Safely visiting clinics in cyberspace
As countries navigate the realities of Covid-19, telemedicine can play a crucial role in providing women with sexual and reproductive health services, writes Whitney Chinongwenya
Telemedicine has been a crucial lifeline for places facing an acute shortage of health-care personnel
● I always think that there is a silver lining to every problem. Starting in January, the world was thrown into a crisis, the extent of which no-one then realised.
The Covid-19 pandemic has propelled the world to re-evaluate, re-strategise and break norms that have been in place for years. It has created the need to collaborate, innovate and work in new ways.
While countries grapple with overburdened health systems and disruption in services, a revolution in health care is slowly brewing — the growing acceptance of telemedicine.
As doctors and patients negotiate the realities of a highly infectious virus, telemedicine stands out as having the potential to transform health-care delivery in unimaginable ways.
Often hailed as the future of health care, telemedicine has been a crucial lifeline for places that have faced an acute shortage of health workers.
It has helped patients who might otherwise have to travel long distances, and bridged distances by offering immediate access to specialised expertise. It is often less costly and time-saving, especially for the provision of critical sexual and reproductive health (SRH) services.
With restricted mobility and lack of access to services due to the coronavirus pandemic, countries are realising and acknowledging the merits of telemedicine in the provision of SRH services.
In the US, for instance, a programme known as TelAbortion — which mails its users abortion pills after a video consultation — reported helping twice as many women in March and April as it did during the previous two months.
Other countries such as France, Ireland and the UK have enabled the use of telemedicine for remote support of medical abortion — drugs that induce miscarriage — while Belgium is using telemedicine for prescriptions and abortion consultations.
Azerbaijan, Finland and Spain have adopted telemedicine for SRH services, while in Germany the mandatory counselling session prior to an abortion can take place over the phone or by video chat.
SA is not far behind in adopting telemedicine during this crisis. The Health Professions Council of SA first published its “general ethical guidelines for good practice in telemedicine” in August 2014. This year, the council updated the guidelines so practitioners can enhance access to health care for those who are disadvantaged and unable to physically reach health services.
This is especially advantageous for many women, who have an unmet need for services such as contraception and abortion.
While the pandemic has exacerbated the challenges women face while accessing SRH services, the time is ripe for policymakers and civil society to use telemedicine as an effective tool to reach women with the services they need, when they need them.
At Marie Stopes SA, we have rolled out a telemedicine consultation service to assist women who are unable to visit the centres in person to access safe abortion services.
The 20-minute teleconsultation with trained professionals provides details about the procedure, what to expect, delivery or collection processes, as well as the aftercare and follow-up procedures. The teleconsultation, which is available to women and girls who are between four and nine weeks into their pregnancy, discusses client eligibility and the options available according to the stage of pregnancy, including the option of self-managed pregnancy termination.
To ensure good quality care, Marie Stopes SA has established strict protocols and standards for medication termination procedures so women can have a safe, homebased option.
This model has enabled us to significantly improve access to abortion health-care services at lower cost and with positive outcomes. With all the protocols and regulations, it has great potential and can be replicated at public health facilities.
As we provide more and more services every day, telemedicine is the silver lining, the revolution in health care that I can see in the immediate future — not just for abortion, but for all SRH services.
While we cannot change the reality that we are living in today, we must grab every opportunity to ensure that we create and innovate in health care. This will not only prepare us for any emergencies, but also help to ensure that women and their health do not bear the unequal burden that such emergencies usually place on their shoulders.
The need of the hour therefore is for a more targeted and focused effort to increase the uptake of telemedicine, plug the gaps that emerge and empower women in every way to make choices about their bodies and health.