A double-edged sword—telemedicine for maternal care during COVID-19: findings from a global mixed-methods study of healthcare providers

Abstract

IntroductionThe COVID-19 pandemic has led to a rapid implementation of telemedicine for the provision of maternal and newborn healthcare. The objective of this study was to document the experiences with providing telemedicine for maternal and newborn healthcare during the pandemic among healthcare professionals globally.MethodsThe second round of a global online survey of maternal and newborn health professionals was conducted, disseminated in 11 languages. Data were collected between 5 July and 10 September 2020. The questionnaire included questions regarding background, preparedness and response to COVID-19, and experiences with providing telemedicine. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregated by country income level.ResultsResponses from 1060 maternal and newborn health professionals were analysed. Telemedicine was used by 58% of health professionals and two-fifths of them reported not receiving guidelines on the provision of telemedicine. Key telemedicine practices included online birth preparedness classes, antenatal and postnatal care by video/phone, a COVID-19 helpline and online psychosocial counselling. Challenges reported lack of infrastructure and technological literacy, limited monitoring, financial and language barriers, lack of non-verbal feedback and bonding, and distrust from patients. Telemedicine was considered as an important alternative to in-person consultations. However, health providers emphasised the lower quality of care and risk of increasing the already existing inequalities in access to healthcare.ConclusionsTelemedicine has been applied globally to address disruptions of care provision during the COVID-19 pandemic. However, some crucial aspects of maternal and newborn healthcare seem difficult to deliver by telemedicine. More research regarding the effectiveness, efficacy and quality of telemedicine for maternal healthcare in different contexts is needed before considering long-term adaptations in provision of care away from face-to-face interactions. Clear guidelines for care provision and approaches to minimising socioeconomic and technological inequalities in access to care are urgently needed.

Utility of telemedicine in sub‐Saharan Africa during the COVID ‐19 pandemic. A rapid review

“…Several studies including Blandford et al ( 2020 ), Mbunge et al ( 2021 ), Dodoo et al ( 2021 ), Galle et al ( 2021 ) and Lam et al ( 2021 ) noted that many countries adopted digital health technologies and some still piloting telemedicine to improve access and quality of healthcare services delivery during the pandemic to reduce transmission by observing COVID‐19 social and physical distancing guidelines. However, despite the progress made toward the adoption and utilization of telemedicine technologies such as tele‐education, teleconsultation (Bitar & Alismail, 2021 ), tele‐pharmacy, tele‐laboratory (Kamulegeya et al, 2020 ), teledermatology, teleradiology, telecardiology, tele‐ophthalmology, tele‐neurology, telerehabilitation, tele‐oncology, and telepsychiatry, little is known pertaining the adoption, success, and impediments hindering the utilization of telemedicine in sub‐Saharan Africa, especially during the pandemic.…”

Business as usual during the COVID‐19 pandemic? Reflections on state‐wide trends in maternity telehealth consultations during lockdown in Victoria and New South Wales

“…A survey of global maternity healthcare providers utilising telemedicine during the pandemic demonstrated a concern regarding the lower quality of care and increasing pre-existing healthcare inequalities. 14 Challenges identified by healthcare professionals to introducing telemedicine included a lack of infrastructure and technological literacy, as well as financial and language barriers. 14 A survey of Australian doctors has revealed that 42% believe changes to maternity care from COVID-19 were temporary, with only 14% believing the changes were for the better.…”

“…14 Challenges identified by healthcare professionals to introducing telemedicine included a lack of infrastructure and technological literacy, as well as financial and language barriers. 14 A survey of Australian doctors has revealed that 42% believe changes to maternity care from COVID-19 were temporary, with only 14% believing the changes were for the better. 2 Furthermore, a systematic review identified numerous issues, including poor digital literacy and cost of technology which require addressing before the implementation of effective digital health.…”

Prenatal care, new media, and COVID-19 pandemic in India

“…The global pandemic prompted the maximization of telemedicine. The incorporation of telemedicine into maternal care showed a positive result in fetus development, maternal health, and obstetrics outcomes (Galle et al, 2021). Since pregnant women could doubt the credibility of online information and services and consequently feel dissatisfied, service providers and health professionals should stabilize quality and safety.…”