Re: Implications for the future of Obstetrics and Gynaecology following the COVID-19 pandemic: a commentary.

Sir,

With immense interest we read the article entitled, ‘Implications for the future of Obstetrics and Gynaecology following the COVID‐19 pandemic: a commentary’ by Kasaven et al. The article briefs on the challenges faced and assesses the impact of COVID‐19 on the healthcare workforce, service providers and public perception. Pregnant women constitute a vulnerable group because of their increased risk of developing complications from viral respiratory infections. To tackle the unmet demands of obstetric care amidst the social distancing protocols and the halting of outpatient services, many obstetric patients have been using telehealth.

We would like to thank the authors for an insightful brief. However, although the commentary sheds light on the inaccessibility of telehealth, it fails to provide solutions to the obstacles imposed on rural communities in adopting and implementing telehealth, both technologically and physically. The global challenges and unique solutions faced by developing countries must also be addressed.

Telehealth clinics exist for rural communities in some inaccessible areas; nonetheless, the current challenges of these clinics include the patient’s physical absence, dissatisfaction through scheduling delays and the lack of technological infrastructure for these systems. Studies note that the use of a dedicated virtual health practitioner eliminates these concerns. A case study examined three models of care to conduct a return of investment (ROI) analysis. The three models investigated included‐ setting up a telehealth clinic, in‐person hospital visits and having a virtual health practitioner. They concluded that the third model was the only service model to have a positive ROI over 3 years. It eliminates patient dissatisfaction as they do not need to worry about transportation and is economically beneficial.

Additionally, one study assessed the feasibility of a paediatric telehealth network in Honduras with consultation support from the USA. They found that 100% of the respondents were satisfied and would continue receiving support from a virtual health practitioner. However, one of the setbacks from the study was poor internet connectivity.

In developing countries, particularly in the worst‐hit South Asian countries like India, poor internet penetration and connectivity issues presented several restrictions, and thus the obstetric care had to be revamped through mobile apps, telephone triage, offline/online local help groups and community health workers. Teleconsultation played a pivotal role in delineating high‐risk patients so that their care could be individualised. India benefitted from a collaborative healthcare model that combined both health workers in the community and regional levels of healthcare centres.

Thus, dedicated virtual health practitioners and connectivity support serve as cheaper and effective methods for patients in rural and tribal communities across the world. International consultations can also be used to help those from impoverished countries where fears of attending crowded clinics exist along with a severe shortage of healthcare workers. As such, the recognition of the practicality of virtual health practitioners and the implementation of a collaborative healthcare model needs to be established to aid in the delivery of virtual prenatal visits for those in rural and remote communities.

Disclosure of interests

None declared. Completed disclosure of interests form available to view online as supporting information.

Contribution to authorship

The conception and planning were jointly performed done by RA and SC. The original write‐up was planned by RA. The write‐up was further analysed, evaluated and revised by SC.

Details of ethics approval

Not applicable.

Funding

None. The authors have not received any monetary benefit.

However, ISCI helped all the authors by providing research mentors to reviewers and other required support, though.

Acknowledgement

We would like to thank the Peer Research Mentorship Programme (PRMP) started by the International Society for Chronic Illnesses (ISCI) for their support.

(Mentor‐Dr Surobhi Chatterjee and Mentee‐ Rama Alkhaldi)

Supplementary Material

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Supplementary Material

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