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

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...

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Autores principales: Escobar, María Fernanda, Echavarria, María Paula, Vasquez, Hilda, Nasner, Daniela, Ramos, Isabella, Hincapié, María Antonia, Pabon, Stephanie, Kusanovic, Juan Pedro, Martínez-Ruíz, Diana Marcela, Carvajal, Javier Andrés
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9336139/
https://www.ncbi.nlm.nih.gov/pubmed/35906534
http://dx.doi.org/10.1186/s12884-022-04935-1
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author Escobar, María Fernanda
Echavarria, María Paula
Vasquez, Hilda
Nasner, Daniela
Ramos, Isabella
Hincapié, María Antonia
Pabon, Stephanie
Kusanovic, Juan Pedro
Martínez-Ruíz, Diana Marcela
Carvajal, Javier Andrés
author_facet Escobar, María Fernanda
Echavarria, María Paula
Vasquez, Hilda
Nasner, Daniela
Ramos, Isabella
Hincapié, María Antonia
Pabon, Stephanie
Kusanovic, Juan Pedro
Martínez-Ruíz, Diana Marcela
Carvajal, Javier Andrés
author_sort Escobar, María Fernanda
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04935-1.
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spelling pubmed-93361392022-07-29 Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia Escobar, María Fernanda Echavarria, María Paula Vasquez, Hilda Nasner, Daniela Ramos, Isabella Hincapié, María Antonia Pabon, Stephanie Kusanovic, Juan Pedro Martínez-Ruíz, Diana Marcela Carvajal, Javier Andrés BMC Pregnancy Childbirth Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04935-1. BioMed Central 2022-07-29 /pmc/articles/PMC9336139/ /pubmed/35906534 http://dx.doi.org/10.1186/s12884-022-04935-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Escobar, María Fernanda
Echavarria, María Paula
Vasquez, Hilda
Nasner, Daniela
Ramos, Isabella
Hincapié, María Antonia
Pabon, Stephanie
Kusanovic, Juan Pedro
Martínez-Ruíz, Diana Marcela
Carvajal, Javier Andrés
Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia
title Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia
title_full Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia
title_fullStr Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia
title_full_unstemmed Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia
title_short Experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in Colombia
title_sort experience of a telehealth and education program with maternal and perinatal outcomes in a low-resource region in colombia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9336139/
https://www.ncbi.nlm.nih.gov/pubmed/35906534
http://dx.doi.org/10.1186/s12884-022-04935-1
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