This draft background paper provides an overview of how telehealth promotes equitable access to essential health services, and the key policy, programmatic and strategic drivers for successful implementation in low- and middle-income countries (LMICs). It aims to provide participants with a basis for discussion and exploration during this e-discussion, and is not intended to be systematic review of telehealth.

Note that this background paper is currently in draft form and readers are encouraged to provide their feedback and comments through this e-discussion on Scaling Up Telehealth to Promote Equitable Access to Essential Health Services (23 August-17 September 2021). Looking forward to your inputs!

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Comments (1)

Kaloyan Kamenov

Hi there,

I think I am too late to provide feedback on the background paper in the comment section in Room 2, so hopefully here will be ok.

In Room 2 we discussed the importance of accessibility and how it can be incorporated in the background paper, and below I have made a shot suggestion of how this can happen.

A practical suggestion for the background paper to incorporate the issue of accessibility - I think that it will be difficult to change much now in terms of text or sections, but perhaps we can add a paragraph or two around accessibility that will then bring the attention of the reader to this issue.

My suggestion is to frame it around the issue of equity, gender and human rights, and perhaps the best place for it is to include it in Box 1 on gender considerations but expand with more text on the importance of equity and human rights to avoid exacerbating inequities in access to health services.

Something along these lines can be considered:

When designing and providing telehealth solutions, special attention needs to be paid to the needs, preferences and requirements of disadvantaged or marginalized populations, hard-to-reach groups, including people with low literacy, people with limited control over or access to digital devices, migrant populations and persons with disabilities.

For example, persons with disabilities, who constitute 15% of the global population, are a diverse group of individuals who experience many barriers and challenges when accessing telehealth services. People with vision impairment might not be able to read text or use online platforms if these are not compatible with screen readers, assistive devices such as Braille keyboards, or screen magnification. People with hearing impairment are unable to communicate with a healthcare provider if captioning and volume control are not available in video conferencing. Without voice synthesizers or text-to-speech generators, people with speech difficulties are unable to communicate their needs and requirements. There are many guidelines, such as the W3C Accessibility Standards, that provide recommendations for accessible web content, which can facilitate the provision of telehealth services to those with disabilities. Currently, WHO and ITU are developing a comprehensive global standard on accessibility of telehealth services which will outline all requirements on concrete accessibility features that healthcare providers and manufacturers of telehealth platforms need to ensure when delivering telehealth services.


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