Expanding access to early medical abortion services in Ghana with telemedicine: findings from a pilot evaluation

Joseph Adu, Matthea Roemer, Georgina Page, Elymas Dekonor, George Akanlu, Chris Fofie, Mary Dornukwor Teye, Patricia Opoku Afriyie, Adjeiwa Akosua Affram, Fidelia Ohemeng, Philip Teg Nefaah Tabong, Duah Dwomoh

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Abortion in Ghana is legally permissible under certain conditions. Updated in June 2021, the National Comprehensive Abortion Care Services Standards and Protocols included telemedicine as a recognised option for early medical abortion (EMA). Subsequently, Marie Stopes Ghana launched this pilot project to understand the feasibility and acceptability of providing EMA services through telemedicine. The pilot evaluation drew on two research protocols–a process evaluation and a qualitative study. The process evaluation focused on existing routine data sources and additional pilot-specific monitoring, while the qualitative protocol included in-depth interviews with a range of key stakeholders, including telemedicine and in-person patients, healthcare managers, and service providers. Telemedicine for EMA is feasible, acceptable, and has likely expanded access to safe abortion in Ghana. The MSIG telemedicine service package enabled 97% of patients to have a successful EMA at home. Thirty-six per cent of the total 878 patients during the pilot reported that they had no other option for accessing an abortion. Patients described telemedicine EMA services as a highly acceptable and appealing service option. Eighty-four per cent reported they would opt for the telemedicine service again and 83% reported they were very likely to recommend the service. There is potential for telemedicine to expand and improve access to critical SRH services. EMA via telemedicine can be delivered effectively in a low-resource setting. This pilot also showed how telemedicine provides access to patients who feel they do not have other safe service options, meeting specific patient needs in terms of discretion, convenience, and timing.

Original languageEnglish
Article number2250621
JournalSexual and Reproductive Health Matters
Volume31
Issue number4
DOIs
Publication statusPublished - 2023

Keywords

  • Ghana
  • digital health
  • early medical abortion
  • family planning
  • sexual and reproductive health
  • telehealth
  • telemedicine

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