Although reserved as a tool to delivering healthcare to underserved communities especially in the rural areas in Africa, the current need to maintain physical distancing and limit viral transmission has seen an increase in the use of telemedicine; in particular, teleconsultation. Experiences shared by Song et al suggests that telemedicine activities prevent close contact and decrease the chances of transmission of latent COVID-19 infection 4Health institutions in Africa are rolling out telehealth initiatives 1while regulatory bodies are modifying protocols for telehealth5
Our data revealed that more than half of the patients who showed interest in teleconsultations eventually got the service. Among those who could not have teleconsultation, about one-third said the insurance companies would not pay for the consultation. Those who eventually got the service had to pay cash. Our data did not explore other barriers to having a teleconsultation among the clients although extant literature shows that lack of awareness of telemedicine options on the part of the patients; unwillingness to explore other modalities of consultations and reluctance to see a new physician are barriers to teleconsultations 6 Our initial social media campaign was an attempt to overcome the barrier of awareness. Our patients were made aware that they could see any doctor of their choice including their regular physician.
The present data suggest that the initial enthusiasm has waned significantly in the four weeks of June. The reasons for this outlook need to be investigated albeit, we posit that the general public perception of a reduction in the number of COVID-19 cases could be responsible. In the immediate, to prevent another wave of COVID-19 infection in Tanzania, the adoption of steps to encouraging teleconsultations and overcoming the barrier should be reiterated to all the stakeholders-patients, healthcare institutions and insurance companies. According to Portnoy et al7, providing education to people that telemedicine is an effective alternative and safer under the current circumstances. There is also the need to institute and expand the system of reimbursement coverage for physicians who see patients through telemedicine. The main steps can be followed up with making people aware that a telemedicine benefit exists, with step-by-step instructions on how it can be accessed, while helping them to understand how telemedicine works. Efforts to reduce cost barriers to accessing telemedicine should be a continuous one.7
While recent clinical practice in high-income countries (HIC) has witnessed a rapid incorporation of telemedicine into conventional practice,8,9 this cannot be said of sub-Saharan Africa health service delivery. Perhaps the capability of telehealth in SSA will be expanded in the immediate future, the uncertain trajectory of the current pandemic calls for an exploration of every avenue to stem the tide. Increasing research into the barriers affecting uptake of services as well as other access, financial and infrastructural issues are needed for the current era and beyond.