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Teleconsultation Support for Obstetric Emergencies During the COVID-19 Pandemic in Rural Nepal: Results and Lessons
Sajana Maharjan1, Swaraj Rajbhandari2, Liladhar Dhakal3
1One Heart Worldwide, Lalitpur, Nepal. sajana@oneheartworldwide.org.
A maternal and newborn health helpline in Nepal provided vital remote clinical support, successfully managing 21% of emergency cases via telephone. This low-tech solution improved decision-making and skills for rural healthcare providers.
Area of Science:
- Public Health
- Telemedicine
- Maternal and Newborn Health
Background:
- The COVID-19 pandemic highlighted the need for innovative healthcare solutions.
- Nepal faced challenges in providing timely maternal and newborn health services in remote areas.
Purpose of the Study:
- To evaluate a maternal and newborn health helpline piloted in Nepal.
- To assess the effectiveness of telephone consultations for obstetric and neonatal emergencies.
Main Methods:
- A helpline connected 551 primary healthcare facilities in 14 districts to 33 clinical experts.
- Data collected via monthly health facility record reviews (July 2020-June 2021) and semi-structured interviews.
Main Results:
- 160 facilities (29%) utilized the helpline, recording 429 teleconsultations.
- 21% of teleconsulted cases were managed on-site, avoiding hospital referral.
- Helpline use was highest in remote facilities with limited referral access.
Conclusions:
- The helpline demonstrated potential as a low-tech solution for improving maternal and newborn emergency care in rural settings.
- The program enhanced clinical decision-making, provider confidence, and referral efficiency.
- Implementation challenges included underreporting, drug shortages, and connectivity issues.
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