A Framework for Enhancing the Uptake and Utilisation of Telehealth in HIV Care in Harare, Zimbabwe

Abstract

Telehealth, a rapidly evolving facet of modern healthcare, is revolutionising the way medical services are delivered. Implementing telehealth involves careful planning, coordination, and consideration of various factors. Despite the promotion of telehealth by the World Health Organisation and key health professionals, several implementation failures have been reported. Previous studies have reported failures related to a lack of well-structured frameworks that provide guidance and standardisation, efficiency, integration, and compliance. This study was part of a multi-phase study aimed at developing a framework to improve the uptake and utilisation of telehealth in HIV care in Harare, Zimbabwe. A mixed-methods approach which includes both qualitative and quantitative approaches was used. Three separate studies of this multi-phase study have been published. Guided by the findings of the previous three studies, and the Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework, a consolidation process was undertaken using an iterative inductive approach to design a framework that demonstrated relationships between the identified key elements and their role in improving telehealth uptake and utilisation in HIV care services. The designed framework highlights separate and distinct sections: current telehealth status; strategies to enhance telehealth implementation, utilisation and scale-up; and recommended actions. Suggested strategies include an improvement of existing infrastructure, increased funding, development of guiding policies, and partnerships. The framework could guide policy formulation and decision-making among stakeholders. Careful consideration of the framework could also ensure the successful future implementation of telehealth across the whole country. However, significant hurdles to telehealth utilisation and scale-up exist and should be addressed to realise the full potential.