanece. La segregación ocupacional ocurre aún en ocupaciones beta tradicionalmente ocupadas por las mujeres pese a la baja percepción de discriminación laboral por parte de las profesoras universitarias. En cuanto a las ocupaciones alfa, estas mantienen la hegemonía masculina. Las características observables hacen que existan diferencias en la modificación salarial entre profesores y profesoras, pero estas cada vez se hacen menos fuertes por el aumento en el nivel de formación y la disminución en el número de hijos e hijas. Existen factores discriminatorios no observados que mantienen la discriminación salarial femenina en respuesta a factores culturales arraigados en el patriarcado y tradicionalismo de la región donde se encuentra la universidad.

Abstract This research aims to capture occupational segregation and wage discrimination by gender in the University of Cauca, located in southwestern Colombia, during four periods (2005, 2010, 2015 y 2020). There are few studies in this direction, and the existing ones do not address it in depth, at least in emerging countries. In this sense, it is the first time it has been done for Colombian higher education institutions. The methodology is quantitative and it implements the Karmel and MacLachlan Index (KM) in the first case and the Kitagawa-Oaxaca-Blinder (KOB) decomposition in the second one. To deepen the analysis panel data information was used for the first time in the KOB decomposition for these issues, which allows evaluating the evolution of segregation over time. The variables analysed include gender, wage, age, years of experience, education level, administrative charges, and academic departments of origin, among others. The information used comes from the official data provided by the Administrative Office of the University of Cauca. This is characterized by being totally anonymous and by exclusively comprising full-time teachers, that is, those with an indefinite term contract. Temporal teachers and/or professors with a defined term contract are excluded, due to the volatility in the employment relationship, which would otherwise introduce noise into the analysis. In general, the information shows that alpha professions (better paid, with greater projection and public recognition) have been dominated in the last five years by professors; while beta professions (that is those with lower salaries, little projection and recognition) have been led by women. This preliminary result leads to consider that there is labor and/or wage segregation within this university. The estimates of the KM index showed, firstly, that all professions, both alpha and beta, have at least some segregation in the period analysed, since this is greater than zero. Second, segregation has been low and slightly decreasing over time for beta professions. In fact, it was 0.09 in 2005 and 0.072 in 2020. Third, for alpha professions, the index has been markedly increasing over time, which suggests that the proportion of female teachers who must change professions so that segregation from men was zero is increasing. Regarding wage discrimination, all the differences were negative, which shows that the average salaries of female teachers are lower than those of male teachers and therefore their difference is less than zero. Although the results are only statistically significant for the years 2011, 2014 and 2020, it can be highlighted that these differentials have been decreasing over time. In effect, it was -0.24 log-wage in 2005 and -0.051 log-wage in 2020. These results are partially in line with those obtained in the KM index. Occupational and salary segregation seems to have decreased slightly in recent years in this university, but it still exists. In the case of decomposition change, all the variations in the endowment are positive and significant but are characterized as decreasing, which indicates that changes in average wage differentials have been narrowing over time. The empirical evidence suggest that occupational segregation still occurs in beta professions traditionally occupied by women despite the low perception of job discrimination by university professors. As for alpha occupations, they maintain male hegemony. The observable characteristics mean that there are differences in the wage modification between male and female teachers, but this is becoming less strong due to the increase in the education level and the decrease in the number of children. There are unobserved discriminatory factors that maintain female wage discrimination in response to cultural factors rooted in the patriarchy and traditionalism of the region where the university is located.

Factores asociados al estigma en personas afectadas por tuberculosis en una región peruana de alto riesgo / Factors associated to stigma in people with tuberculosis from a high-risk region in Peru

Introducción: El estigma hacia los afectados por tuberculosis es un desafío importante para el control de la enfermedad. De ahí la necesidad de conocer los factores que lo desencadenan, ya que puede comprometer la adherencia al tratamiento y, por tanto, incremento de complicaciones y mortalidad. Objetivos: Determinar los factores asociados al estigma en personas afectadas por tuberculosis en una región de alto riesgo en el Perú. Métodos: Estudio correlacional en 110 pacientes tratados por tuberculosis. Los factores fueron la funcionalidad familiar medida con la escala de Apgar familiar; las características sociodemográficas y clínicas, los conocimientos sobre la enfermedad y la comunicación médico-paciente, a través de una encuesta. Para el estigma se utilizó la escala de Yang. En el análisis bivariado se utilizó la prueba de chi cuadrado. La relación entre variables se evaluó mediante la correlación de Pearson y la regresión lineal multivariada. Resultados: El nivel de estigma mostró un punto de corte (cutt off) ≥ 9 en 21,3 por ciento en tuberculosis sensible y 69,4 por ciento en tuberculosis multirresistente, con diferencias significativas (p = 0,000). El análisis de regresión lineal multivariado evidenció que el nivel bajo de conocimientos sobre la tuberculosis (ß = -0,32; p = 0,000), bajas puntuaciones en escala Apgar familiar (ß = -0,41; p = <0,000) y la baja comunicación médico-paciente (ß = -0,47; p = 0,000) se asociaron negativamente con estigma. Conclusiones: Se encontró un nivel alto de estigma relacionado con tuberculosis y una asociación negativa entre el estigma con el nivel de conocimientos sobre la enfermedad, la funcionalidad familiar y la comunicación con el médico.(AU)

Introduction: The stigma attached to people with tuberculosis is an important challenge posed to the control of this disease. Hence the need to know what factors trigger it, for they may affect adherence to treatment, increasing complications and mortality. Objectives: Determine the factors associated to stigma in people with tuberculosis from a high-risk region in Peru. Methods: A correlational study was conducted of 110 patients treated for tuberculosis. The factors analyzed were family function as gauged by the Family Apgar scale, sociodemographic and clinical characteristics, knowledge about the disease and doctor-patient communication as measured through a survey. Stigma was determined by Yang's scale. Bivariate analysis was based on the chi-square test, whereas the relationship between variables was evaluated by Pearson's correlation and multivariate linear regression. Results: The level of stigma showed a cut off value ≥ 9 in 21.3 percent in sensitive tuberculosis and 69.4 percent in multiresistant tuberculosis, with significant differences (p = 0.000). Multivariate linear regression analysis found that a low level of knowledge about tuberculosis (ß = -0.32; p = 0.000), low scores on the Family Apgar scale (ß = -0.41; p = <0.000) and poor doctor-patient communication (ß = -0.47; p = 0.000) were negatively associated to stigma. Conclusions: The study found a high level of stigma associated to tuberculosis, as well as a negative association between stigma and knowledge about the disease, family function and communication with the doctor(AU)

Determinantes del acceso a los servicios de salud y adherencia al tratamiento de la tuberculosis / Determinants of the access to health services and adherence to TB treatment

Introducción: El papel fundamental de un sistema de salud es responder a las necesidades de la población, lo cual implica desarrollar mecanismos que permitan una prestación integral, accesible y equitativa a sus servicios. Objetivos: Valorar las barreras de acceso a la atención de salud y la adherencia en pacientes con tuberculosis en una región de alta carga en el Perú. Métodos: Investigación de enfoque mixto, realizada en el periodo de enero a septiembre del 2018 en 120 pacientes con tuberculosis. Para el enfoque cuantitativo se realizó un estudio transversal analítico, donde se abordaron preguntas de acceso a servicios de salud utilizando el modelo de Tanahashi. La adherencia al tratamiento fue medida a través del test de Morisky-Green. Para el diseño cualitativo se utilizó la metodología de grupos focales con 30 pacientes para profundizar sus experiencias acerca de los determinantes de acceso. Resultados: La mayoría de las barreras se identificaron en las dimensiones: aceptabilidad, contacto y disponibilidad. Se encontró asociación entre la adherencia al tratamiento y los siguientes indicadores: el temor o vergüenza de atenderse en un servicio de salud, desconfianza con los equipos de salud, percepción de mala calidad de la atención, falta de conciencia de la enfermedad, efectos secundarios de los medicamentos el número y tamaño de las píldoras. Conclusiones: Los hallazgos del presente estudio sugieren la existencia de barreras contextuales y del sistema de salud que impiden el acceso a los pacientes con tuberculosis, y si estas no se tienen en consideración podrían dificultar la adherencia del tratamiento para tuberculosis. Sin embargo, conseguir actuar dentro de una lógica que privilegie una asistencia centrada en el paciente, considerando sus singularidades y autonomía frente al proceso terapéutico puede tornarse una tarea difícil para los servicios de salud donde la demanda supera los recursos y su estructura(AU)

Introduction: The fundamental role of a health system is to respond to the needs of the population, which involves developing mechanisms that enable a comprehensive, accessible and equitable delivery of its services. Objectives: Assess access barriers to health care and adherence in TB patients in a high-burden region of Peru. Methods: Mixed-approach research conducted in the period January to September 2018 in 120 TB patients. For the quantitative approach, an analytical cross-sectional study was conducted, where questions on access to health services were addressed using the Tanahashi model. Adherence to treatment was measured through the Morisky-Green test. For qualitative design, the focus group methodology with 30 patients was used to deepen in their experiences of access determinants. Results: Most barriers were identified in the following dimensions: acceptability, contact and availability. An association was found between adherence to treatment and the following indicators: the fear or shame of being attended in a health service, mistrust with health teams, perception of poor quality of care, lack of awareness of the disease, side effects of medications, the number and size of the pills. Conclusions: The findings of this study suggest contextual and health system barriers that prevent access to TB patients, and if these are not taken into account, they could hinder adherence to TB treatment. However, acting within a logic that favors patient-centered care, considering its uniqueness and autonomy from the therapeutic process can become a difficult task for health services where demand exceeds the resources and their structure(AU)