Examinando por Autor "Martínez-Fernández, Andrés"

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Detection of high-risk pregnancies in low resource settings: a case study in Guatemala
(BMC, 2019) Crispín Milart, Patricia Hanna; Prieto-Egido, Ignacio; Díaz Molina, Cesar Augusto; Martínez-Fernández, Andrés
Background: Maternal and neonatal mortality is still very high at a global level, even though its reduction is a goal established among the Sustainable Development Goals by the United Nations. In order to improve prenatal care to address this challenge, this article proposes a strategy to detect and refer high risk pregnancies in rural setting through a portable ultrasound system combined with blood and urine strip tests. Methods: The Healthy Pregnancy project was conceived as a single, explanatory and positivist case study, with a sample of ten thousand pregnant women attended by itinerant nurses of the Departments of Alta Verapaz and San Marcos. These nurses were trained and equipped with 31 portable ultrasound, and blood and urine tests to detect common obstetric pathology. Moreover, two obstetricians were responsible for remotely supervising the quality of prenatal care. Target communities were selected by the Health Directorates of the public health system from those that had the highest maternal mortality in previous years. Results: The project attended to 10,108 women in 2 years and 3 months. 55 twin gestations (0.54%) were diagnosed. Non-cephalic presentation was found in 14.87% of the pregnant women attended from week 32 onwards. 20 patients were referred for non-evolutive gestation. An 11.08% prevalence of anemia was detected. Urine infections were diagnosed in 16.43% of the cases. Proteinuria was detected in 2.6% of patients, but only 17 of them presented high blood pressure and were therefore referred with a suspected pre-eclampsia. Discussion: The results obtained indicate that an intervention of these characteristics makes it possible to improve the quality of care of rural pregnant women in low and middle-income countries. Conclusion: The results show that with suitable equipment, training, and supervision, the nursing staff in charge of care in rural areas can identify and refer most of the obstetric risks in time, which may contribute to the reduction of maternal mortality.
Interdisciplinary Alliances to Deploy Telemedicine Services in Isolated Communities: The Napo Project Case
(MDPI, 2018-07-02) Prieto-Egido, Ignacio; Simó-Reigadas, Javier; Martínez-Fernández, Andrés
Rural telecommunications projects in developing regions have a long history of unsuccessful experiences due to the complexity of such projects: Practically none of the dimensions of integral sustainability are straight forward in such projects. When sustainability becomes a priority, it is difficult for traditional alliances of development to account for all critical success factors. In the Peruvian Amazon Rainforest, some institutions have developed rural telecommunications projects along the Napo River during the last 10 years. The experience has shown at each stage what aspects of sustainability were not taken into account because the partners involved did not have all the needed capacities, and this has made the alliances of partners evolve in a sustainability-driven manner. This paper analyzes these cases and assesses how sustainability has evolved in relation to the structure of such alliances.