Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study

Abstract Background Telemedicine interventions, while promising for enhancing healthcare access, require an evaluation of feasibility and acceptability to inform field implementation. This qualitative study explored the acceptability of a telemedicine intervention in which surgical incision photos t...

Full description

Saved in:
Bibliographic Details
Main Authors: Laban Bikorimana, Eve Hiyori Estrada, Anne Niyigena, Robert Riviello, Fredrick Kateera, Bethany Hedt-Gauthier, Vincent K. Cubaka
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Maternal Health, Neonatology and Perinatology
Subjects:
Online Access:https://doi.org/10.1186/s40748-024-00200-9
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1823861722739376128
author Laban Bikorimana
Eve Hiyori Estrada
Anne Niyigena
Robert Riviello
Fredrick Kateera
Bethany Hedt-Gauthier
Vincent K. Cubaka
author_facet Laban Bikorimana
Eve Hiyori Estrada
Anne Niyigena
Robert Riviello
Fredrick Kateera
Bethany Hedt-Gauthier
Vincent K. Cubaka
author_sort Laban Bikorimana
collection DOAJ
description Abstract Background Telemedicine interventions, while promising for enhancing healthcare access, require an evaluation of feasibility and acceptability to inform field implementation. This qualitative study explored the acceptability of a telemedicine intervention in which surgical incision photos taken by community health workers (CHWs) were sent to hospital-based general practitioners to diagnose surgical site infections (SSIs) following cesarean section in rural Rwanda. As the study timeline coincided with the beginning of the COVID-19 pandemic we additionally asked about their perceptions of telemedicine in this context . Methods We conducted qualitative, semi-structured in-depth interviews in Kinyarwanda among 26 individuals (14 women and 12 CHWs) who participated in the telemedicine intervention. The interviews were transcribed verbatim and translated into English. Thematic analysis was applied and parallel inductive coding was used to develop English and Kinyarwanda codebooks. These were consolidated into a master codebook for final coding. Results All women and CHWs found the photo-based telemedicine program acceptable, though some concerns were raised. One woman voiced concerns about the reliability of photos in detecting SSIs compared to in-person visits. Women and CHWs reported perceived faster healing associated with the intervention, enhanced access to postoperative care from home, and cost savings as notable benefits of the telemedicine program. Trust in CHWs emerged as a critical factor for community acceptance. While one CHW expressed reservations about implementing the intervention during COVID-19, the majority of CHWs and patients indicated strong acceptance, with some even preferring it. Conclusion These findings highlight the acceptance - from both caregivers and patients - of the photo-based telemedicine intervention in a resource-limited context, even amid crises like the COVID-19 pandemic. This acceptance was reinforced with recognized benefits, with trust in CHWs serving as a crucial factor. These insights can inform the development of telemedicine interventions in similar settings.
format Article
id doaj-art-5f709f4c11ed4f279fc9353abd0f96ed
institution Kabale University
issn 2054-958X
language English
publishDate 2025-02-01
publisher BMC
record_format Article
series Maternal Health, Neonatology and Perinatology
spelling doaj-art-5f709f4c11ed4f279fc9353abd0f96ed2025-02-09T12:50:55ZengBMCMaternal Health, Neonatology and Perinatology2054-958X2025-02-0111111010.1186/s40748-024-00200-9Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative studyLaban Bikorimana0Eve Hiyori Estrada1Anne Niyigena2Robert Riviello3Fredrick Kateera4Bethany Hedt-Gauthier5Vincent K. Cubaka6Partners In Health - RwandaDepartment of Global Health and Social Medicine, Harvard Medical SchoolPartners In Health - RwandaDepartment of Global Health and Social Medicine, Harvard Medical SchoolPartners In Health - RwandaDepartment of Global Health and Social Medicine, Harvard Medical SchoolPartners In Health - RwandaAbstract Background Telemedicine interventions, while promising for enhancing healthcare access, require an evaluation of feasibility and acceptability to inform field implementation. This qualitative study explored the acceptability of a telemedicine intervention in which surgical incision photos taken by community health workers (CHWs) were sent to hospital-based general practitioners to diagnose surgical site infections (SSIs) following cesarean section in rural Rwanda. As the study timeline coincided with the beginning of the COVID-19 pandemic we additionally asked about their perceptions of telemedicine in this context . Methods We conducted qualitative, semi-structured in-depth interviews in Kinyarwanda among 26 individuals (14 women and 12 CHWs) who participated in the telemedicine intervention. The interviews were transcribed verbatim and translated into English. Thematic analysis was applied and parallel inductive coding was used to develop English and Kinyarwanda codebooks. These were consolidated into a master codebook for final coding. Results All women and CHWs found the photo-based telemedicine program acceptable, though some concerns were raised. One woman voiced concerns about the reliability of photos in detecting SSIs compared to in-person visits. Women and CHWs reported perceived faster healing associated with the intervention, enhanced access to postoperative care from home, and cost savings as notable benefits of the telemedicine program. Trust in CHWs emerged as a critical factor for community acceptance. While one CHW expressed reservations about implementing the intervention during COVID-19, the majority of CHWs and patients indicated strong acceptance, with some even preferring it. Conclusion These findings highlight the acceptance - from both caregivers and patients - of the photo-based telemedicine intervention in a resource-limited context, even amid crises like the COVID-19 pandemic. This acceptance was reinforced with recognized benefits, with trust in CHWs serving as a crucial factor. These insights can inform the development of telemedicine interventions in similar settings.https://doi.org/10.1186/s40748-024-00200-9Maternal healthPostpartum careCommunity health workersAfricaMobile health
spellingShingle Laban Bikorimana
Eve Hiyori Estrada
Anne Niyigena
Robert Riviello
Fredrick Kateera
Bethany Hedt-Gauthier
Vincent K. Cubaka
Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study
Maternal Health, Neonatology and Perinatology
Maternal health
Postpartum care
Community health workers
Africa
Mobile health
title Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study
title_full Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study
title_fullStr Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study
title_full_unstemmed Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study
title_short Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study
title_sort acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural rwanda a qualitative study
topic Maternal health
Postpartum care
Community health workers
Africa
Mobile health
url https://doi.org/10.1186/s40748-024-00200-9
work_keys_str_mv AT labanbikorimana acceptabilityoftelemedicineforearlysurgicalsiteinfectiondiagnosisaftercesareandeliveryinruralrwandaaqualitativestudy
AT evehiyoriestrada acceptabilityoftelemedicineforearlysurgicalsiteinfectiondiagnosisaftercesareandeliveryinruralrwandaaqualitativestudy
AT anneniyigena acceptabilityoftelemedicineforearlysurgicalsiteinfectiondiagnosisaftercesareandeliveryinruralrwandaaqualitativestudy
AT robertriviello acceptabilityoftelemedicineforearlysurgicalsiteinfectiondiagnosisaftercesareandeliveryinruralrwandaaqualitativestudy
AT fredrickkateera acceptabilityoftelemedicineforearlysurgicalsiteinfectiondiagnosisaftercesareandeliveryinruralrwandaaqualitativestudy
AT bethanyhedtgauthier acceptabilityoftelemedicineforearlysurgicalsiteinfectiondiagnosisaftercesareandeliveryinruralrwandaaqualitativestudy
AT vincentkcubaka acceptabilityoftelemedicineforearlysurgicalsiteinfectiondiagnosisaftercesareandeliveryinruralrwandaaqualitativestudy