Honduras is taking an important step towards improving maternal and neonatal healthcare by partnering with the Pan American Health Organization/World Health Organization (PAHO/WHO) to pilot a telemedicine project. Although there have been concerns about maternal and neonatal mortality rates in Honduras, with an estimated 58 deaths per 100,000 live births and 18 deaths per 1,000 live births, the country is committed to finding innovative solutions to these challenges. Despite the COVID-19 pandemic creating gaps in healthcare services, this project has the potential to increase access to prenatal care and reduce delays, ensuring better health outcomes for mothers and babies. Teleconsultations in three prioritized communities in the municipality of Trinidad were conducted where they yielded significant benefits. These included improvements in direct contact with users, access to care, and care quality for pregnant women; increased vaccination coverage for pregnant women for COVID-19, influenza, and Tetanus Toxoid vaccines; and improved satisfaction with care and trust in healthcare personnel [1]. Based on the success of the telemedicine pilot project, it is expected that the initiative will expand to other municipalities in the department of Santa Bárbara.
Key WHO Contributions
Technical guidance to develop a teleconsultation pilot project
Technical expertise to build the capacity of midwives and volunteers through trainings
Provision of equipment to enable the project’s implementation
Steering the project, including through monitoring and evaluation activities.
How did Honduras, with the PAHO/WHO Secretariat’s support, achieve this?
In Honduras, telemedicine emerged as a critical healthcare solution during the COVID-19 pandemic, particularly in facilitating consultations between rural general practitioners and specialists. To address the challenges of accessing prenatal healthcare services, PAHO/WHO and the Latin American Center for Perinatology/Women's and Reproductive Health (CLAP/SMR) provided technical assistance in developing a teleconsultation pilot project as part of the Health of Women and Adolescents in Vulnerable Conditions initiative. The project aimed to enhance the access and quality of prenatal care while ensuring timely detection of danger signs to prevent maternal mortality.
"The implementation of the Prenatal Telemedicine care model (hybrid model) improved direct contact with users and enhanced access and quality of care for pregnant women."
-Gissela Fernandez, Municipal Health Coordinator, Municipality of Trinidad.
To build capacity for the teleconsultation pilot project in Honduras, the Health of Women and Adolescents in Vulnerable Conditions initiative facilitated training for four volunteers. These volunteers were then empowered to implement teleconsultations in three prioritized communities in the municipality of Trinidad - La Zona, El Diviso, and La Huerta. Health centre staff were trained in the use of the Perinatal Information System (SIP+) and in essential neonatal obstetric care. Trainings were conducted with financial support from the Government of Canada and technical guidance from the PAHO/WHO and CLAP/SMR.
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Maria and Paula are two volunteers trained on the teleconsultation project in the municipality of Trinidad.
Photo credit: PAHO/WHO Honduras.
PAHO/WHO and partners then facilitated the implementation of the teleconsultation project by providing trainees with basic computer equipment, scheduling and medical records software, Internet access, prepaid phone cards, and digital sphygmomanometers. Additionally, the Ministry of Health (MoH) supplied flip charts for prenatal education.
Once a Health Centre had learned of the pregnancy they proactively contacted expectant mothers by telephone, reminding them of danger signs and the importance of monitoring blood pressure and scheduling two additional medical teleconsultations. Trained volunteers conducted monthly visits to pregnant women at the community level, measuring blood pressure and assessing their overall health status while identifying potential danger signs such as headaches or swollen feet. Volunteers also educated families on prenatal and neonatal care using the MoH-provided flip charts, assisted in developing a birth plan, and referred women to health professionals at the health center, if necessary.
“Teleconsultation users have expressed greater trust in health personnel and increased satisfaction with the care received. An impressive 82% of pregnant women have initiated vaccination for COVID-19, influenza, and Tetanus Toxoid."
- Dr. Iveth Moreno, doctor from the Integral Health Center of Trinidad.
The MoH participates in the teleconsultation project's steering group with technical support from PAHO/WHO. The steering group carries out monitoring and evaluation of the project and is currently holding technical meetings to attain feedback on the project’s process, identify challenges, and document improvement processes that have been, or should be, implemented. PAHO/WHO also supports monitoring of the Perinatal Informatics System (SIP+) of pregnant women attended by the Trinidad Integral Health Centre. This system provides critical data on the health outcomes of pregnant women in the project enabling for better evaluation of the effectiveness of the teleconsultation initiative.
The successful implementation of the teleconsultation pilot project represents a crucial milestone in enhancing maternal and neonatal health outcomes in vulnerable communities in Honduras. It serves as a prime example of how collaborative efforts between governments, international organizations, and local health centers can facilitate innovative solutions to address healthcare challenges and improve health equity. The hybrid model demonstrated how telemedicine has the potential to improve healthcare access and quality for pregnant women in low-income settings, leading to improved maternal and neonatal health outcomes. This approach has the potential to significantly improve healthcare outcomes for vulnerable communities in Honduras and beyond.
