Digital health tools in hypertension management in sub-Saharan Africa: a scoping review of barriers and facilitators of adoption into mainstream healthcare

Thomas Hinneh; Bernard Mensah; Charles Kwanin; Chidi Okonkwo; Samuel Byiringiro

doi:10.1136/bmjhci-2024-101261

Digital health tools in hypertension management in sub-Saharan Africa: a scoping review of barriers and facilitators of adoption into mainstream healthcare

Charles Kwanin·Thomas Hinneh·Bernard Mensah·Charles Kwanin·Chidi Okonkwo·Samuel Byiringiro

BMJ Health & Care InformaticsOctober 16, 2025DOI: 10.1136/bmjhci-2024-101261

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Abstract

Objective 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. Materials and methods 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. Results 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. Conclusion 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.

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Hinneh, T., Mensah, B., Kwanin, C., Okonkwo, C., & Byiringiro, S. (2025). Digital health tools in hypertension management in sub-Saharan Africa: a scoping review of barriers and facilitators of adoption into mainstream healthcare. BMJ Health &amp; Care Informatics. https://doi.org/10.1136/bmjhci-2024-101261

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Digital health tools in hypertension management in sub-Saharan Africa: a scoping review of barriers and facilitators of adoption into mainstream healthcare

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