Telehealth services for global emergencies: implications for COVID-19: a scoping review based on current evidence.

INTRODUCTION: The availability of low-cost computing and digital telecommunication in the 1980s made telehealth practicable. Telehealth has the capacity to improve healthcare access and outcomes for patients while reducing healthcare costs across a wide range of health conditions and situations. OBJECTIVE: This study compares the adoption, advantages, and challenges of telehealth services between high-income (HICs) and low-and-middle-income countries (LMICs) before and during the COVID-19 pandemic. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The key search terms were: "Telehealth", "Telehealth in HICs", "Telehealth in LMICs", "Telehealth before COVID-19", "Telehealth during COVID-19". We searched exhaustively ProQuest, Scopus, Web of Science, Google Scholar, CINAHL, and EMBASE databases from 2012. Booleans OR/AND were combined with key search terms to increase relevant search results. The literature search and selection process followed the Sample, Phenomena of Interest, Design, Evaluation, and Research (SPIDER) question format. RESULTS: The adoption of telehealth before COVID-19 was generally low in both HICs and LMICs. The impact of COVID-19 accelerated the adoption of telehealth at the facility level but not nationwide in both high-income countries and LMICs. The rapid adoption of telehealth at the facility level in both high-income and LMICs introduced several challenges that are unique to each country and need to be addressed. CONCLUSION: The lack of national policies and regulations is making the adoption of telehealth at the national level challenging in both high and low-middle-income countries. Governments and Stakeholders of healthcare must consider telehealth as a healthcare procedure that should be deployed in clinical working procedures. Primary quantitative and qualitative studies must be conducted to address challenges encountered during the pilot implementation of telehealth services in both high-income countries and LMICs before and during pandemics.

Effects of coronavirus pandemic on expanded program on immunization in weija gbawe municipality (Accra-Ghana).

The introduction of Expanded Program on Immunization (EPI) and the availability of vaccines have contributed to significant reduction in morbidity and mortality rate, particularly among infants and children under five years. The coronavirus pandemic has however interrupted vaccination systems, limiting access and coverage for children. This study assesses the effect of the coronavirus disease outbreak on the EPI activities. The study employed a cross-sectional study design. Purposive and convenience sampling methods were used to sample 510 health workers directly engaged in immunization activities from 15 health care facilities. Coverages for five selected antigens (Diphtheria, Tetanus, Pertussis, Poliomyelitis, Tuberculosis) and Measles in the year 2020 experienced an overall decline ranging from 38.8% for measles rubella vaccine to 53.1% for Penta vaccine. The year 2019 recorded coverages ranging from 69.1% for BCG vaccine to 78.4% for penta vaccine, relatively higher than 2020. EPI services patronization rose up after COVID-19 peaks periods for BCG vaccine 67.7% to 89.2% for penta vaccine. The COVID-19 pandemic disrupted the delivery of EPI services significantly. Healthcare stakeholders can envisage telehealth services in care delivery against pandemic outbreaks. This study contributes to empirical knowledge by recommending vital predictive factors during a pandemic outbreak.