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Sagastume D, Serra A, Gerlach N, Portela A, Beňová L. Interventions to maintain essential services for maternal, newborn, child, and adolescent health during the COVID-19 pandemic: A scoping review of evidence from low- and middle-income countries. J Glob Health 2024; 14:05024. [PMID: 38867685 PMCID: PMC11170233 DOI: 10.7189/jogh.14.05024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic had challenged health systems worldwide, including those in low- and middle-income countries (LMICs). Aside from measures to control the pandemic, efforts were made to continue the provision and use of essential services. At that time, information was not organised and readily available to guide country-level decision-making. This review aims to summarise evaluated interventions to maintain essential services for maternal, newborn, child, and adolescent health in response to COVID-19 in LMICs, in order to learn from the interventions and facilitate their use in the next disruption. Methods We conducted a scoping review by Embase, MEDLINE, and Global Health for literature published between 1 January 2020 and 26 December 2022, without restrictions for language. We extracted information about the setting, population targeted, service type, intervention, and evaluation from the included studies and summarised it both quantitatively and narratively. Results We retrieved 11 395 unique references and included 30 studies describing 32 evaluated interventions. Most interventions (84%) were implemented in 2020, with a median duration of five months (interquartile range (IQR) = 3-8), and were conducted in Africa (34%) or Southeast Asia (31%). Interventions focussed on maintaining services for maternal and newborn health (56%) or children and adolescents (56%) were most common. Interventions aimed to address problems related to access (94%), fear (31%), health workers shortage (25%), and vulnerability (22%). Types of interventions included telehealth (69%), protocols/guidelines to adapt care provision (56%), and health education (40%); a few entailed health worker training (16%). The described interventions were mostly led by the public (56%) or non-profit (34%) sectors. Methodologies of their evaluations were heterogeneous; the majority used quantitative methods, had a prospective research design, and used output- and outcome-based indicators. Conclusions In this review, we identified an important and growing body of evidence of evaluated interventions to maintain essential services for maternal, newborn, child, and adolescent health during COVID-19 in LMICs. To improve preparedness and responsiveness for future disruptions, managers for decision-makers in LMICs could benefit from up-to-date inventories describing implemented interventions and evaluations to facilitate evidence-based implementation of strategies, as well as tools for conducting optimal quality operational and implementation research during disruptions (e.g. rapid ethical approvals, access to routine data).
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Affiliation(s)
- Diana Sagastume
- Institute of Tropical Medicine, Department of Public Health, Antwerp, Belgium
| | - Aloma Serra
- London School of Economics and Political Science, Department of International Development, London, UK
- United Nations Development Programme, Department of Climate Change and Energy, Quito, Ecuador
| | | | - Anayda Portela
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Lenka Beňová
- Institute of Tropical Medicine, Department of Public Health, Antwerp, Belgium
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Mohapatra I, Rai VK, Samantaray SR. Impact of telemedicine on antenatal care at a teaching institution in Eastern India: An insight into the future of better India. J Family Med Prim Care 2023; 12:2652-2660. [PMID: 38186769 PMCID: PMC10771158 DOI: 10.4103/jfmpc.jfmpc_995_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 01/09/2024] Open
Abstract
Objectives Telemedicine (TM) emergence has been profound in using technology to address the problems of obstetrics in remote and rural places, especially in low-risk pregnancy. Through this study, we made an effort to assess the satisfaction level and concerns of antenatal and postnatal patients who availed the telemedicine facility during the study period. We also made an effort to facilitate improved access to antenatal and postnatal care, especially the low-risk pregnancies through telemedicine for patients from remote areas of eastern India that do not have the availability of specialists. Materials and Methods Primary data were collected by means of a telephonic survey of all the antenatal patients who used telemedicine services of AIIMS, Kalyani, based on a preformed questionnaire. Results A total of 80 antenatal patients gave consent to participate in the study. Most of the patients were from the upper lower class [43.75%] followed by the lower middle class [35%]. The average gestational age of respondents was 23.95 weeks. Seventy-one out of 80 patients felt that the appointment was made within a reasonable time. Only 12 patients [15.3%] had waiting time greater than 10 min. The average waiting time was 6.93 min. 56.3% of respondents felt that the person who attended their call was very cooperative. 86.3% of respondents strongly agreed that the consultant was able to understand their health issues completely. Eighty percent of the respondents said that they would like to continue using telemedicine in the future. There is a significant difference between those preferring to use telemedicine in the future and those who do not prefer telemedicine in the future. Poor internet facility and privacy were prominent reasons for not opting for telemedicine in the future by some respondents. Conclusion From this study, it was concluded that TM certainly has great potential to make health care accessible to people residing in rural and far-off places.
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Affiliation(s)
- Ipsita Mohapatra
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Vikash K Rai
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Subha Ranjan Samantaray
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
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Shi J, Tan Z, Ma Q, Sun D, Lu Y, Ye M, Wang L, Cui F, He X, Fan Z, Zhao J. Implementation, service effectiveness and satisfaction with teleconsultation services in China during the COVID-19 pandemic: from the Perspective of Primary Health Care Professionals. Int J Med Inform 2023; 178:105202. [PMID: 37651778 DOI: 10.1016/j.ijmedinf.2023.105202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE This study aims to evaluate satisfaction and service effectiveness of primary hospital physicians participating in the National Telemedicine Center of China during the COVID-19 period, and to identify potential improvement suggestions. METHODS An online questionnaire was developed to assess the impact and satisfaction of teleconsultation services. A teleconsultation manager from each of the 98 hospitals randomly invited the medical staff involved in teleconsultation to complete the online questionnaire. RESULTS A total of 379 health care professionals responded to the online questionnaire, with a mean age of 36.74 years. Out of these respondents, 95.5% had a positive attitude towards teleconsultation during the epidemic. Only 6.6% believed that teleconsultation systems were not useful in preventing and controlling the COVID-19 pandemic. Those respondents who were very satisfied with teleconsultation participated in it 1.81 times per week averagely. Factors related to satisfaction included weekly participation frequency(P=.003), patient data quality(P=.023), equipment operation proficiency(P=.006), audio and video clarity and smoothness(P=.004, P=.020), environmental satisfaction(P=.032), and incentive measures of title promotion(P=.003). The main challenges in teleconsultation were the lack of understanding of medical staff and the public, insufficiently advanced software and hardware equipment, and the lack of optimization of service processes. CONCLUSIONS Primary hospital doctors demonstrate high satisfaction levels, suggesting that teleconsultation could be an effective tool for patients seeking medical care in areas under lockdown during the COVID-19 pandemic. The primary barriers to teleconsultation include lack of public understanding and unadvanced equipment. These findings should inform future efforts to establish regional telemedicine programs in the post-COVID-19 era.
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Affiliation(s)
- Jinming Shi
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhongke Tan
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qianqian Ma
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongxu Sun
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yaoen Lu
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ming Ye
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Linlin Wang
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fangfang Cui
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xianying He
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhaohan Fan
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Zhao
- National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Digital health and telemedicine in Pakistan: Improving maternal healthcare. Ann Med Surg (Lond) 2022; 81:104425. [PMID: 36046714 PMCID: PMC9421176 DOI: 10.1016/j.amsu.2022.104425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/21/2022] Open
Abstract
Pakistan has not benefited significantly from telemedicine, despite the promise that it could overcome many of the barriers impeding maternal healthcare delivery in emerging markets. Due to a lack of a regulatory framework and a lack of government interest, new companies in Pakistan have a hard time establishing healthcare projects that will be cost-effective and innovative. A review of telemedicine adoption in the past and present for improving maternal healthcare standards is presented in this article. Furthermore, a discussion of the challenges associated with digital health adoption is provided, as well as possible and feasible policies for making the use of digital health in maternal health more effective.
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Goyal LD, Garg P, Verma M, Kaur N, Bakshi D, Arora J. Effect of restrictions imposed due to COVID-19 pandemic on the antenatal care and pregnancy outcomes: a prospective observational study from rural North India. BMJ Open 2022; 12:e059701. [PMID: 35387835 PMCID: PMC8987212 DOI: 10.1136/bmjopen-2021-059701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To assess the difficulties faced by the pregnant women in seeking appropriate antenatal care due to the restrictions imposed during the COVID-19 pandemic; assess the difficulties encountered during delivery and postpartum period; the suitability of the teleconsultation services offered; effect of COVID-19 infection on pregnancy outcomes and the effect of restrictions on the nutrition profile of the pregnant women. DESIGN Prospective observational study. SETTING AND PARTICIPANTS We included 1374 pregnant women from the rural areas of three districts of Punjab, India registered at government health centres before the implementation of lockdown due to the COVID-19 pandemic on 24 March 2020. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the difficulties faced by the women during their pregnancies due to restrictions imposed during the lockdown. The secondary outcomes included the effect of COVID-19 infections on pregnancy outcomes, satisfaction from the telemedicine services and restrictions on the nutrition profile of the pregnant women. RESULTS One-third of the women (38.4%) considered their last pregnancy unplanned. Women faced difficulties due to the restrictions in getting adequate nutrition (76.5%), accessing transportation facilities (35.4%), consultations from doctors (22.4%) or getting an ultrasonography scan (48.7%). One-fifth (21.9%) of women could not access safe abortion services. Only 3.6% of respondents ever took any teleconsultation services offered by the government. Most of them felt unsatisfied compared with routine visits (77.5%). COVID-19-infected women were primarily asymptomatic (76.1%), but there was a high incidence of preterm birth (42.8%). Frontline workers could visit 64.3% of the women in the postpartum period despite restrictions. CONCLUSIONS Lockdown compromised the antenatal care in our study area while the frontline workers attempted to minimise the inconvenience. Telemedicine services did not prove to be of many benefits to pregnant women and should only work as a supplement to the existing protocols of antenatal care.
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Affiliation(s)
- Lajya Devi Goyal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences-Bathinda, Bathinda, Punjab, India
| | - Priyanka Garg
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences-Bathinda, Bathinda, Punjab, India
| | - Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences-Bathinda, Bathinda, Punjab, India
| | - Navdeep Kaur
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences-Bathinda, Bathinda, Punjab, India
| | - Dapinder Bakshi
- Punjab State Council for Science and Technology, Chandigarh, India
| | - Jatinder Arora
- Punjab State Council for Science and Technology, Chandigarh, India
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Wali R, Alhakami A, Alsafari N. Evaluating the level of patient satisfaction with telehealth antenatal care during the COVID-19 pandemic at King Abdul-Aziz Medical City, Primary Health Care Center, Specialized Polyclinic. WOMEN'S HEALTH 2022; 18:17455057221104659. [PMID: 35726912 PMCID: PMC9218447 DOI: 10.1177/17455057221104659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: To evaluate the client satisfaction with a phone-based antenatal care consultation and identify the associated factors during the COVID-19 pandemic at King Abdul-Aziz Medical City, Primary Health Care Center Specialized Polyclinic during 2020. Method: The study was a cross-sectional, retrospective study conducted with pregnant women attending the maternity clinic at the Specialized Polyclinic, Primary Health Care Center at King Abdul-Aziz Medical City, Jeddah. A self-administered questionnaire was sent via a text message (short message service) to collect the data after signed written consent. Result: Of 279 pregnant women, 262 (93.9%) attended phone clinic appointments one to five times. The total satisfaction level score was 73.4 ± 6.5, indicating a high level of satisfaction with the phone clinics, and 252 (90.3%) reported a high level of satisfaction. There was a significant difference in the total score regarding education, occupation, husband’s occupation, smoking, gravidity, parity, menstruation, gestational age, pregnancy complication, number of phone clinics during pregnancy, number of attending clinics during pregnancy, visiting another health facility, and reason of visiting phone clinic ( p < 0.0001, p < 0.0001, p < 0.0001, p = 0.015, p = 0.033, p < 0.0001, p < 0.0001, p = 0.027, p = 0.001, p < 0.0001, and p = 0.002). Conclusion: The study indicated a high level of satisfaction with the antenatal telephone clinics during the pandemic, which supports the trend of transition in the direction of the digitalization of antenatal care.
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Affiliation(s)
- Razaz Wali
- Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia, Department of Primary Healthcare, King Abdul-Aziz Medical City (KAMC), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- King Saud Bin Abdul-Aziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Amani Alhakami
- Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia, Department of Primary Healthcare, King Abdul-Aziz Medical City (KAMC), Jeddah, Saudi Arabia
| | - Nada Alsafari
- Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia, Department of Primary Healthcare, King Abdul-Aziz Medical City (KAMC), Jeddah, Saudi Arabia
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