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Open Access 01-12-2024 | Telemedicine | Systematic Review

Attitudes towards Telemedicine Services and Associated Factors among health professionals in Ethiopia: a systematic review and meta-analysis

Authors: Alex Ayenew Chereka, Gebrehiwot Berie Mekonnen, Amlaku Nigusie Yirsaw, Berihun Agegn Mengistie, Eyob Getachew, Gebeyehu Lakew, Adamu Ambachew Shibabaw, Gemeda Wakgari Kitil

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

Telemedicine is a vital tool for improving healthcare delivery in Ethiopia, where geographic, economic, and infrastructural challenges limit access to care, particularly in rural areas. With a shortage of healthcare professionals and limited medical services, telemedicine offers a solution by enabling remote consultations and continuous monitoring, extending healthcare to underserved populations. However, the successful adoption of telemedicine depends largely on the attitudes of healthcare professionals, whose acceptance and use of the technology are crucial for its integration. This study reviews the factors influencing Ethiopian health professionals’ attitudes toward telemedicine to provide insights that can support its adoption and improve healthcare delivery in the country.

Methods

Following the PRISMA guidelines, we conducted a systematic review of studies on telemedicine attitudes, initially identifying 15,900 articles. After screening, 5 full-text articles were selected for inclusion. The data were analyzed using STATA version 11, where heterogeneity was assessed using the I² test, and publication bias was evaluated through funnel plots and Egger’s regression. The pooled effect size was calculated using a random-effects model, with a 95% confidence interval to ensure the robustness and precision of the findings.

Results

The finding that 53.42% (95% CI: 42.02–64.83) of Ethiopian health professionals hold positive attitudes towards telemedicine suggests a moderate level of acceptance. Factors associated with these positive attitudes included receiving computer training in telemedicine (AOR 4.47, 95% CI: 1.94–10.26), possessing advanced digital literacy (AOR 4.08, 95% CI: 1.30–12.81), comprehensive knowledge of telemedicine technology (AOR 3.28, 95% CI: 1.73–6.23), access to reliable internet (AOR 3.04, 95% CI: 1.67–5.53), and availability of electronic devices in healthcare settings (AOR 2.59, 95% CI: 1.73–3.87).

Conclusion and recommendations

This meta-analysis reveals that 53.42% of Ethiopian health professionals hold positive attitudes towards telemedicine, influenced by specialized training, digital literacy, and resource access. To enhance adoption, initiatives should focus on targeted training, reliable internet connectivity, availability of devices in healthcare settings, and promoting broader awareness about telemedicine benefits and applications among healthcare professionals.
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Literature
1.
go back to reference Tabish SA, Nabil S. Future of healthcare delivery: Strategies that will reshape the healthcare industry landscape. Int J Sci Res. 2014;4(2):727–58. Tabish SA, Nabil S. Future of healthcare delivery: Strategies that will reshape the healthcare industry landscape. Int J Sci Res. 2014;4(2):727–58.
3.
go back to reference Du Y, et al. Factors influencing adoption and use of Telemedicine Services in Rural areas of China: mixed methods study. JMIR Public Health Surveillance. 2022;8(12):e40771.CrossRefPubMedPubMedCentral Du Y, et al. Factors influencing adoption and use of Telemedicine Services in Rural areas of China: mixed methods study. JMIR Public Health Surveillance. 2022;8(12):e40771.CrossRefPubMedPubMedCentral
4.
go back to reference Biruk K, Abetu E. Knowledge and attitude of health professionals toward telemedicine in resource-limited settings: a cross-sectional study in North West Ethiopia. J Healthc Eng. 2018;2018(1):2389268. Biruk K, Abetu E. Knowledge and attitude of health professionals toward telemedicine in resource-limited settings: a cross-sectional study in North West Ethiopia. J Healthc Eng. 2018;2018(1):2389268.
5.
go back to reference Mahmood S, et al. Global preparedness against COVID-19: we must leverage the power of digital health. JMIR Public Health Surveillance. 2020;6(2):e18980.CrossRefPubMedPubMedCentral Mahmood S, et al. Global preparedness against COVID-19: we must leverage the power of digital health. JMIR Public Health Surveillance. 2020;6(2):e18980.CrossRefPubMedPubMedCentral
6.
go back to reference Alotaibi YK, Federico F. The impact of health information technology on patient safety. Saudi Med J. 2017;38(12):1173. Alotaibi YK, Federico F. The impact of health information technology on patient safety. Saudi Med J. 2017;38(12):1173.
7.
go back to reference Meher SK, Tyagi RS, Chaudhry T. Awareness and attitudes to telemedicine among doctors and patients in India. J Telemed Telecare. 2009;15(3):139–41.CrossRefPubMed Meher SK, Tyagi RS, Chaudhry T. Awareness and attitudes to telemedicine among doctors and patients in India. J Telemed Telecare. 2009;15(3):139–41.CrossRefPubMed
8.
go back to reference Chau PY, Hu PJ-H. Investigating healthcare professionals’ decisions to accept telemedicine technology: an empirical test of competing theories. Inf Manag. 2002;39(4):297–311.CrossRef Chau PY, Hu PJ-H. Investigating healthcare professionals’ decisions to accept telemedicine technology: an empirical test of competing theories. Inf Manag. 2002;39(4):297–311.CrossRef
9.
go back to reference Rao SS, et al. Establishing telemedicine in an academic total joint arthroplasty practice: needs and opportunities highlighted by the COVID-19 pandemic. Arthroplasty Today. 2020;6(3):617–22.CrossRefPubMedPubMedCentral Rao SS, et al. Establishing telemedicine in an academic total joint arthroplasty practice: needs and opportunities highlighted by the COVID-19 pandemic. Arthroplasty Today. 2020;6(3):617–22.CrossRefPubMedPubMedCentral
10.
go back to reference Ugwu OP, Alum EU, Ugwu JN, Eze VH, Ugwu CN, Ogenyi FC, Okon MB. Harnessing technology for infectious disease response in conflict zones: Challenges, innovations, and policy implications. Medicine. 2024;103(28):e38834. Ugwu OP, Alum EU, Ugwu JN, Eze VH, Ugwu CN, Ogenyi FC, Okon MB. Harnessing technology for infectious disease response in conflict zones: Challenges, innovations, and policy implications. Medicine. 2024;103(28):e38834.
11.
go back to reference Garavand A, et al. Acceptance of telemedicine technology among physicians: a systematic review. Inf Med Unlocked. 2022;30:100943.CrossRef Garavand A, et al. Acceptance of telemedicine technology among physicians: a systematic review. Inf Med Unlocked. 2022;30:100943.CrossRef
12.
go back to reference Bashshur RL. On the definition and evaluation of telemedicine. Telemedicine J. 1995;1(1):19–30.CrossRef Bashshur RL. On the definition and evaluation of telemedicine. Telemedicine J. 1995;1(1):19–30.CrossRef
14.
go back to reference Snoswell CL, et al. The clinical effectiveness of telehealth: a systematic review of meta-analyses from 2010 to 2019. J Telemed Telecare. 2023;29(9):669–84.CrossRefPubMed Snoswell CL, et al. The clinical effectiveness of telehealth: a systematic review of meta-analyses from 2010 to 2019. J Telemed Telecare. 2023;29(9):669–84.CrossRefPubMed
15.
go back to reference Yilma TM, et al. Maturity Assessment of District Health Information System Version 2 implementation in Ethiopia: current status and improvement pathways. Volume 12. JMIR Medical Informatics; 2024. p. e50375. Yilma TM, et al. Maturity Assessment of District Health Information System Version 2 implementation in Ethiopia: current status and improvement pathways. Volume 12. JMIR Medical Informatics; 2024. p. e50375.
16.
go back to reference Wubante SM, Nigatu AM, Jemere AT. Health professionals’ readiness and its associated factors to implement Telemedicine system at private hospitals in Amhara region, Ethiopia 2021. PLoS ONE. 2022;17(9):e0275133.CrossRefPubMedPubMedCentral Wubante SM, Nigatu AM, Jemere AT. Health professionals’ readiness and its associated factors to implement Telemedicine system at private hospitals in Amhara region, Ethiopia 2021. PLoS ONE. 2022;17(9):e0275133.CrossRefPubMedPubMedCentral
17.
go back to reference Temesgen MW. A Framework for evaluating telemedicine-based Healthcare Inequality reduction in Ethiopia: A grounded Theory Approach. UNIVERSITY OF SOUTH AFRICA; 2019. Temesgen MW. A Framework for evaluating telemedicine-based Healthcare Inequality reduction in Ethiopia: A grounded Theory Approach. UNIVERSITY OF SOUTH AFRICA; 2019.
18.
go back to reference Brauchli K. Telemedicine for improving access to health care in resource-constrained areas: from individual diagnosis to strengthening health systems. University_of_Basel; 2006. Brauchli K. Telemedicine for improving access to health care in resource-constrained areas: from individual diagnosis to strengthening health systems. University_of_Basel; 2006.
19.
go back to reference Wamala DS, Augustine K. A meta-analysis of telemedicine success in Africa. J Pathol Inf. 2013;4(1):6.CrossRef Wamala DS, Augustine K. A meta-analysis of telemedicine success in Africa. J Pathol Inf. 2013;4(1):6.CrossRef
20.
go back to reference Kifle M, et al. Transfer and adoption of advanced information technology solutions in resource-poor environments: the case of telemedicine systems adoption in Ethiopia. Telemedicine e-Health. 2010;16(3):327–43.CrossRefPubMed Kifle M, et al. Transfer and adoption of advanced information technology solutions in resource-poor environments: the case of telemedicine systems adoption in Ethiopia. Telemedicine e-Health. 2010;16(3):327–43.CrossRefPubMed
21.
go back to reference Bokolo AJ. Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic. Ir J Med Sci (1971-). 2021;190(1):1–10.CrossRef Bokolo AJ. Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic. Ir J Med Sci (1971-). 2021;190(1):1–10.CrossRef
22.
go back to reference Connolly SL, et al. Provider perceptions of virtual care during the coronavirus disease 2019 pandemic: a multispecialty survey study. Med Care. 2021;59(7):646.CrossRefPubMedPubMedCentral Connolly SL, et al. Provider perceptions of virtual care during the coronavirus disease 2019 pandemic: a multispecialty survey study. Med Care. 2021;59(7):646.CrossRefPubMedPubMedCentral
23.
go back to reference Djamasbi S, Fruhling A, Loiacono E. The influence of affect, attitude and usefulness in the acceptance of telemedicine systems. J Inform Technol Theory Application (JITTA). 2009;10(1):4. Djamasbi S, Fruhling A, Loiacono E. The influence of affect, attitude and usefulness in the acceptance of telemedicine systems. J Inform Technol Theory Application (JITTA). 2009;10(1):4.
24.
go back to reference Naqvi SZ et al. Healthcare workers’ knowledge and attitude toward telemedicine during the COVID-19 pandemic: a global survey. Cureus, 2022. 14(10).PubMedPubMedCentral Naqvi SZ et al. Healthcare workers’ knowledge and attitude toward telemedicine during the COVID-19 pandemic: a global survey. Cureus, 2022. 14(10).PubMedPubMedCentral
25.
go back to reference Bashir MS, Lalithabai DS, AlOtaiby S, Abu-Shaheen A. Health care professionals' knowledge and attitudes toward telemedicine. Front Public Health. 2023;11:957681. Bashir MS, Lalithabai DS, AlOtaiby S, Abu-Shaheen A. Health care professionals' knowledge and attitudes toward telemedicine. Front Public Health. 2023;11:957681.
28.
go back to reference Almathami HKY, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients’ homes: systematic literature review. J Med Internet Res. 2020;22(2):e16407.CrossRefPubMedPubMedCentral Almathami HKY, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients’ homes: systematic literature review. J Med Internet Res. 2020;22(2):e16407.CrossRefPubMedPubMedCentral
29.
go back to reference Moher D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.CrossRefPubMed Moher D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.CrossRefPubMed
30.
go back to reference Joanna Briggs Institute. The Joanna Briggs Institute critical appraisal tools for use in JBI systematic reviews Critical Appraisal Checklist for Cohort Studies. 2017. Joanna Briggs Institute. The Joanna Briggs Institute critical appraisal tools for use in JBI systematic reviews Critical Appraisal Checklist for Cohort Studies. 2017.
31.
go back to reference Biruk K, Abetu E. Knowledge and attitude of health professionals toward telemedicine in resource-limited settings: a cross‐sectional study in North West Ethiopia. J Healthc Eng. 2018;2018(1):2389268.PubMedPubMedCentral Biruk K, Abetu E. Knowledge and attitude of health professionals toward telemedicine in resource-limited settings: a cross‐sectional study in North West Ethiopia. J Healthc Eng. 2018;2018(1):2389268.PubMedPubMedCentral
32.
go back to reference Sidelil H, et al. Attitude towards tele rehabilitation-based therapy services and its associated factors among health professional working in specialized teaching hospitals in Amhara region, Northwest Ethiopia. Inf Med Unlocked. 2023;36:101145.CrossRef Sidelil H, et al. Attitude towards tele rehabilitation-based therapy services and its associated factors among health professional working in specialized teaching hospitals in Amhara region, Northwest Ethiopia. Inf Med Unlocked. 2023;36:101145.CrossRef
33.
go back to reference al RMMe. Physicians’ knowledge and attitudes towards telesurgery and its associated factors in a resource-limited setting, Northwest Ethiopia, 2022: a facility based cross-sectional study. BMJ OPEN; 2024. al RMMe. Physicians’ knowledge and attitudes towards telesurgery and its associated factors in a resource-limited setting, Northwest Ethiopia, 2022: a facility based cross-sectional study. BMJ OPEN; 2024.
34.
go back to reference al BF. W.e. Attitudes of nurses toward Telenursing and influencing factors in Resource-Limited settings: Northwest Ethiopia 2022. Frontiers; 2024. al BF. W.e. Attitudes of nurses toward Telenursing and influencing factors in Resource-Limited settings: Northwest Ethiopia 2022. Frontiers; 2024.
35.
go back to reference Adem JB, et al. Attitude of mental healthcare providers toward tele-psychiatry services and associated factors at public referral hospitals in Addis Ababa city, Ethiopia. Int J Mental Health Syst. 2023;17(1):26.CrossRef Adem JB, et al. Attitude of mental healthcare providers toward tele-psychiatry services and associated factors at public referral hospitals in Addis Ababa city, Ethiopia. Int J Mental Health Syst. 2023;17(1):26.CrossRef
36.
go back to reference Jones-Esan L, Somasiri N, Lorne K. Enhancing Healthcare Delivery Through Digital Health Interventions: A Systematic Review on Telemedicine and Mobile Health Applications in Low and Middle-Income Countries (LMICs). Jones-Esan L, Somasiri N, Lorne K. Enhancing Healthcare Delivery Through Digital Health Interventions: A Systematic Review on Telemedicine and Mobile Health Applications in Low and Middle-Income Countries (LMICs).
37.
go back to reference Manyazewal T, et al. The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia. NPJ Digit Med. 2021;4(1):125.CrossRefPubMedPubMedCentral Manyazewal T, et al. The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia. NPJ Digit Med. 2021;4(1):125.CrossRefPubMedPubMedCentral
38.
go back to reference Assaye BT, Shimie Aworku. Telemedicine use during COVID-19 pandemics and associated factors among health professionals working in health facilities at resource-limited setting 2021. Inf Med Unlocked. 2022;33:101085.CrossRef Assaye BT, Shimie Aworku. Telemedicine use during COVID-19 pandemics and associated factors among health professionals working in health facilities at resource-limited setting 2021. Inf Med Unlocked. 2022;33:101085.CrossRef
39.
go back to reference Buonanno P, et al. Telemedicine in cancer pain management: a systematic review and meta-analysis of randomized controlled trials. Pain Med. 2023;24(3):226–33.CrossRefPubMed Buonanno P, et al. Telemedicine in cancer pain management: a systematic review and meta-analysis of randomized controlled trials. Pain Med. 2023;24(3):226–33.CrossRefPubMed
40.
go back to reference Shibabaw AA, et al. Knowledge of telemedicine and its associated factors among health professional in Ethiopia: a systematic review and meta-analysis. PLoS ONE. 2024;19(4):e0301044.CrossRefPubMedPubMedCentral Shibabaw AA, et al. Knowledge of telemedicine and its associated factors among health professional in Ethiopia: a systematic review and meta-analysis. PLoS ONE. 2024;19(4):e0301044.CrossRefPubMedPubMedCentral
41.
go back to reference Nigatu AM, et al. Barriers and facilitators experienced during the implementation of web-based Teleradiology System in Public hospitals of the Northwest Ethiopia: an interpretive description study. Int J Telemedicine Appl. 2024;2024(1):5578056.CrossRef Nigatu AM, et al. Barriers and facilitators experienced during the implementation of web-based Teleradiology System in Public hospitals of the Northwest Ethiopia: an interpretive description study. Int J Telemedicine Appl. 2024;2024(1):5578056.CrossRef
42.
go back to reference Connolly SL, et al. A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clin Psychol Sci Pract. 2020;27(2):e12311.CrossRef Connolly SL, et al. A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clin Psychol Sci Pract. 2020;27(2):e12311.CrossRef
Metadata
Title
Attitudes towards Telemedicine Services and Associated Factors among health professionals in Ethiopia: a systematic review and meta-analysis
Authors
Alex Ayenew Chereka
Gebrehiwot Berie Mekonnen
Amlaku Nigusie Yirsaw
Berihun Agegn Mengistie
Eyob Getachew
Gebeyehu Lakew
Adamu Ambachew Shibabaw
Gemeda Wakgari Kitil
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-11979-w