Evaluation of the use and effectiveness of telemedicine among the health professionals during the COVID 19 lockdown period: A cross sectional study

Telemedicine Service Adoption During the COVID-19 Pandemic: Physicians' Experience from Nigeria

Introduction: Telemedicine practice experiences during the COVID-19 pandemic have not been well documented in resource-constrained settings, such as Nigeria. We set out to assess knowledge, attitude, and factors associated with telemedicine practice during the COVID-19 lockdown, as well as physician experiences in Kano, Nigeria. Methods: We employed a mixed-methods approach, utilizing structured questionnaires administered to 246 physicians, followed by in-depth interviews with a purposive subsample of 20 individuals. The data were analyzed using logistic regression and the framework approach. Results: Overall, 65.0% of the respondents demonstrated moderate to good knowledge of telemedicine. Before COVID, only 47.6% (n = 117) reported practicing telemedicine, compared with 77.2% (n = 190) during the COVID lockdown (p < 0.05). Factors associated with telemedicine practice included having at least 5 years of work experience, working in pediatrics, undergoing senior residency training, receiving formal telemedicine training, possessing good knowledge of telemedicine, and having a positive attitude toward it. The odds of engaging in telemedicine practice were four times higher (adjusted odds ratio = 4.10, 95% confidence interval: 1.79-9.40) for those who practiced it before the pandemic. Challenges identified included knowledge and skill gaps, slow internet connectivity, unstable electricity, and inadequate equipment. Conclusion: To enhance telemedicine practice in resource-limited settings, it is important to focus on strengthening information and communication infrastructure, providing comprehensive clinician training, implementing careful patient selection processes, and improving practice guidelines.

Telemedicine in the age of the pandemics: The prospects of web-based remote patient monitoring systems for orthopaedic ambulatory care management in the developing economies

Objective

The goal of this research was to demonstrate the efficacy of telemedicine via design, implementation and evaluation of a web-based remote patient monitoring system (WB-RPMS) across the tertiary/university teaching hospitals in a developing country Nigeria, as a tool to continue to expand access to an affordable and resilient tertiary healthcare system through the challenging times of the COVID-19 pandemic or any future disruptions.

Methods

This research employed an agile and human-centred design thinking philosophy, which saw the researchers iteratively collaborate with clinicians across the system development value chain. It also employed qualitative and quantitative research methods for new system evaluations. After the system's development, a 20-patient sample was randomly selected from members of the National Youth Service Corp to evaluate the WB-RPMS Patient Portal for usability and user experience through a survey based on the system usability scale. Again, the COREQ standards for reporting research result were adopted for this study.

Results

The evaluation of the WB-RPMS Patient Portal by a select patient sample showed that 95.0% of the respondents believed that they would like to use the system frequently. It was also discovered that 90.0% of all respondents also indicated that they found the Patient Portal to be simple; 85.0% of the respondents believed and indicated that the WB-RPMS Patient Portal was easy to use.

Conclusions

The result of the usability evaluation of the developed WB-RPMS Patient Portal showed that it was well received by the select patient sample and by the clinicians who participated in the development process. In fact, the performance of the system shows that it has the potential to remotely support and sustain improved access to affordable healthcare for outpatients in developing countries even during times of uncertainties and disruptions as recently occasioned by COVID-19 pandemic.

Attitude of postpartum women towards multiple postnatal clinic schedule in south-west Nigeria

Background

The postnatal period is a critical in the lives of mothers and babies due to the risk of maternal and perinatal morbidity and mortality. According to the Nigeria Demographic Health Survey 2018, only 38 % of women and 42;% of newborns received a postnatal check in the first 2 days after birth. The World Health Organisation (WHO) recommends that postpartum women should have contact with healthcare providers within 24 h, at day 3, days 10-14 and 6 weeks post-delivery. Multiple postnatal clinic (PNC) visits will allow assessment and prompt treatment of complications arising from delivery. This study assessed the attitude of postpartum women towards multiple PNC schedule.

Methods

This descriptive cross-sectional study assessed the attitude of postpartum women towards multiple PNC schedules. A total of 167 respondents participated in the study and data was collected using a semi-structured interviewer administered questionnaire. Information on awareness, knowledge and purpose of postnatal care, preference for multiple schedules and the timing of postnatal care visits were obtained. Data was analysed using IBM SPSS version 23; and the level of significance was set at p < 0.05.

Results

Of the respondents, 71.9 % had poor or incorrect knowledge. About 87.4 % perceived PNC as beneficial; and that mothers and newborns should be seen at least three times (47.9 %) in the postnatal period. A high proportion of women were willing to come for PNC on day 3 (74.3 %), days 10-14 (86.2 %) and six weeks postpartum (91.6 %). Also, 69.5 % were willing to come for multiple PNC visits. Parity was significantly associated with willingness to attend multiple PNC visits.

Conclusion

Despite suboptimal knowledge of the components of postnatal care services, postpartum women have a good attitude to postnatal care and are willing to attend scheduled and multiple PNC schedules. However, fewer women wanted the multiple PNC schedules. Health education and quality postnatal care will enhance postpartum surveillance with prompt detection and treatment of maternal and neonatal complications to forestall life-threatening complications or mortality.

Evaluation of the effect and investment benefit of Marine ecosystem protection and restoration

In order to explore the effectiveness of Marine ecosystem conservation and restoration, an evaluation method based on the effectiveness and investment benefit of Marine ecosystem conservation and restoration was proposed. This method recommends key technical problems and solutions based on the information represented by Marine ecosystem protection to explore the effectiveness of Marine ecosystem protection and restoration. The results show that the evaluation efficiency of Marine ecosystem protection and restoration and investment benefit is about 30% higher than that of traditional methods. Due to the uncertainty of Marine ecological restoration, the role of adaptive management in Marine ecological restoration has been paid more and more attention, and the systematic process of improved management adapted to new knowledge and information has been explored.