Use of Telemedicine in Improving Access for Pregnant Women to Hospital in Nairobi During the Covid – 19 Pademic ( Mixed – Method Cross – Sectional Study)

Abstract

Study Background: Maternal deaths are preventable if the three delays to accessing health care outlined by Thaddeus and Maine are actively addressed. These delays have been identified chronologically as delays in (I) the decision to access care, (ii) the identification of- and transport to a medical facility (delay in seeking healthcare), and the receipt of adequate and appropriate treatment (delay in receiving quality healthcare). The strides taken by the World Health Organisation and Local Governments to reduce the burden of maternal mortalities have been affected by the Covid-19 pandemic, and lockdown and travel restrictions to mitigate the spread of the Covid-19 disease with more deaths and pregnancy complications noted. Telehealth has emerged as a solution to ensure all women, especially the vulnerable, access teleconsultation from doctors and free transport from their homes to facilities. Wheels for Life is an initiative that began in April 2020 (at the core of Covid -19) to enable pregnant women to get care during curfew hours and 24 hours free consultation in 6 counties. The intervention handled more than 120,000 calls during the Covid 19 pandemic, with over 10000 women receiving telemedicine and over 2000 dispatched safely to a hospital. Broad objective: To determine the utilisation, uptake and experience with telemedicine in reducing delays in access to maternal health services during the Covid 19 pandemic in Kenya from May 2020 to April 2021 in Nairobi County Methodology: We used a partially mixed sequential quantitative-qualitative research to objectively determine the intervention's effectiveness by retrospectively analysing data from the intervention's database using forms. Our study population was the pregnant women, their caregivers and health care workers who interacted with the intervention during the Covid -19 pandemic within Nairobi County. We collected data retrospectively from intervention records and in-depth interviews were used to assess the views of the different stakeholders. i.e. the patients, taxi drivers, and health care workers. The quantitative analysis was analysed using descriptive analyses and qualitative analysis done using thematic deduction. Utility of the study: We hope that our research can objectively show the usefulness of telemedicine and easily accessible emergency transport in improving maternal health care, especially during pandemics; moreover, that it can guide different policymakers in analysing the intervention for possible integration into the counties and national government health systems