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INTRODUCTION: The availability of low-cost computing and digital telecommunication in the 1980s made telehealth practicable. Telehealth has the capacity to improve healthcare access and outcomes for patients while reducing healthcare costs across a wide range of health conditions and situations. OBJECTIVE: This study compares the adoption, advantages, and challenges of telehealth services between high-income (HICs) and low-and-middle-income countries (LMICs) before and during the COVID-19 pandemic. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The key search terms were: "Telehealth", "Telehealth in HICs", "Telehealth in LMICs", "Telehealth before COVID-19", "Telehealth during COVID-19". We searched exhaustively ProQuest, Scopus, Web of Science, Google Scholar, CINAHL, and EMBASE databases from 2012. Booleans OR/AND were combined with key search terms to increase relevant search results. The literature search and selection process followed the Sample, Phenomena of Interest, Design, Evaluation, and Research (SPIDER) question format. RESULTS: The adoption of telehealth before COVID-19 was generally low in both HICs and LMICs. The impact of COVID-19 accelerated the adoption of telehealth at the facility level but not nationwide in both high-income countries and LMICs. The rapid adoption of telehealth at the facility level in both high-income and LMICs introduced several challenges that are unique to each country and need to be addressed. CONCLUSION: The lack of national policies and regulations is making the adoption of telehealth at the national level challenging in both high and low-middle-income countries. Governments and Stakeholders of healthcare must consider telehealth as a healthcare procedure that should be deployed in clinical working procedures. Primary quantitative and qualitative studies must be conducted to address challenges encountered during the pilot implementation of telehealth services in both high-income countries and LMICs before and during pandemics.
Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Emergencies , Developing Countries , Health Services AccessibilityABSTRACT
Background Telemedicine, which is the practice of medicine using technology to deliver health care remotely, has a low adoption rate in low- and middle-income countries (LMICs). However, the advent of coronavirus disease 2019 (COVID-19) has forced healthcare systems in these settings to begin implementing telemedicine programs. It is unknown how prepared health professionals and the healthcare system are to adopt this technology. Therefore, this study aimed to assess the readiness of health professionals and explore factors associated with telemedicine implementation in Ghana. Methods A cross-sectional study was conducted in six health facilities between March and August 2021. Convenience sampling was used to select the six health facilities, and the participants were selected randomly for the study. Questionnaires were self-completed by participants. Data was exported into STATA 15.0 for analysis, and appropriate statistical methods were employed. All statistical tests were performed at a significance level of p < 0.05. Results Of the 613 health professionals involved in the study, about 579 (94.5%) were comfortable using computers, and the majority, 503 (82.1%) of them, had access to computers at the workplace. Health professionals agreed that the measures outlined by the health facilities supported their readiness to use telemedicine for healthcare services. Analysis revealed a statistically significant positive relationship between health facilities' core readiness and health professionals' readiness, with a correlation coefficient (r) of 0.5484 and a p-value<0.0001. Of the factors associated with health professionals' readiness towards telemedicine implementation, facility core readiness, engagement readiness, staff knowledge and attitude readiness showed a statistically significant relationship with health professionals' readiness. Conclusion The study revealed that health professionals are ready to adopt telemedicine. There was a statistically significant relationship between health facilities' core readiness, engagement readiness, staff knowledge and attitude readiness, and health professionals' readiness. The study identified factors facilitating telemedicine adoption.
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The coronavirus pandemic is the greatest crisis of our time, having claimed over 2 million lives and shocking the global economy. Scientists and governments have suggested the idea of a digital COVID-19 certificate, to identify vaccinated persons easily. This paper assesses the positions of stakeholders on COVID-19 vaccination certificates, their presentation, and their importance. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was applied in this study. Search terms with Boolean and/or operators were combined to increase relevant results. Four large digital databases were used for the search. Inclusion and exclusion criteria were used to screen 298 collated studies. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. It is essential to re-examine digital COVID-19 vaccination certificates, considering their benefits, such as real-time detection of fake vaccination certificates and identifying and mapping non-vaccinated areas for strategic vaccination planning. The use of a single electronic platform globally will ease verification processes while bringing economies back to their feet. Digital COVID-19 vaccination certificates may provide balance in this pandemic era. With digital COVID-19 certificate exceeding documentation purposes, it is important to recognise factors such as global economy and human rights, boosting free movements of persons.
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The introduction of Expanded Program on Immunization (EPI) and the availability of vaccines have contributed to significant reduction in morbidity and mortality rate, particularly among infants and children under five years. The coronavirus pandemic has however interrupted vaccination systems, limiting access and coverage for children. This study assesses the effect of the coronavirus disease outbreak on the EPI activities. The study employed a cross-sectional study design. Purposive and convenience sampling methods were used to sample 510 health workers directly engaged in immunization activities from 15 health care facilities. Coverages for five selected antigens (Diphtheria, Tetanus, Pertussis, Poliomyelitis, Tuberculosis) and Measles in the year 2020 experienced an overall decline ranging from 38.8% for measles rubella vaccine to 53.1% for Penta vaccine. The year 2019 recorded coverages ranging from 69.1% for BCG vaccine to 78.4% for penta vaccine, relatively higher than 2020. EPI services patronization rose up after COVID-19 peaks periods for BCG vaccine 67.7% to 89.2% for penta vaccine. The COVID-19 pandemic disrupted the delivery of EPI services significantly. Healthcare stakeholders can envisage telehealth services in care delivery against pandemic outbreaks. This study contributes to empirical knowledge by recommending vital predictive factors during a pandemic outbreak.