Implementation of Telemedicine Services for Safe Abortion Access During the Covid-19 Pandemic in Colombia

Abstract

Background: Covid-19 represented a health, humanitarian and economic crisis that affected the world's population, causing changes in the dynamics, structure and behavior of society. Health services were reorganized or interrupted due to the change in the prioritization of health needs and tele-abortion was one of the alternatives to ensure access to safe abortion during the pandemic. Aim: To identify the challenges and opportunities for the provision of tele-abortion services in Colombia, specifically in the Profamilia Association during and after the Covid-19 health emergency. Methods: Qualitative exploratory-descriptive research, based on the methodology of systematization of experiences, developed in three stages: the review of public policy documents, the use of manuscript and oral primary sources, and the analysis of the information collected. Results: In Colombia, the health crisis led to a more accelerated implementation of telemedicine and telehealth standards. The implementation of tele-abortion services in Profamilia began in 2020 through the "Mía Kit" as part of a strategy to expand the right to self-managed abortion. The organization faced challenges and opportunities at the organizational, socio-political and cultural levels. The challenges were related to the need for training in the effective use of Information and Communication Technologies, the lack of guidelines for the provision of tele-abortion services and social imaginaries about the suitability of face-to-face care. Opportunities were found to be related to national coverage, protocols, programs and organizational policies on abortion care, and the preference of some users to receive abortion care in a non-face-to-face setting. Conclusion: Tele-abortion represents an opportunity to reduce the stigma associated with this intervention, allowing women to access this service in an environment they consider adequate and safe. Virtual advising and accompaniment are essential for this practice to be effective.