Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia

Abstract Introduction Maternal morbidity and mortality rates associated with perinatal care remain a significant public health concern. Rural populations from low and middle-income countries have multiple barriers to access that contribute to a lack of adherence to prenatal care, and high rates of m...

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Main Authors: María Fernanda Escobar (Author), María Paula Echavarria (Author), Hilda Vasquez (Author), Daniela Nasner (Author), Isabella Ramos (Author), María Antonia Hincapié (Author), Stephanie Pabon (Author), Juan Pedro Kusanovic (Author), Diana Marcela Martínez-Ruíz (Author), Javier Andrés Carvajal (Author)
Format: Book
Published: BMC, 2022-07-01T00:00:00Z.
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Summary:Abstract Introduction Maternal morbidity and mortality rates associated with perinatal care remain a significant public health concern. Rural populations from low and middle-income countries have multiple barriers to access that contribute to a lack of adherence to prenatal care, and high rates of maternal mortality and morbidity. An intervention model based on telehealth and education was implemented between a tertiary high complex care hospital and a second-level hospital from a limited source region. Objectives We sought to identify an association in maternal and perinatal care quality indicators after implementing a model based on telehealth and education for patients with obstetric emergencies between two hospitals in a southwestern region of Colombia. Methods We conducted an ecological study between 2017 and 2019 to compare before and after obstetric emergency care through telemedicine from a secondary care center (Hospital Francisco de Paula Santander-HFPS) to the referral center (Fundación Valle del Lili-FVL). The intervention included verification visits to determine the installed capacity of care, a concerted improvement plan, and on-site educational training modules in obstetric and perinatal care. Results There were 102 and 148 patients treated before and after telemedicine implementation respectively. Clinical indicators after model implementation showed a reduction in perinatal mortality of 29%. In addition, a reduction in the need for transfusion of blood products due to postpartum hemorrhage was observed as well as the rate of eclampsia. Conclusions Implementing a model based on telehealth and education between secondary and tertiary care centers allowed the strengthening of the security of care in obstetric emergencies and had a positive effect on perinatal mortality.
Item Description:10.1186/s12884-022-04935-1
1471-2393