ON World Population Day as the Covid-19 pandemic rages on, upending lives and lifestyles, there should be a realisation that healthcare providers have had to come up with creative solutions to provide uninterrupted services to the most vulnerable populations, including pregnant women and new mothers.
A disruption in family planning services and supplies can lead to untold tragedies. This may result in a spike in unexpected pregnancies, unsafe abortions, pregnancy-related complications and even maternal deaths. Launched just ahead of World Population Day, a report by the UNFPA warns that if services and programmes for women remain closed for six months, an additional 13 million girls may be forced into marriage between now and 2030.
While the state grappled with whatever semblance of an on-the-ground healthcare system it had to battle the virus, the digital revolution quickly jumped into the fast lane. With social distancing an important measure to contain the coronavirus, e-health became all the more necessary to ensure safety of both healthcare providers and patients seeking medical advice.
Many physicians and private hospitals began offering consultations electronically using videoconferencing services. Digital health applications that help find nearby doctors, offer home consultations, order medicines, and even help find blood donors, were rolled out rapidly.
The pandemic has been a catalyst for tech solutions.
One silver lining to the pandemic has been the thousands of women doctors returning to the field of medicine and resuming their practice. Sehat Kahani, a social enterprise founded in 2017, was running 26 clinics in low-income communities across Pakistan where a nurse connected patients to a doctor via videoconferencing. Last year, they released an app through which users could reach a physician using a smartphone device. But it was not until the pandemic that this app gained traction. On the one hand, it has provided a platform to nearly 1,500 female doctors to practise medicine; on the other, it has alleviated the suffering of nearly 35,000 patients.
Sehat Kahani is not alone, and many healthcare ventures are riding the digital wave. Through a new reproductive health helpline, Pakistani women can seek advice and guidance for their sexual and reproductive health over the phone in the privacy of their own homes.
Staying on the World Population Day theme of raising awareness of women’s and girls’ needs for sexual and reproductive health during the pandemic, this free phone service has been initiated by a group of organisations that have long been working on women’s health. They include the Association for Mothers & Newborns (AMAN), the Society of Obstetricians and Gynaecologists of Pakistan, the Population Council and the UNFPA. While it isn’t the same as a face-to-face conversation in a clinic along with physical examinations, the helpline enables a cohort of trained female gynaecologists and obstetricians across Pakistan to provide women consultations about any reproductive and sexual health issue.
The calls they are receiving range from issues of abnormal or irregular periods to advice on what tests to get done in case of pregnancy, or what to do in case a pregnant woman tests positive for Covid-19, or queries on post-abortion care.
Still rudimentary, it is not without its own set of challenges ranging from connectivity issues due to slow internet speed, power outages, or some other technical glitch. Some doctors have found counselling uneducated patients over phone challenging as they are unable to prescribe them tests or medicines accurately.
Most doctors have also realised that it is an excellent filtering process to find out if a patient needs to reach a facility at all or if the situation can be handled at home.
For the patient, this consultation means that she does not have to step out of her home for hours on end or spend money on transport. Sitting in the privacy of her home, she can ask whatever is bothering her without fear of being judged by the person accompanying her, usually her husband, her mother-in-law or her mother.
While the pandemic may have shown us the way towards adopting technology at an accelerated pace, it also presents an opportunity for policymakers to think of ways to transform the health system beyond this moment.
According to DataReportal, in January 2020, Pakistan had 164.9m mobile connections, an increase of 6.2 per cent from the previous year and which makes up 75pc of the total population. There were 76.38m internet users and internet penetration stood at 35pc in the same month.
Clearly, e-health and telemedicine may prove to be critical solutions to overcoming geographical, financial or other barriers for those seeking sexual and reproductive health care in the rural and remote regions of Pakistan where healthcare access is severely limited but mobile usage is on the rise.
The writer is a freelance journalist based in Karachi.
Published in Dawn, July 11th, 2020