Identification and mapping of mHealth interventions applied in palliative care in Sub Saharan Africa: a scoping review
Clinical Snapshot
PICO Framework
| P — Population | Patients receiving palliative care in Sub-Saharan Africa |
| I — Intervention | mHealth interventions (mobile health technologies including apps, SMS, telemedicine, phone calls, wearable sensors) |
| C — Comparator | Not applicable (scoping review mapping existing interventions) |
| O — Outcomes | Nature and use of mHealth interventions, factors influencing their use, barriers and facilitators |
Bottom Line
This scoping review maps mHealth interventions for palliative care across Sub-Saharan Africa, finding implementation in only 12 countries with predominantly app-based and SMS-based approaches. Key applications include health system strengthening, psychosocial support, appointment compliance, and healthcare professional capacity building. While facilitators include widespread mobile phone access and perceived usefulness, significant barriers exist including technological limitations, power supply issues, and privacy concerns. The evidence suggests mHealth has potential for palliative care delivery in resource-limited settings but requires substantial infrastructure development. For Australian practice, findings are particularly relevant for rural and remote palliative care delivery, especially for Indigenous communities where similar technological and infrastructure challenges exist.
Key Findings
P Value: Not applicable for scoping review
Effect Size: 35.3% app-based, 26.5% SMS-based, 14.7% phone call-based interventions
Primary Outcome: Mapping of mHealth interventions across 12 SSA countries
Nnt Or Sensitivity: Coverage in 25% of SSA countries (12 of 48 countries)
Confidence Interval: Not applicable for scoping review
Clinical Application
High feasibility given widespread mobile phone ownership, but requires consideration of technological infrastructure Relevant for rural and remote palliative care delivery, particularly for Indigenous communities. Could inform TGA digital health framework and support RACGP rural health initiatives Palliative care patients in resource-limited settings, particularly relevant to Indigenous and rural Australian populations
Abstract
BACKGROUND: Although palliative care is very essential for improving quality of life (QOL) by providing relief from pain and other distressing symptoms, its coverage in sub Saharan Africa remains remarkably low. Utilization of mHealth could be a fundamental healthcare system strengthening approach to enhance and promote palliative care in the region. There is paucity of evidence regarding evidence on the use of these interventions in SSA because it is a relatively new concept in the region. Therefore, there was need to identify and map the available/ applied mHealth interventions for palliative care in SSA basing on published and grey literature. AIM: To examine the nature and use of mHealth interventions for palliative care and factors influencing their use in sub Saharan Africa (SSA). METHODS: The review was based on the JBI methodology for scoping review. PUBMED, CINAHL, Embase and Google Scholar databases were searched for published articles with no time restrictions. Unpublished and grey literature was also searched for. Data was extracted from the retrieved sources and synthesized. The findings were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) in a comprehensive and transparent way. RESULTS: A total of 224 articles were identified and 35 of these met the inclusion criterion and were considered for the review. The results show use of mHealth interventions for palliative care in 12 countries of the SSA. Only 12 (35.3%) were app-based, 9(26.5%) were SMS-text-based, 4(11.8%) were telemedicine-based,5(14.7%) were phone call-based, 3(8.8%) were mixed while 1(2.9%) used wearable-sensor-based mHealth interventions. Key uses of mHealth interventions in palliative care included health strengthening, psychosocial support to patients and families, enhancement of compliance to appointments for patients, promotion of adherence to medication, health education, monitoring, evaluation and research and capacity building for palliative care health professionals. A number of influencing factors were identified and they included wide-spread telephone ownership and access, great robustness of telephone and internet connectivity, high degree of perceived usefulness and ease of use, feasibility and acceptability of mHealth. Also, vital barriers such as low levels of technological advancement/expertise, irregularity and paucity of electric power supply, high likelihood to compromise patients' privacy and confidentiality and high illiteracy rates among the population were articulated by the articles. CONCLUSION: About a quarter of SSA countries have incorporated mHealth interventions for palliative care, underscoring the need for further research and development of the technologies. These approaches are quite beneficial to SSA, where there is a disproportionate disease burden and an inadequate healthcare system.
References
- 1.Ndinawe, J. B., Kabakyenga, J., Namukwaya, E., Mulogo, E. M., & Nagujja, F. (2026). Identification and mapping of mHealth interventions applied in palliative care in Sub Saharan Africa: a scoping review. BMC Palliative Care. https://doi.org/10.1371/journal.pone.0237910
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