The increasing burden of hypertension in Africa underscores the need to embrace digital health innovations to improve delivery and access to quality hypertension care. This review aimed at (1) identifying barriers and facilitators to the implementation and uptake of digital health tools and (2) examining the scope and use of digital health tools based on the Practical Reviews in Self-Management Support (PRISMS) taxonomy. We searched PubMed, CINAHL (Medline) and HINARI from inception to June 2024. The Joanna Briggs Institute (Population, Concept, and Context (PCC)) framework guided the formulation of research questions, and the PRISMS taxonomy was used to analyse the functions of digital tools. Sixteen studies (k=16) across three African regions were included. Common digital health tools were mobile Health (mHealth) or electronic Health applications and short message service (SMS)-based interventions. Supported self-management functions included medication adherence (k=10), lifestyle counselling (k=12) and home blood pressure monitoring (k=9). Implementation strategies included prior training (k=10), continuous digital support (k=10) and provision of resources including BP devices and data credit (k=11). Targeted users were healthcare workers (k=8), patients (k=11) or both (k=3). Barriers included limited digital literacy, poor communication among healthcare workers, privacy concerns and weak internet infrastructure. Facilitators included competency-based training, contextual adaptations, continuous technical support and enhanced user experience through effective feedback systems between users. Digital health tools, particularly mHealth apps and SMS, support key hypertension self-management tasks in African settings. Addressing technological and contextual barriers while reinforcing training and support systems is critical to successful implementation and scale-up.
Hinneh et al. (Fri,) studied this question.