Surgical site infections (SSI) are common in low- and middle-income countries (LMIC), especially after Cesarean delivery. Women in LMICs are three times more likely to have SSI compared to those in Western countries. One particular SSI, puerperal sepsis, is responsible for 10 to 15% of postpartum deaths globally. Besides the risk of death, postpartum SSI can lead to anxiety, depression, hinder breastfeeding, and increase healthcare costs. Detecting SSI early and providing swift treatment can help, but LMICs suffer from a shortage of healthcare workers and limited resources.
Recent evidence from 2wT research shows that a low-cost, two-way text-based telehealth system can improve post-operative care and reduce the burden on healthcare workers. This system allows direct communication between patients and healthcare providers, using both automated and manual messages. It has been successful in a trial in Zimbabwe for adult male circumcision, reducing costs and maintaining safety. Both patients and providers found it easy to use. This approach has also been adapted for the COVID-19 context, reaching over 18,000 patients in Zimbabwe by 2022.
Building on the success of this telehealth system developed for post-surgical follow-up of male circumcision, 2wT could be applied to prevent, refer, and care for SSI after Cesarean sections. The advantages include being open source, evidence of success in routine settings, proactive engagement with patients for daily monitoring, validation of visits, user-friendly design, optimization for low-income settings, and compatibility with existing systems.