Shaikh Irum, Küng Stephanie Andrea, Aziz Hina, Sabir Samina, Shabbir Ghulam, Ahmed Mukhtar, Dabash Rasha
Ipas Pakistan, Islamabad, Pakistan.
Ipas, Chapel Hill, NC, United States.
Front Glob Womens Health. 2021 Jul 26;2:705262. doi: 10.3389/fgwh.2021.705262. eCollection 2021.
The COVID-19 pandemic led overburdened health care systems to deprioritize essential sexual and reproductive healthcare, including abortion and contraception care, while accelerating shifts in healthcare delivery to digital technologies. However, in many countries, including Pakistan, inequalities in access to digital technologies remain, presenting an opportunity for interventions that both increase access to deprioritized sexual and reproductive health and rights (SRHR) services and overcome the digital divide in delivering digital solutions to those in need of SRHR services. In June 2020, Ipas Pakistan partnered with Sehat Kahani (SK), a local health care NGO and telehealth service, and an existing network of Lady Health Workers (LHWs) to launch a novel hybrid telemedicine-community accompaniment pilot. The model linked women LHWs with mobile devices to online providers for telemedicine consultations for SRH, including abortion services, contraception, and other gynecological consultations. In June 2020, we trained 98 LHWs and 22 telehealth doctors. Between June 2020 and March 2021, a total of 176 women were referred by LHWs for telehealth consultations. Among women who received abortion services, nearly all (90%) reported complete uterine evacuation. No serious adverse events were reported. Overall satisfaction was high; 81% reported being satisfied, and 86% said it is likely they would recommend the telehealth service to others. Data show that the provision of SRHR services a telehealth-accompaniment model can be successfully implemented in Pakistan. Outcome data show high satisfaction and good clinical outcomes for women accessing care through this model. However, more data are needed to understand the full potential of this model. Barriers to digital health models, such as poor or inconsistent internet access, remain in places like Pakistan, especially in rural settings. This approach has its limitations but should be considered as an option in settings with similarly established community health networks and inequitable access to digital health.
新冠疫情导致不堪重负的医疗系统将包括堕胎和避孕护理在内的基本性健康和生殖健康护理的优先级降低，同时加速了医疗服务向数字技术的转变。然而，在包括巴基斯坦在内的许多国家，获取数字技术方面的不平等现象依然存在，这为开展干预措施提供了契机，这些干预措施既能增加人们获得优先级降低的性健康和生殖健康及权利（SRHR）服务的机会，又能在为有SRHR服务需求的人提供数字解决方案时克服数字鸿沟。2020年6月，国际帕思组织巴基斯坦分部与当地医疗非政府组织及远程医疗服务机构Sehat Kahani（SK）以及现有的女性健康工作者（LHWs）网络合作，启动了一项新型的远程医疗与社区陪伴相结合的试点项目。该模式将配备移动设备的女性健康工作者与在线医疗服务提供者相连，以便进行性健康和生殖健康的远程医疗咨询，包括堕胎服务、避孕咨询及其他妇科咨询。2020年6月，我们培训了98名女性健康工作者和22名远程医疗医生。在2020年6月至2021年3月期间，女性健康工作者共转诊了176名女性进行远程医疗咨询。在接受堕胎服务的女性中，几乎所有人（90%）报告子宫完全排空。未报告严重不良事件。总体满意度较高；81%的人表示满意，86%的人表示很可能会向他人推荐这项远程医疗服务。数据显示，在巴基斯坦可以成功实施通过远程医疗陪伴模式提供性健康和生殖健康及权利服务。结果数据显示，通过该模式获得护理的女性满意度较高，临床效果良好。然而，需要更多数据来了解该模式的全部潜力。在巴基斯坦等地，数字健康模式仍存在障碍，如网络接入差或不稳定，尤其是在农村地区。这种方法有其局限性，但在具有类似社区健康网络且数字健康获取不平等的环境中应被视为一种选择。
