Feasibility of Adopting Telemedicine Abortion (TMA) Care to Improve Access to Quality Abortion Services in Kenya: A Systematic Review

Background: Unsafe abortion accounts for one of the leading causes of maternal deaths in Kenya. Access to safe abortion has been bombarded by the restrictive factors such as legal, economic, and social aspects thus denying the eligible group their universal right of quality healthcare. This study explored the feasibility of implementing Telemedicine Abortion (TMA) to improve accessibility of safe abortion care services based on safety, effectiveness, acceptability, and accessibility.

Methodology: This study applied a systematic review approach. The following electronic databases were searched; Cochrane Library, CINHAL plus, Embase, Scopus Medline studies for the articles published between 2012 up until 2024. Abstracts and articles were subjected to double screening and data extracted using Data Extraction Form (DEF) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thematic analysis was carried out using Atlas.ti software. Mixed Methods Appraisal Tool was adopted to determine the quality of selected articles.

Results: Out of 2147 articles searched, 44 papers met the inclusion criteria. Most papers originated from the developed countries such as United States, United Kingdom, and Australia. The following themes emerged, safety of Telemedicine Abortion, effectiveness of Telemedicine Abortion, acceptability of Telemedicine Abortion and Access through Telemedicine Abortion. Most studies reported high patient satisfaction and increased access. Also, TMA was found to be highly effective with no deaths and an insignificant proportion of complications reported.

Conclusion: Telemedicine Abortion is safe, acceptable and improves access to abortion care services. This study recommends further research on tackling health inequalities linked to telemedicine abortion.