The state of home blood pressure monitoring in perinatal care in Africa: A scoping review of evidence, barriers, facilitators and research priorities

Background Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal mortality in Africa. Understanding the current state of evidence on home blood pressure monitoring (HBPM) in African perinatal care is essential to inform future implementation and research. Objective We aimed to map the current evidence on HBPM among pregnant and postpartum women in Africa. Eligibility Criteria Studies reporting on home, self, or remote blood pressure monitoring among pregnant or postpartum women in African countries were eligible for inclusion. Sources of Evidence PubMed, CINAHL, Cochrane Database of Systematic Reviews, Embase, Global Health, and Web of Science were searched from inception through November 2025 without language restrictions. Charting Methods Studies were screened and data were extracted within Covidence. Extracted data included study characteristics, participant characteristics, equity indicators, HBPM intervention characteristics, and reported outcomes. Data were summarized descriptively, qualitative findings were synthesized thematically, and methodological quality was appraised using Joanna Briggs Institute critical appraisal checklists. Results Of 189 studies screened, 10 met inclusion criteria. Studies were published between 2019 and 2025 across four African countries. Most were conducted in urban tertiary settings and focused on feasibility and acceptability rather than clinical effectiveness. Common implementation barriers included health literacy, device access, provider training, and health system integration. Family and social support were important facilitators of adherence. Only one study evaluated a postpartum monitoring program, and no study assessed maternal mortality, severe maternal morbidity, or neonatal outcomes. Seven of the 10 publications came from two institutions, one in Ghana and one in Nigeria. Conclusion Evidence supporting HBPM in African perinatal care is emerging but remains limited and concentrated in a small number of countries and urban tertiary settings. Existing studies suggest that HBPM is generally feasible and acceptable, but important implementation challenges remain. Further research evaluating postpartum monitoring, implementation strategies, and maternal and neonatal outcomes is needed to inform broader adoption and policy development.