Satisfaction of Quechua-speaking indigenous pregnant women from a rural community in Peru with telemonitoring during the COVID-19 pandemic.

COVID‐19 has restricted the face‐to‐face care of 88% of Peruvian pregnant women, mainly in rural communities such as Atipayan (3364 masl, Huaraz), classified with an extreme alert level of contagion. The authorities have implemented telemonitoring based on telephone calls since April 2020, but its application in rural areas has not been evaluated. The present research addressed the satisfaction of Quechua‐speaking indigenous pregnant women from the Atipayan community with telemonitoring during the COVID‐19 pandemic.

Cross‐sectional research was carried out with 82 Quechua‐speaking indigenous pregnant women of any gestational age with low obstetric risk, as determined by the Atipayan health post staff, with a minimum of 16 weekly telemonitoring telephone calls. None of the pregnant women with low obstetric risk received face‐to‐face care due to the COVID‐19 pandemic. However, births did have to be at the Huaraz Hospital, a guideline that did not change during the pandemic.

The telemonitoring program was carried out by two midwives who were Quechua speakers, but this language was not their mother tongue. They worked at the aforementioned health post and they followed a standardized protocol for each telephone call with respect to the topics to be discussed, schedules, and duration. This telemonitoring protocol was established by the authorities for its application to all Peruvian pregnant women regardless of their place of residence (urban or rural).

In the absence of validated instruments in Quechua‐speaking indigenous populations, an anonymous questionnaire was prepared in Quechua, composed of 13 Likert‐type questions with a scale from 1 (totally dissatisfied) to 5 (totally satisfied). These questions were formulated as a result of a thorough review of the research literature on the satisfaction with telemonitoring and the aspects considered in the standardized protocol for each telephone call. Subsequently, six health professionals (three midwives, two obstetricians, and one psychologist) with experience and academic training in telemonitoring participated in the content validation of the questionnaire (Kendall's W = 0.879, P < 0.001); followed by the participation of 20 Quechua‐speaking indigenous pregnant women from Atipayan community in the pilot survey (Cronbach's alpha index = 0.886), which was conducted over the telephone. As a result of the pilot survey, the wording of the questions was modified to avoid ambiguities and confusing terms.

A descriptive analysis was carried out. Voluntary informed consent was obtained verbally and the protocol was approved by the Ethics Committee of the Santiago Antúnez de Mayolo National University (Registration No. 011–2020).

The final version of the questionnaire was applied via telephone calls in December 2020 by the Quechua‐speaking authors of the research, who did not work at the Atipayan health post. Of the 82 pregnant women from Atipayan, 20 participated in the pilot test, nine refused to participate due to lack of time and fear of reprisals, and 53 answered the questionnaire. The mean age was 28.6 years (SD = 2.9 years); 69% (37) were younger than 30 years old and 58% (31) were more than 20 weeks pregnant. Of all the aspects of satisfaction evaluated (Table 1), 38% (5) had scores lower than 4, that is, they were rated with responses of dissatisfaction or indifference. The worst valued aspects were the adequate resolution of doubts and communication based on respect for the culture and customs of the pregnant woman, results that could be due to the lack of knowledge of the language and customs of the population by health professionals. ,

TABLE 1

Satisfaction level of the Quechua‐speaking indigenous pregnant women who answered the final version of the questionnaire

Items	Mean a (n = 53)	Standard deviation (n = 53)
Communication based only on the Quechua language	3.21	0.514
Concern for the pregnant woman's state of health	4.03	0.627
Communication based on respect for the culture and customs of the pregnant woman	2.94	0.421
Cordial and patient treatment by the professional	4.27	0.587
Carrying out telemonitoring at an appropriate time	4.81	0.608
Development of telemonitoring constantly and periodically	4.59	0.571
Adequate duration of each telemonitoring session	4.42	0.509
Clear and detailed explanation about pregnancy care	4.25	0.499
Clear and detailed explanation about danger signs in pregnancy	4.93	0.602
Clear and detailed explanation of preventive and diagnostic measures for COVID−19	3.17	0.611
Adequate resolution of doubts	2.86	0.536
Information on the means and channels of attention in cases of emergency due to prenatal complications	4.65	0.449
Information on the means and channels of attention in emergency cases related to COVID−19	3.08	0.573

<4, dissatisfaction or indifference; ≥4, satisfaction.

Mean

The main limitation of research was the non‐inclusion of more satisfaction indicators as a result of the lack of specific telemonitoring protocols for Quechua‐speaking indigenous pregnant women. This can be improved through the application of other measurement instruments in indigenous populations.

In conclusion, although the majority of pregnant women in Atipayan have been satisfied with the telemonitoring during the COVID‐19 pandemic, there are still aspects that could be improved, such as a deeper knowledge of the Quechua language, respect for culture and customs, resolution of doubts, and explanation of the prevention, diagnosis, and care of COVID‐19. These require immediate action in direct coordination with community health agents.

CONFLICTS OF INTEREST

The authors have no conflicts of interest.

AUTHOR CONTRIBUTIONS

YMDR and AFOM contributed to the conception and design of the research, as well as the collection, analysis, and interpretation of the data. Both authors were responsible for the writing and approval of the final version of this brief communication.