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PROGRAM CASE STUDY
Open Access

Teleconsultation Support for Obstetric Emergencies During the COVID-19 Pandemic in Rural Nepal: Results and Lessons Learned From a Mixed-Methods Study

Sajana Maharjan, Swaraj Rajbhandari, Liladhar Dhakal, Bhagawati Shrestha, Michaela Hayes, Punya Paudel, Anjana Karki, Binod Dangal and Surya Bhatta
Global Health: Science and Practice December 2025, 13(2):e2300423; https://doi.org/10.9745/GHSP-D-23-00423
Sajana Maharjan
aOne Heart Worldwide, Lalitpur, Nepal.
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  • For correspondence: sajana{at}oneheartworldwide.org
Swaraj Rajbhandari
bNidan Hospital, Lalitpur, Nepal.
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Liladhar Dhakal
aOne Heart Worldwide, Lalitpur, Nepal.
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Bhagawati Shrestha
aOne Heart Worldwide, Lalitpur, Nepal.
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Michaela Hayes
cOne Heart Worldwide, Hoover, Alabama, USA.
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Punya Paudel
dFamily Welfare Division, Department of Health Services, Kathmandu, Nepal.
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Anjana Karki
eB & B Hospital, Lalitpur, Nepal.
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Binod Dangal
fTsho-Rolpa Hospital, Dolakha, Nepal.
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Surya Bhatta
aOne Heart Worldwide, Lalitpur, Nepal.
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    FIGURE

    Number of Teleconsultations Reported by Month, 14 Districts of Nepal, July 2020–June 2021 (N=429)

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    TABLE 1.

    Number of Teleconsultations Reported by District, 14 Districts of Nepal, July 2020–June 2021 (N=429)

    District20202021Total
    JulAugSepOctNovDecJanFebMarAprMayJune
    Bhojpur31116
    Dhading7221473356
    Dolakha23113314244141465
    Ilam224
    Kavre51053224329550
    Khotang3321111214
    Nuwakot31241222
    Okhaldhunga224611221324
    Ramechhap29541232112133
    Sankhuwasabha4856462136
    Sindupalchowk3118111105747
    Solukhumbu15112212
    Taplejung35832221127
    Udayapur2751132333333
    Total3110071442220151314243738429
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    TABLE 2.

    Characteristics of the Reported Teleconsultations, 14 Districts of Nepal, July 2020–June 2021 (N=429)

    CategoriesNo. (%)
    Affiliation of experts providing consultation
    Within the district243 (53.7)
    Outside the district186 (43.3)
    Type of cases consulted
    Antenatal120 (28.0)
    Delivery242 (56.4)
    Postnatal10 (2.3)
    Newborn55 (12.8)
    Gynecology2 (0.4)
    Time of consultation
    Day (8 am to 8 pm)263 (61.0)
    Night (8 pm to 8 am)166 (39.0)
    Reasons for consultation
    Prolonged labor126 (29.0)
    Eclampsia31 (7.2)
    Postdated pregnancy20 (4.6)
    Retained placenta17 (3.9)
    Fetal malpresentation during delivery (breech/transverse)14 (3.2)
    Per vaginal leaking14 (3.2)
    Postpartum hemorrhage13 (3.0)
    Antepartum hemorrhage12 (2.8)
    Irregular/absent fetal heart sound9 (2.1)
    Rh incompatibility9 (2.1)
    Abortion8 (1.8)
    COVID-19 positive3 (0.7)
    Other153 (35.0)
    Outcome of the cases
    Managed inside PHC facilities90 (21.0)
    Referred and managed311 (72.5)
    Neonatal death24 (5.6)
    Stillbirth3 (0.7)
    Intrauterine fetal death1 (0.2)
    Means of transportation used to reach referral center
    Ambulance128 (29.8)
    Hired vehicle127 (29.6)
    Public vehicle36 (8.4)
    Helicopter20 (4.7)
    Stretcher and truck2 (1.4)
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Global Health: Science and Practice: 13 (2)
Global Health: Science and Practice
Vol. 13, No. 2
December 31, 2025
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Teleconsultation Support for Obstetric Emergencies During the COVID-19 Pandemic in Rural Nepal: Results and Lessons Learned From a Mixed-Methods Study
Sajana Maharjan, Swaraj Rajbhandari, Liladhar Dhakal, Bhagawati Shrestha, Michaela Hayes, Punya Paudel, Anjana Karki, Binod Dangal, Surya Bhatta
Global Health: Science and Practice Dec 2025, 13 (2) e2300423; DOI: 10.9745/GHSP-D-23-00423

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Teleconsultation Support for Obstetric Emergencies During the COVID-19 Pandemic in Rural Nepal: Results and Lessons Learned From a Mixed-Methods Study
Sajana Maharjan, Swaraj Rajbhandari, Liladhar Dhakal, Bhagawati Shrestha, Michaela Hayes, Punya Paudel, Anjana Karki, Binod Dangal, Surya Bhatta
Global Health: Science and Practice Dec 2025, 13 (2) e2300423; DOI: 10.9745/GHSP-D-23-00423
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