Digital Hope: How Telemedicine is Improving Quality of Care for Pregnant Women in Rural Areas of Honduras and Peru

Phone Contacts and Community Support

When Paula Fajardo, a traditional birth attendant and volunteer with more than 40 years of experience, welcomes Elsa into her home, the first thing she asks about is her prenatal check-ups. Elsa, who is pregnant, responds calmly, “I’ve been fine; the doctor is calling me tomorrow,” and soon they chat about her pregnancy. Then, Doña Paula takes her blood pressure and provides the reassurance that a pregnant woman needs.

In Trinidad, Honduras, many women face geographic and economic barriers that prevent them from receiving the minimum five recommended medical check-ups, exacerbating care gaps that could be linked to maternal and neonatal mortality.

Traditional birth attendants and community health volunteers like Doña Paula play an essential role in supporting and caring for pregnant women. The close bond and trust they create strengthen the connection between healthcare providers and women.

The teleconsultation strategy in this municipality relies on the role of health volunteers to increase contact between healthcare providers and pregnant women through phone calls, which supplement in-person check-ups. The volunteers accompany the process from within the community, assisting with early identification of risks and illnesses and referring women to health centers when necessary.

“Thanks to this initiative, teleconsultation users have reported greater confidence in healthcare personnel and increased satisfaction with the care received. Additionally, 82% of pregnant women have started their vaccinations against COVID-19, influenza, and tetanus toxoid” says Dr. Iveth Moreno, at the Comprehensive Health Center (CHC) in Trinidad.

Now, when Doña Paula welcomes a pregnant woman, she feels reassured knowing she can make a call to share information about the patient’s health with obstetricians at the CHC in Trinidad .

“Through these initiatives, we see the importance of involving local stakeholders, understanding the realities, contexts, needs, and available resources to provide the best responses and seek tailored solutions”, explains Dr. Bremen De Mucio, regional advisor in Maternal Health for PAHO.

Video Calls Connecting Health Professionals

Sarita Culqui lives in a locality in the Amazonas region of Peru. She has two children and is a patient at the Pedro Ruiz Health Center. Toward the end of her second pregnancy, she encountered complications when diagnosed with an excessive accumulation of amniotic fluid, a condition known as polyhydramnios. When staff at the health center noticed something was amiss, they arranged a video call with an obstetrician-gynecologist at Virgen de Fátima Regional Hospital in Chachapoyas, who advised on the next steps in her care.

In the Amazonas region, geographic conditions and high turnover among healthcare personnel continue to pose barriers to specialized healthcare access for pregnant women.

Leveraging available telecommunications infrastructure, the telemedicine strategy in Amazonas has been adapted to connect primary care health professionals with specialists in referral hospitals with facilities equipped to handle more complex cases. This model has enabled women in remote areas, like Sarita, to receive specialized gynecological and obstetric care, improving the quality of care they receive.

Through a video call with the doctor from the Pedro Ruiz Health Center and the physician at the Virgen de Fátima Hospital, Sarita understood that she needed a more thorough evaluation. This virtual consultation allowed her to meet the obstetrician who would later oversee her delivery, Dr. Christian Tiburcio, head of the Gynecology and Obstetrics Department at Virgen de Fátima Hospital. He acknowledges that “having direct contact with patients and healthcare staff is a key asset for promptly addressing risk situations during pregnancy. Additionally, it promotes knowledge exchange among healthcare personnel from different regions.”     delivery in various settings and includes a selection of high-quality medical devices designed for portable and ultra-portable applications, ensuring both flexibility and adaptability.

Models That Build Trust

Training healthcare personnel is a key component of the telemedicine strategy that has yielded positive results. In Peru, this model has allowed women to receive timely care without needing to travel long distances. Additionally, primary care staff have been able to address complications early, such as infections and anemia.

In Honduras, bringing communities closer to healthcare services has fostered stronger connections between healthcare providers and women, enhancing the follow-up care they receive during pregnancy.

The flexible telemedicine strategies implemented by PAHO as part of the Improved Health of Women and Adolescent Girls in Situations of Vulnerability project, funded by Global Affairs Canada (GAC), represent progress in advancing maternal health in communities and are essential to bridging gaps in access to quality care through telecommunications. These strategies also create opportunities for other regions to replicate these models and complement ongoing efforts to reduce maternal and neonatal mortality in the region.

Ivy Lorena Talavera, advisor on family, health promotion, and life course at PAHO and project leader in Peru, notes that “this initiative helps close gaps in access to care for women living in hard-to-reach areas, most of whom are Indigenous, migrants, or live in highly vulnerable conditions. These actions support the Roadmap for Digital Transformation in the Health Sector based on international standards, approved by PAHO’s governing bodies in 2021.”

Through the Regional Revolving Funds, PAHO has developed the All-in-One Telehealth Package to expand telehealth services across the Americas. This kit offers an all-encompassing and versatile solution to improve healthcare delivery in various settings and includes a selection of high-quality medical devices designed for portable and ultra-portable applications, ensuring both flexibility and adaptability.