Keywords
How to Cite
Abstract
Objetive: To evaluate the quality of prenatal care during the outbreak of Zika virus infection in endemic and non-endemic vector-borne regions in Colombia. Materials and methods: A descriptive study of prenatal care supplemented by interviews to explore personal experiences during the epidemic. A total of 40 pregnant women in endemic areas and 44 in nonendemic areas participated. Information collected included previous pregnancies, reasons for starting prenatal care, information about Zika, prenatal care (activities of doctors, nurses, laboratories, and images), and perceptions of quality. Then, 8 interviews were conducted with pregnant women diagnosed with Zika. Questioned about knowledge of Zika and the quality of medical care services. Results: Problems with laboratories and diagnostic images were found in both regions and dehumanizing treatment in the endemic region. Women from the endemic region received news and communications about the effects of Zika during pregnancy, causing anxiety and fear among some women. The quality of health care was not what the women expected and they thought they would receive more care from doctors and nurses. Discussion: Our findings show deficiencies in education provided in health institutions. The experience during prenatal control in the endemic regions was imprecise and the information came from other sources, different from the health sector. Adittionally, support and follow-up was deficient as well. It's possible that health professionals have few knowledge about information management, which generated confusion, fear and uncertainity among the pregnant women about the adverse effects on the newborns. Conclusions: Findings suggest deficiencies in the technical quality of the prenatal care provided, particularly in the region that was endemic for vector-borne diseases. Reproductive health services and the technical quality of prenatal care need to be strengthened, especially during a sanitary crisis.
References
Pacheco O, Beltrán M, Nelson CA, Valencia D, Tolosa N, Farr SL et al. Zika virus isease in Colombia - Preliminary report. N Engl J Med. 2020; 383(6): 537-545. doi: 10.1056/NEJMoa1911023.
Alvarado-Socarras JL, Idrovo AJ, Contreras-García GA, Rodríguez-Morales AJ, Audcent A, Mogollon-Mendoza AC et al. Congenital microcephaly: A diagnostic challenge during Zika epidemics. Travel Med Infect Dis. 2018; 23:14-20. doi: 10.1016/j.tmaid.2018.02.002
Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika virus and birth defects-Reviewing the evidence for causality. N Engl J Med. 2016; 374(20): 1981-1987. doi: 10.1056/NEJMsr1604338
Aiken AR, Scott JG, Gomperts R, Trussell J, Worrell M, Aiken CE. Requests for abortion in Latin America related to concern about Zika virus exposure. N Engl J Med. 2016; 375(4): 396-398. doi: 10.1056/NEJMc1605389
Roa M. Zika virus outbreak: reproductive health and rights in Latin America. Lancet 2016; 387(10021): 843. doi:10.1016/S0140-6736(16)00331-7
Darney BG, Simancas-Mendoza W, Edelman AB, Guerra-Palacio C, Tolosa JE, Rodriguez MI. Post-abortion and induced abortion services in two public hospitals in Colombia. Contraception. 2014; 90(1): 36-41. doi: 10.1016/j.contraception.2014.03.004
Noreña-Herrera C, Leyva-Flores R, Palacio-Mejía LS, Duarte-Gómez MB. Inequidad en la utilización de servicios de salud reproductiva en Colombia en mujeres indígenas y afrodescendientes. Cad Saude Publica. 2015; 31(12): 2635-2648. doi: 10.1590/0102-311X00016515
Machado-Alba JE, Machado-Duque ME, Gaviria-Mendoza A, Orozco-Giraldo VA. Hormonal contraceptive prescriptions in Colombia and Zika virus. Lancet. 2016; 387(10032): 1993. doi: 10.1016/S0140-6736(16)30429-9
Baum S, De Piñeres T, Grossman D. Delays and barriers to care in Colombia among women obtaining legal first- and second-trimester abortion. Int J Gynaecol Obstet. 2015; 131(3): 285-288. doi: 10.1016/j.ijgo.2015.06.036
Molina G, Oquendo T, Bastidas D, Rodríguez S, Flórez M. Georreferenciación de la oferta de programas de salud pública en cuatro ciudades en el contexto del mercado competitivo del sistema de salud, Colombia 2014. Iatreia. 2015; 28(3): 223-239. doi: 10.17533/udea.iatreia.v28n3a01.
Briceño-Ayala L, Pinzón-Rondón ÁM, Zárate-Ardila CJ. Acceso, seguridad e integralidad en registros de gestantes colombianas entre los años 2007 al 2009. Rev Cienc Salud. 2015; 13(3): 355-367. doi: dx.doi.org/10.12804/revsalud13.03.2015.03
Castillo IY. Factores asociados al uso adecuado del control prenatal en 13 municipios de Bolívar, Colombia. Rev Cubana Enferm. 2017; 33(1): 1-10.
Ortiz-Grisolle K, Garcia-Galezo K, Gómez-Cardona AP, Maestre-Álvarez SJ, Vargas-Guerrero V, Ramos-Navas N, et al. Adherencia a guías de atención de control prenatal en red pública de subregión norte, departamento del Magdalena (Colombia). Duazary. 2019; 16(1): 115-127. doi: 10.21676/2389783X.2511
Greene JC, Caracelli VJ, Graham WF. Toward a conceptual framework for mixed- method evaluation designs. Educat Evaluat Polic Anal. 1989; 11(3): 255-274. doi: 10.1016/j.ijgo.2015.06.036
Chaparro-Narváez P, León-Quevedo W, Castañeda-Orjuela CA. Comportamiento de la mortalidad por dengue en Colombia entre 1985 y 2012. Biomedica. 2016; 36(Supl.2): 125-134. doi: org/10.7705/biomedica.v36i0.3009
Departamento Administrativo de Salud de Aguachica. Alcaldía de Aguachica. Análisis de la situación de salud con el modelo de determinantes sociales, Aguachica, Cesar, Colombia, 2016.
Alcaldía de Monguí. Empresa Social del Estado Hospital Las Mercedes de Monguí. Análisis de situación de salud con el modelo de los determinantes sociales, Monguí, Boyacá, Colombia, 2016.
Morestin F, Bicaba A, Sermé J de D, Fournier P. Evaluating quality of obstetric care in low-resource settings: building on the literature to design tailor-made evaluation instruments-an illustration in Burkina Faso. BMC Health Serv Res. 2010; 10:20. doi: 10.1186/1472-6963-10-20
Heidegger M. The basic problems of phenomenology. Vol. 478: Indiana University Press; 1998.
Husserl E. Ideas: General introduction to pure phenomenology. London: Routledge; 2012.
Morse JM. The significance of saturation. Qualitat Health Res 1995; 5:147-149. doi: org/10.1177/104973239500500201
Bertaux D. Biography and Society: The life history approach in the social sciences. Beverly Hills, Calif: Sage Publications, 1981.
Romney A, Batchelder W, Weller S. Culture as consensus: a theory of culture and informant accuracy. Am Anthropol Association. 1986; 88: 313-338.
Brasil P, Pereira JP, Moreira E, Ribeiro Nogueira RM, Damasceno L, Wakimoto M, et al. Zika virus infection in pregnant women in Rio de Janeiro. N Engl J Med. 2016; 375: 2321-2334. doi: 10.1056/NEJMoa1602412
Basha GW. Factors affecting the utilization of a minimum of four antenatal care services in Ethiopia. Obstet Gynecol Int. 2019; 5036783. doi: 10.1155/2019/5036783
Rabionet SE, Zorrilla CD, Rivera-Viñas JI, Guerra-Sanchez Y. Pregnancy and Zika: The quest for quality care and reproductive justice. P R Health Sci J. 2018;37: S45-S50.
Morón-Duarte LS, Ramirez Varela A, Segura O, Freitas da Silveira M. Quality assessment indicators in antenatal care worldwide: a systematic review. Int J Qual Health Care. 2019; 31(7): 497-505. doi: 10.1093/intqhc/mzy206
Alvarado-Socarras JL, Meneses-Silvera K, Zarate-Vergara AC, Guerrero-Gomez C, Rodriguez-Morales AJ. Not everything is Zika: congenital toxoplasmosis, still prevalent in Colombia? Rev Peru Med Exp Salud Publica. 2017; 34(2): 332-336. doi: 10.17843/rpmesp.2017.342.2697
Alvarado Socarras J. Cytomegalovirus screening during pregnancy. Must be implemented by the Zika virus. Arch Argent Pediatr. 2016; 114(5): e390-397.
Dos Santos Oliveira SJG, de Melo ES, Reinheimer DM, Gurgel RQ, Santos VS, Martins-Filho PRS. Anxiety, depression, and quality of life in mothers of newborns with microcephaly and presumed congenital Zika virus infection. Arch Womens Ment Health 2016; 19(6): 1149-1151. doi: 10.1007/s00737-016-0654-0
Ebuenyi ID, Bhuyan SS, Bain LE. Zika Virus infection and microcephaly: anxiety burden for women. Pan Afr Med J. 2018; 30: 2. doi: 10.11604/pamj.2018.30.2.11794
Epelboin L; Douine M, Carles G, Villemant N, Nacher M, Rousset D, et al. Épidémie de virus Zika en Amérique latine: quels enjeux pour la Guyane française en avril 2016? Bull Soc Pathol Exot. 2016; 109: 114-125. doi: 10.1007/s13149-016-0490-5
Beare S, Simpson E, Gray K, Andjelic D. Rapid integration of Zika virus prevention within sexual and reproductive health services and beyond: programmatic lessons from Latin America and the Caribbean. Glob Health Sci Pract. 2019; 7(1): 116. doi: 10.9745/GHSP-D-18-00356
Rodriguez-Morales AJ. Zika and microcephaly in Latin America: An emerging threat for pregnant travelers? Travel Med Infect Dis. 2016; 14(1): 5-6. doi: 10.1016/j.tmaid.2016.01.011
Nishiura H, Mizumoto K, Villamil-Gómez WE, Rodríguez-Morales AJ. Preliminary estimation of the basic reproduction number of Zika virus infection during Colombia epidemic, 2015-2016. Travel Med Infect Dis. 2016; 14(3): 274-276. doi: 10.1016/j.tmaid.2016.03.016
Musso D, Rodriguez-Morales AJ, Levi JE, Cao-Lormeau VM, Gubler DJ. Unexpected outbreaks of arbovirus infections: lessons learned from the Pacific and tropical America. Lancet Infect Dis. 2018; 18(11): e355-e361. doi: 10.1016/S1473-3099(18)30269-X
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Jorge Luis Alvarado-Socarras, Claudia Amaya-Castellanos, Edgar Fabian Manrique-Hernandez, Myriam Ruiz-Rodríguez, Jackeline Bracho-Fernández , Daniela Díaz-Páez, Fernando Tenza