Digital Health Services in Sub-Saharan Africa: A Narrative Review of Benefits, Adoption Factors, and Implementation Challenges

Abstract

Digital health is often presented as a way for African health systems to overcome shortages of facilities, specialists, and dependable supply chains, yet the supporting evidence is scattered across separate literatures. This article reviews published work on digital health services in sub-Saharan Africa, with particular attention to telemedicine and mobile health (mHealth). The review uses a narrative design with a documented search specification covering material published between 2012 and 2026. Thirty sources were retained and coded using a hybrid framework, in which three themes were set deductively from the review questions while subthemes were developed inductively from the reading. The methodological character of each source was recorded rather than scored, since the corpus mixes trials, qualitative studies, and reviews. Three findings emerge. First, the evidence for benefit is strongest at the level of reach and utilisation, as in South Africa's MomConnect, and considerably thinner at the level of clinical outcomes, so the two should not be conflated. Second, adoption studies in Nigeria and Ethiopia converge in showing that performance expectancy, effort expectancy, and facilitating conditions predict intention while social influence does not, which suggests that provider incentives and institutional readiness matter more than peer persuasion. Third, barriers separate into foundational constraints, namely infrastructure and financing, and context-specific ones that vary by country. The review contributes an integrative framework linking enabling conditions, adoption, and outcomes, and sets out priority questions for further research.