Use of tele-health and telemedicine interventions for the prevention and management of COVID-19: providers' and users' perspective from Nepal

Background: The COVID-19 pandemic disrupted routine healthcare services worldwide, including in Nepal. To ensure continuity of healthcare delivery during lockdowns and movement restrictions, telemedicine and telehealth services were widely adopted. This study explored the implementation, strengths, challenges, and perceived effectiveness of telemedicine and telehealth interventions for the prevention and management of COVID-19 in Nepal. Methods: A cross-sectional mixed-methods study was conducted among 10 governmental and non-governmental organizations providing telemedicine services. Data were collected from 15 purposively selected healthcare providers and 20 randomly selected service users using semi-structured interviews, structured questionnaires, observation checklists, and record reviews. Quantitative data were analyzed descriptively, while qualitative data were analyzed using thematic analysis. Results: Telemedicine ensured continuity of healthcare services through telephone calls, text messaging, video consultations, hotlines, and social media platforms. Participants reported improved access to healthcare, timely referrals, follow-up services, reliable health information, psychosocial support, and reduced travel-related costs. Service users expressed positive perceptions regarding the accessibility, affordability, and convenience of telemedicine services. Major challenges included inadequate patient recording and follow-up systems, shortages of trained personnel, poor internet connectivity, lack of standardized protocols, dependence on donor funding, and limited access in rural areas. Conclusions: Telemedicine played a critical role in maintaining essential healthcare services during the COVID-19 pandemic in Nepal. Strengthening digital infrastructure, standardized guidelines, patient information systems, sustainable financing, and workforce capacity is essential for integrating telemedicine into routine healthcare and future public health emergency preparedness.