Telehealth Utilisation in HIV Care Services in Harare, Zimbabwe: Awareness and Acceptability among Healthcare Workers
Abstract:
Access to healthcare
in developing countries is generally poor due to limited health facilities and shortage
of healthcare workers. Recent developments
in technology and telehealth promise to address challenges of access to health facilities through remote service
provision. However, the level of awareness and acceptability of telehealth in HIV
care among healthcare workers in Zimbabwe is not well known. The main objective
of this study is to assess the level of awareness and acceptability of telehealth
among healthcare workers involved in HIV care in Harare, Zimbabwe. A cross-sectional survey was employed to conveniently
sample and interview 395 healthcare workers from 15 public healthcare facilities and 34 private healthcare facilities
in Harare. A pretested questionnaire was employed to collect data. Logistic regression
analysis was carried out to establish
possible association of the independent variable and dependent variables (awareness
and acceptance). All statistical analyses
were performed using SPSS software version 28.0.1.1. Of the 395 healthcare workers interviewed,
87% were aware of telehealth, while 85% found it acceptable. Logistic regression
analysis identified educational level, and type of profession to be significantly
(p < 0.05) associated with telehealth awareness. There was an association
between telehealth acceptance and level of education (p < 0.05). Lack of resources was a major barrier to telehealth
utilisation. The findings of this study reveal high awareness and acceptability
of telehealth in HIV care among healthcare workers in Harare. The findings provide optimism for telehealth uptake
and the promotion of telehealth as an
important intervention in HIV care.
References:
[1] World Health Organization. (n.d.). Social determinants of health. Retrieved
3 August 2022, from https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1.
[2] Loewenson,
R., & Masotya, M. (2018). Equity Watch: Assessing progress towards equity
in health in Zimbabwe, 2018 Training and Research Support Centre, Regional Network
for Equity in Health in East and Southern Africa (EQUINET). https://www.tarsc.org/publications/documents/Zim%20equitywatch%2009.pdf.
[3] Mangundu,
M., Roets, L., & Van Rensberg, E. J. (2020). Accessibility of healthcare in
rural Zimbabwe: The perspective of nurses and healthcare users. African Journal
of Primary Health Care & Family Medicine, 12(1). https://doi.org/10.4102/phcfm.v12i1.2245.
[4] Tessema,
Z. T., Worku, M. G., Tesema, G. A., Alamneh, T. S., Teshale, A. B., Yeshaw, Y.,
Alem, A. Z., Ayalew, H. G., & Liyew, A. M. (2022). Determinants of accessing
healthcare in Sub-Saharan Africa: A mixed-effect analysis of recent Demographic
and Health Surveys from 36 countries. BMJ Open, 12(1), e054397. https://doi.org/10.1136/bmjopen-2021-054397.
[5] Oleribe,
O. E., Momoh, J., Uzochukwu, B. S., Mbofana, F., Adebiyi, A., Barbera, T., Williams,
R., & Taylor Robinson, S. D. (2019). Identifying Key Challenges Facing Healthcare
Systems In Africa And Potential Solutions. International Journal of General Medicine,
Volume 12, 395–403. https://doi.org/10.2147/IJGM.S223882.
[6] Druetz,
T. (2018). Integrated primary health care in low- and middle-income countries: A
double challenge. BMC Medical Ethics, 19(S1), 48. https://doi.org/10.1186/s12910-018-0288-z.
[7] Tafuma,
T. A., Mahachi, N., Dziwa, C., Moga, T., Baloyi, P., Muyambo, G., Muchedzi, A.,
Chimbidzikai, T., Ncube, G., Murungu, J., Nyagura, T., & Lew, K. (2018). Barriers
to HIV service utilisation by people living with HIV in two provinces of Zimbabwe:
Results from 2016 baseline assessment. Southern African Journal of HIV Medicine,
19(1), 721. https://doi.org/10.4102/hivmed.v19i1.721.
[8] Keesara,
S., Jonas, A., & Schulman, K. (2020). Covid-19 and Health Care’s Digital Revolution.
New England Journal of Medicine, 382(23), e82. https://doi.org/10.1056/NEJMp2005835.
[9] Health Resources
and Services Administration. (2020). Glossary. https://bhw.hrsa.gov/glossary#t.
[10] Lurie, N.,
& Carr, B. G. (2018). The Role of Telehealth in the Medical Response to Disasters.
JAMA Internal Medicine, 178(6), 745. https://doi.org/10.1001/jamainternmed.2018.1314.
[11] Miyawaki,
A., Tabuchi, T., Ong, M. K., & Tsugawa, Y. (2021). Age and Social Disparities
in the Use of Telemedicine During the COVID-19 Pandemic in Japan: Cross-sectional
Study. Journal of Medical Internet Research, 23(7), e27982. https://doi.org/10.2196/27982.
[12] Williams,
C., & Shang, D. (2023). Telehealth Usage Among Low-Income Racial and Ethnic
Minority Populations During the COVID-19 Pandemic: Retrospective Observational Study.
Journal of Medical Internet Research, 25, e43604. https://doi.org/10.2196/43604.
[13] Fouad, A.
A., Osman, M. A., Abdelmonaem, Y. M. M., & Karim, N. A. H. A. (2023). Awareness,
knowledge, attitude, and skills of telemedicine among mental healthcare providers.
Middle East Current Psychiatry, 30(1), 5. https://doi.org/10.1186/s43045-022-00272-3.
[14] Ammenwerth,
E. (2019). Technology Acceptance Models in Health Informatics: TAM and UTAUT. Studies
in Health Technology and Informatics, 263, 64–71. https://doi.org/10.3233/SHTI190111.
[15] Venkatesh,
Morris, Davis, & Davis. (2003). User Acceptance of Information Technology: Toward
a Unified View. MIS Quarterly, 27(3), 425. https://doi.org/10.2307/30036540.
[16] López-Cabarcos,
M. Á., Piñeiro-Chousa, J., & Quiñoá-Piñeiro, L. (2021). An approach to a country’s
innovation considering cultural, economic, and social conditions. Economic Research-Ekonomska
Istraživanja, 34(1), 2747–2766. https://doi.org/10.1080/1331677X.2020.1838314.
[17] Chitungo,
I., Mhango, M., Mbunge, E., Dzobo, M., Musuka, G., & Dzinamarira, T. (2021).
Utility of telemedicine in sub‐Saharan Africa during the COVID ‐19 pandemic. A rapid
review. Human Behavior and Emerging Technologies, 3(5), 843–853. https://doi.org/10.1002/hbe2.297.
[18] Furusa,
S. S., & Coleman, A. (2018). Factors influencing e-health implementation by
medical doctors in public hospitals in Zimbabwe. SA Journal of Information Management,
20(1). https://doi.org/10.4102/sajim.v20i1.928.
[19] International Center for AIDS Care and Treatment
Program (2020). Zimbabwe population-based HIV impact assessment.
https://phia.icap.columbia.edu/zimbabwe2020-final-report/
[20] Banya, N.
(2018). Zimbabwe’s health delivery system. ZimFact. https://zimfact.org/factsheet-zimbabwes-health-delivery-system/.
[21] Raosoft.
(2004). Sample Size Calculator. http://www.raosoft.com/samplesize.html.
[22] Mugarisi,
V. (2022). Zimbabwe conducts health labour market analysis. World Health
Organization. https://www.afro.who.int/countries/zimbabwe/news/zimbabwe-conducts-health-labour-market-analysis.
[23] Gurupur,
V. P., & Wan, T. T. H. (2017). Challenges in implementing mHealth interventions:
A technical perspective. MHealth, 3, 32–32. https://doi.org/10.21037/mhealth.2017.07.05.
[24] Ministry of Child and Child Care. (n.d.). National Health Strategy 2020-2025 on the cards.
Retrieved 3 September 2023, from http://www.mohcc.gov.zw/index.php?option=com_content&view=article&id=343:national-health-strategy-2020-2025-on-the-.
[25] Naqvi, S.
Z., Ahmad, S., Rocha, I. C., Ramos, K. G., Javed, H., Yasin, F., Khan, H. D., Farid,
S., Mohsin, A., & Idrees, A. (2022). Healthcare Workers’ Knowledge and Attitude
Toward Telemedicine During the COVID-19 Pandemic: A Global Survey. Cureus.
https://doi.org/10.7759/cureus.30079.
[26] Elhadi,
M., Elhadi, A., Bouhuwaish, A., Bin Alshiteewi, F., Elmabrouk, A., Alsuyihili, A.,
Alhashimi, A., Khel, S., Elgherwi, A., Alsoufi, A., Albakoush, A., & Abdulmalik,
A. (2021). Telemedicine Awareness, Knowledge, Attitude, and Skills of Health Care
Workers in a Low-Resource Country During the COVID-19 Pandemic: Cross-sectional
Study. Journal of Medical Internet Research, 23(2), e20812. https://doi.org/10.2196/20812.
[27] Ayatollahi,
H., Sarabi, F. Z. P., & Langarizadeh, M. (2015). Clinicians’ Knowledge and Perception
of Telemedicine Technology. Perspectives in Health Information Management,
12(Fall), 1c.
[28] Renu, N.
(2021). Technological advancement in the era of COVID-19. SAGE Open Medicine,
9, 205031212110009. https://doi.org/10.1177/20503121211000912.
[29] Mahtta,
D., Daher, M., Lee, M. T., Sayani, S., Shishehbor, M., & Virani, S. S. (2021).
Promise and Perils of Telehealth in the Current Era. Current Cardiology Reports,
23(9), 115. https://doi.org/10.1007/s11886-021-01544-w.
[30] Yaghobian,
S., Ohannessian, R., Iampetro, T., Riom, I., Salles, N., De Bustos, E. M., Moulin,
T., & Mathieu-Fritz, A. (2022). Knowledge, attitudes and practices of telemedicine
education and training of French medical students and residents. Journal of Telemedicine
and Telecare, 28(4), 248–257. https://doi.org/10.1177/1357633X20926829.
[31] Ncube, B.,
Mars, M., & Scott, R. E. (2023). Perceptions and attitudes of patients and healthcare
workers towards the use of telemedicine in Botswana: An exploratory study. PLOS
ONE, 18(2), e0281754. https://doi.org/10.1371/journal.pone.0281754.