Telehealth for All: Rwanda's digital leap in sexual and reproductive healthcare access

In Rwanda, unsafe abortion contributes significantly to maternal mortality despite a legal framework permitting abortion under specific circumstances. Barriers to accessing safe abortion services persist, necessitating innovative solutions. This commentary describes the development and implementation of a telehealth tool for provision of safe abortion care in Rwanda, driven by national ownership and youth engagement. Framed within a human rights-based approach to health equity, this initiative saw young Rwandan innovators create a cost-effective and context-fit digital solution through a hackathon modality. The hackathon process led to the transition of the telehealth tool which was being piloted, from fragmented, informal communication channels into a secure platform that ensured data privacy, patient confidentiality and standardised clinical documentation. The new platform facilitates remote consultation between the patient, the midwife/nurse, and the medical doctor, while providing support to healthcare providers. This initiative demonstrates the potential of leveraging local talents and the power of home grown solutions in the area of digital technology to improve access to essential healthcare services, bridging the gap between rural primary care and specialised medical oversight. Ultimately this contributes to the reduction of maternal morbidity and mortality in Rwanda. Moreover, the paper underscores the need for a continuous evaluation of telehealth effectiveness to ensure ethical, rights-based and legal alignment. The project's success underscores the importance of a needs-driven and people-centred approach, government ownership, and the active role of young people as co-designers in developing and implementing sustainable digital health solutions.