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Abstract

Background

Information technologies have made it easier to integrate electronic devices and programs that use digital technology interventions for the distribution of medications and the delivery of healthcare globally. This proposed study aimed at mapping evidence on digital health interventions for managing medication and healthcare service delivery by health professionals in sub-Saharan Africa (SSA).

Methods

The review will be guided by Arksey and O'Malley's scoping review framework and Levac et al. 2010 recommendations, and updated guidelines from the Joanna Briggs Institute. A scoping review will be conducted to map evidence regarding digital health interventions for managing medication and healthcare service delivery by health professionals in SSA. A search strategy will be employed to search literature in electronic databases, including PubMed, Science Direct, Web of Science, Google Scholar, MEDLINE, and CINAHL with full-text, ERIC, and Academic Search Complete via EBSCOhost using keywords and Medical Subject Headings. In addition to the electronic resources, references on the included research will be manually searched. The search will begin from 2015 to 2025. Two independent screeners will examine and conduct both abstract and full-text screening of the articles for eligibility using the EndNote software. The PRISMA flow diagram will be used and followed in the documentation of the selection process. A narrative description of the extracted data will be provided by a thematic content analysis.

Conclusion

This scoping review will provide the evidence currently available on digital health interventions for medication management and healthcare service delivery by medical professionals in SSA. The outcomes of this planned study will highlight gaps in the literature, impact decision-makers, advance our understanding, and enhance healthcare in SSA.

Keywords

Digital health intervention digital health technologies medication delivery medication management healthcare service delivery Sub-Saharan African

Introduction

There have been significant changes in information technology in the past few decades.¹ These have made it easier to integrate electronic devices and programs that use digital technology interventions or applications for the distribution of medications and the delivery of healthcare globally.^2,3 Digital health interventions such as mobile health, mobile apps, wearable devices, telemedicine and telehealth, electronic health records, eHealth, digital diagnostics and predictive modeling, decision support systems, patient portals, digital therapeutics, and others could be used for clinical decision-making, monitoring, consulting, and management.⁴ Due to its simplicity of implementation and scalability to vast and frequently scattered populations, digital health treatments have grown in popularity within the health sector. Recently, digital health interventions have become so popular within the health industry due to their simplicity of implementation and scalability to vast and frequently scattered populations.⁵ Digital health technology has the potential to improve the delivery of high-quality healthcare by improving care, empowering patients, lowering medical costs, and streamlining the use of health resources.⁶

Many digital health intervention methods, including web-based interventions, mobile apps, and telephone-based interventions such as telehealth and telemedicine, have been utilized over the years to promote vaccination rates, chronic disease management, smoking cessation, diagnostics, and drug delivery.^7–11 Research has also demonstrated that digital interventions have positive health effects.^11–13 Healthcare professionals may be able to remotely monitor patients’ health problems and help them adhere to treatment protocols with the use of digital health applications such as telemedicine and telehealth mobile apps, patient portals, and others.¹⁴ Healthcare professionals may be able to take a more proactive approach to treating their patients’ ailments with the use of digital tools like reference and diagnostic applications.¹⁵

These technologies or tools could potentially help patients receive healthcare treatments in real-time, improving bad clinical outcomes, preventing late disease identification, and many others.¹⁶ Additionally, it promotes patients’ overall health and appropriate self-management of chronic illnesses. Therefore, there is compelling evidence from these earlier studies that show the use of digital interventions in the healthcare system and the distribution of medications.¹⁷

Digital health interventions such as ePrescribing applications could be used to support medication reconciliation, remote monitoring of adherence through refill tracking, and issuing of automatic refill alerts.¹⁸ eHealth applications could be used for setting appointments, consulting a healthcare provider, making decisions, giving medication, supporting carers, gathering and keeping track of information, and learning about medications and how to manage them in day-to-day living.¹⁹ Digital health interventions like eHealth could be employed to improve the medication adherence and quality of life of patients.²⁰ Telemedicine is one of the digital health interventions that could be deployed for treatment adherence support, remote patient monitoring, enhancing communication between patients and their healthcare providers, access to medical records, virtual consultations, and others in sub-Saharan Africa (SSA).^19,21 The full range of care for patients with NCDs has benefited greatly from telemedicine and telehealth in a number of ways.^22,23 These include encouraging healthy habits, preventing risk factors, identifying and starting treatment as soon as possible, monitoring and following up on illnesses, rehabilitation, and palliation.^22,23 Particularly in remote areas, telemedicine and telehealth not only expand access to healthcare but also enhance its quality.

Telerehabilitation is a crucial component of telemedicine that can provide access to rehabilitation services for many patients who are immobile and reside in remote places due to a shortage of physicians and other healthcare professionals.²⁴ According to recent research, telerehabilitation could help stroke patients with their motor function, balance issues, spatial neglect, speech, and verbal interaction.^24,25 Digital health interventions like Clinical Decision Support Systems (CDSS) integrated in healthcare delivery could enhance decision-making, clinicians’ efficiency, manual error reduction, and process optimization in healthcare departments.²⁵ In addition to clinical guidelines and therapy customization based on patient profile and disability, as well as software integration with electronic health records, the CDSS could assist medical officers and other prescribers by recommending lifestyle changes for patients to enhance treatment results and quality of life.²⁵ In the healthcare industry, CDSS could bridge the gap between clinical practice and evidence-based medicine by giving physicians and others with the required evidence-based medical knowledge and facilitating prompt decision-making.^25,26

The incorporation of digital health interventions into the healthcare system has been the subject of numerous reviews. A systematic review of research on digital health for high-quality healthcare was recently carried out by Ibrahim et al.,²⁷ while Giravi et al.,²⁸ published a short review on adjunct digital therapies for pain management. The findings from these reviews showed that digital technologies have improved health outcomes. Though a small number of these assessments are conducted within Africa, the majority have concentrated on the impact of incorporating digital interventions into the healthcare system outside of SSA. There are currently limited reports critically mapping the evidence of digital health interventions for managing medications and healthcare service delivery by health professionals in SSA.

Healthcare systems are generally in appalling conditions, with inferior health outcomes in most SSA countries.²⁹ Despite accounting for just over 10% of the world's population, the disease burden of Africa stands at 24%, and less than 1% of global health spending is available in SSA.³⁰ Most of the countries in SSA fall short of the World Health Organization (WHO)'s fundamental healthcare requirements, making it seem like the worst region in the world.³⁰ Access to high-quality healthcare may be limited for residents of SSA's resource-poor areas due to several factors, including poor roads, inadequate health or medical facilities, and insufficient highly skilled health workers.³¹

To support healthcare delivery in these communities, health professionals could embrace digital technology, which can reach more individuals more quickly than the conventional method of disease control. Due to the unique characteristics of SSA and the potential of digital interventions in healthcare delivery, this study aims to map evidence on digital health interventions for medication and healthcare service delivery in SSA. This will help assess the impact and offer suggestions to enhance their overall healthcare integration.

Methodology

Protocol design

Following the 2015 Joanna Briggs Institute^15,32 guidelines, the Arksey and O'Malley framework,³³ and Levac et al.³⁴ guidelines, a scoping review will be conducted by mapping evidence regarding digital health interventions for managing medication and healthcare service delivery by health professionals in SSA. The following are the five steps in Arksey and O'Malley's structure:

Identify the research question

Identification of the relevant studies

Selection of eligible studies

Data charting

Collating, summarizing, and reporting the results

Using Arksey and O'Malley's framework³⁵ and recommendations by Levac et al.³⁶ for this scoping review is the type that will provide a rigorous and transparent methodology for mapping the available evidence and for identifying research gaps, and guiding future research. The PRISMA-ScR guidelines will be followed in conducting this scoping review ScR (Preferred Reporting Items for Systematic Reviews and Meta-analysis: Extension for Scoping Reviews) (Figure 1).³⁷ The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) recommendations have been followed in reporting this procedure (Additional file 1).

Figure 1.

PRISMA-ScR flowchart which demonstrates literature search and study selection processes.

Step 1: Identify the research question

The relevant research question is: What is the evidence on digital health interventions for managing medication and healthcare service delivery by health professionals in SSA?

The following are the subresearch questions:

What evidence exists on the utilization of digital health interventions for healthcare professionals in SSA to manage medications?

What evidence exists on the utilization of digital health interventions for healthcare service delivery by health professionals in SSA?

The Population, Concept, and Context framework, designed by the Joanna Briggs Institute,¹⁵ has been used to determine the eligibility of the research question for this scoping review (Table 1).

Table 1.

Assessing the research question's eligibility.

Determinants	Description
Population	Healthcare professionals- This is made up of the following categories: doctors, nurses, pharmacists and dispensing technicians, community health workers, laboratory scientists, laboratory technicians, physiotherapists, radiologists, disease control officers, health promotion officers, speech therapists, and other allied health professionals working in health facilities in sub-Saharan Africa. These are the professionals who have received the necessary education and training to offer healthcare services to the general population. To provide their patients with high-quality healthcare services, some of these medical professionals have received additional training in digital health initiatives.
Concept	Medication and Healthcare Service Delivery Medication: Medication is any substance given by a health professional to prevent, treat, or cure illnesses, injuries, or diseases. This includes tablets, liquids, creams, injections, and others Healthcare Service Delivery - The techniques and procedures employed in providing patients with medical care and services with the goals of enhancing patient satisfaction, reducing costs, and improving the quality of care.
Context	Use in sub-Saharan Africa Use – This is the process of using digital health interventions to perform a task such as providing medication, and healthcare services, including preventative care, diagnosis, treatment, rehabilitation, and palliative care.

Step 2: Identification of the relevant studies

An electronic database search will be conducted utilizing advanced search from the following databases to find pertinent articles: PubMed, Science Direct, Web of Science, MEDLINE, CINAHL with full-text, ERIC, and Academic Search Complete via EBSCOhost. A Google Scholar search will be taken into account as an extra information source. In order to choose pertinent databases for this study and to conduct keyword searches, we have consulted the Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development (AAMUSTED) Library Service. A comprehensive search for pertinent materials will also be conducted on the websites of health departments and the WHO. Relevant articles will also be found by searching the reference lists of all contained articles. The following keywords will be used to search the literature: “digital health interventions,” “electronic health interventions,” “connected health interventions,” “managing medications,” “medication therapy management” “medication administration,” “healthcare services,” “medical care,” “medical treatment,” “clinical services,” “Sub-Saharan Africa.” The keywords will be separated using Boolean terms (AND, OR). Our electronic search for pertinent papers will also make use of Medical Subject Headings terminology. We conducted a pilot search in PubMed to demonstrate that the suggested scoping review method is feasible (Table 2).

Table 2.

Draft search for PubMed/MEDLINE.

Date of search	Search engine used	Keywords search	Number of publications retrieved
3 April 2025	PubMed	((“digital health"[MeSH Terms] OR (“digital"[All Fields] AND “health"[All Fields]) OR “digital health"[All Fields]) AND “interventions"[All Fields]) OR ((“electronics"[MeSH Terms] OR “electronics"[All Fields] OR “electronic"[All Fields]) AND (“health"[MeSH Terms] OR “health"[All Fields]) AND “interventions"[All Fields]) OR (((“connected"[All Fields] AND “health"[All Fields]) OR “connected health"[All Fields]) AND “interventions"[All Fields]) AND (Managing[All Fields] AND (“pharmaceutical preparations"[MeSH Terms] OR (“pharmaceutical"[All Fields] AND “preparations"[All Fields]) OR “pharmaceutical preparations"[All Fields] OR “medications"[All Fields])) OR (“medication therapy management"[MeSH Terms] OR (“medication"[All Fields] AND “therapy"[All Fields] AND “management"[All Fields]) OR “medication therapy management"[All Fields]) OR ((“pharmaceutical preparations"[MeSH Terms] OR (“pharmaceutical"[All Fields] AND “preparations"[All Fields]) OR “pharmaceutical preparations"[All Fields] OR “medication"[All Fields]) AND (“organization and administration"[MeSH Terms] OR (“organization"[All Fields] AND “administration"[All Fields]) OR “organization and administration"[All Fields] OR “administration"[All Fields])) AND ((“delivery of health care"[MeSH Terms] OR (“delivery"[All Fields] AND “health"[All Fields] AND “care"[All Fields]) OR “delivery of health care"[All Fields] OR “healthcare"[All Fields]) AND “services"[All Fields]) OR ((“medical"[All Fields] AND “care"[All Fields]) OR “medical care"[All Fields]) OR (Medical[All Fields] AND (“therapy"[Subheading] OR “therapy"[All Fields] OR “treatment"[All Fields] OR “therapeutics"[MeSH Terms] OR “therapeutics"[All Fields])) OR (Clinical[All Fields] AND “services"[All Fields]) AND (“africa south of the sahara"[MeSH Terms] OR (“africa"[All Fields] AND “south"[All Fields] AND “sahara"[All Fields]) OR “africa south of the sahara"[All Fields] OR (“sub"[All Fields] AND “saharan"[All Fields] AND “africa"[All Fields]) OR “sub saharan africa"[All Fields]) OR SSA[All Fields]	5,001

Inclusion criteria

The following will be included in this scoping review:

Studies involving health professionals using digital health interventions/technologies

Articles reporting evidence on digital health interventions such as telehealth, telemedicine, mHealth, wearable devices, electronic health records, mobile apps, digital health apps, patient portals, remote monitoring, digital therapeutics, artificial intelligence, eHealth, digital diagnostics and predictive modeling, decision support systems, and others

Articles presenting evidence on using digital health interventions for managing medications.

Articles presenting evidence on using digital health interventions in accessing healthcare services.

Articles presenting evidence on using health interventions to train and educate medical health professionals on medication management and service delivery.

Articles reporting evidence on digital health interventions from SSA.

Primary research studies on qualitative, quantitative, mixed-method, randomized controlled trials, and nonrandomized controlled trials

Peer-reviewed literature, systematic reviews and meta-analysis, grey literature, government documents, and policy briefs.

All articles published from 2015 to 2025.

Exclusion criteria

We will exclude the following:

Studies involving patients using digital health interventions.

Articles presenting evidence on digital health interventions for training and educating health professionals on diagnostics

Articles reporting evidence on digital health interventions from outside SSA.

Articles published in languages other than English.

Step 3: Selection of eligible studies

The principal investigator, EO, will conduct a thorough study title screening after searching databases for pertinent articles. An EndNote X21 library built explicitly for this scoping review will receive exports of all qualifying study titles. Before sharing the EndNote library with the review team, all duplicates that have been found will be removed. The screening tool, which will be created with inputs from the inclusion and exclusion criteria, will be used independently in parallel by two trained reviewers (EO and LSA) to screen abstracts. During the abstract screening phase, the review team will debate any differences between the two reviewers’ findings until they reach an agreement. Using the eligibility criteria provided tool, two reviewers (EO and LSA) will do the complete article screening for the chosen, pertinent articles. After the full-text screening process, any differences in the reviewers’ comments will be addressed by contacting a third reviewer (SAW). As previously stated, the AAMUSTED library services will be asked to assist our study search strategy by retrieving complete publications that were not available in the databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram will then be used to report the screening results.³⁷

Step 4: Data charting

For consistency, two independent reviewers will use the first five articles or more to evaluate the data extraction form (Table 3). The data extraction form will be updated and changed as the study progresses. The data extraction will be carried out separately and concurrently by two reviewers (EO and PMA). The standard bibliographical details (i.e., authors, title, and year of publication), study design, study setting, geographical location, and study aim will all be recorded. Information regarding the population being studied, the type and nature of digital health interventions, the nature of digital health intervention, medication management, healthcare services, main findings, most significant findings, conclusions, and notes will be tabulated for each of the included primary studies. The software program NVivo version 12 will help us in performing a thematic content analysis based on the pertinent findings of the collected articles.³⁸

Table 3.

Data charting table.

Author and Date

Country

Aim of the Study

Geographical Setting

Study Setting

Study Design

Study Population

Type of Digital Health Intervention

Nature of Digital Health Intervention

Purpose of Digital Health Intervention

Managing Medication

Healthcare Service Delivery

Key Findings of the Study

Most Significant Findings of the Study

Conclusions

Notes

Quality appraisal of studies

The quality of the included primary studies will be evaluated using the electronic version of the Mixed-Meth Appraisal Tool (MMAT) Version 2018.³⁹ The MMAT, which explains the quality of the technique for qualitative, quantitative, and mixed-method research, will be utilized for quality appraisal. The purpose of each study, the clarity of the research question, the methodology, the study design, the pertinent data sources, the proper sampling strategy, the appropriate data collection processes, and the recruitment of participants will all be examined in this quality assessment. Additional factors include the representativeness of the population, the appropriateness of the statistical analysis of the data, the appropriateness of the data's interpretation, the authors’ recognition of any potential biases, the presentation of the findings, the discussions, and the authors’ conclusions regarding all the included primary studies. The quality of research evidence that will be presented from each of the included primary studies will be evaluated, along with the strengths, weaknesses, and potential for bias in clinical research. In general, the MMAT guidelines will be used to compute and score the quality of all the chosen studies, with a low-quality rating of 25%, an average rating of 50%, an above-average rating of 75%, and a high average rating of 100%.

Step 5: Collating, summarizing, and reporting the results

The primary objective of this study is to map the evidence that is currently available and summarize the results as presented in all of the included articles. With the aid of NVivo version 12,⁴⁰ we will do a thematic content analysis of the included studies. The emerging themes will be thoroughly examined by the review team, which will then connect them to our research question. In order to answer the research question and encourage more SSA research, the reviewers will also examine all the implications of the notable findings. By the results, we shall give a narrative explanation of all our findings.

Discussion

This scoping review is aimed at mapping evidence on digital health interventions for managing medication and healthcare service delivery by health professionals in SSA. The WHO, via its global observatory report, suggested that harnessing the power of digital health technologies is crucial to achieving universal healthcare.⁴¹ Digital health technologies are not ends in themselves but they are necessary instruments to promote health, keep the world safe, and serve the vulnerable.⁴¹

Digital health interventions have positive effects in some regions, such as sending reminders to pregnant women to attend antenatal care appointments and having children return for vaccinations.⁴¹ Other digital health technologies reviewed include decision-support tools to guide health workers as they provide care, and enabling individuals and health workers to communicate and consult on health issues from across different locations.⁴²

Additionally, studies have indicated that digital health interventions, such as telemedicine and mobile health, could improve access to healthcare and healthcare delivery in areas with inadequate infrastructure to support traditional healthcare services.^43,44 Digital health interventions are said to be less expensive than in-person healthcare services.

Recent studies showed that digital health technologies helped patients, particularly those in hard-to-reach communities, adhere to treatment plans, keep appointments, and others.^1,45,46 Considering these benefits regarding digital health interventions, there is a need to map available evidence on digital health interventions for managing medication and healthcare service delivery by health professionals in SSA.

Due to the related health issues, the scoping review will only include articles that describe findings from SSA. Articles outside of SSA will not be included in our study because their health goals and issues differ. Because we aim to investigate the influence of health workers’ use of digital health interventions to assist healthcare delivery, the study will not include articles that give findings on patient usage of these tools.

Additionally, publications that offer results on digital health interventions for health professional training on diagnostics will not be included in this study. Once more, publications reporting results on digital health interventions for education will not be included in our proposed study. This review will cover articles that offer evidence published from 2015 to 2025 to obtain current information on the reports of digital health interventions. The findings of our scoping review study will be published in a peer-reviewed journal.

This scoping review will map available evidence to address and inform practice, which is a significant strength of the study. Also, this method will give the researchers insight into the amount of literature and studies available on digital health interventions for medication management and service delivery. Using Arksey and O'Malley's framework³⁵ and recommendations by Levac et al.³⁶ for this scoping review is the type that will provide a rigorous and transparent methodology for mapping the available evidence and for identifying research gaps, and guiding future research. Furthermore, coscreeners will be included in the abstract and full-text screening processes, and the degree of agreement between the screeners’ responses will be calculated after the full-text screening. The data extraction will be carried out by two reviewers independently. As a result, errors and bias will be minimized in the review, the instruments will be validated and reliable, and the review findings will be reproducible.

The screening procedures could be a lengthy process because of the multiple competing activities of the coscreeners. The scoping review could demonstrate limited published studies on the use of digital health interventions for medication management and service delivery. This scoping review will cover only available articles in English because of the limited human resources and funding. Since scoping reviews are typically intended to be broad, it could be difficult to define the review's precise parameters. Dealing with a high number of potentially relevant studies during a scoping review can be time-consuming and resource-intensive, requiring a great deal of work for data extraction, analysis, and screening. Scoping reviews mostly do not assess the risk of bias in included studies, which could limit the ability to draw definitive conclusions or make specific recommendations based on the evidence. Scoping reviews may be more prone to subjective interpretation and analysis due to their greater scope, especially during the data extraction and synthesis stages.

Conclusion

This article provides a scoping review protocol with a comprehensive and detailed methodology. Peer-reviewed papers and grey literature are included in the review, which will advance studies on digital health interventions for medication management and healthcare service delivery by medical professionals in SSA. This scoping review will provide the evidence currently available on digital health interventions for medication management and healthcare service delivery by medical professionals in SSA. The outcomes of this planned study will highlight gaps in the literature, impact decision-makers, advance our understanding, and enhance healthcare in SSA.

Footnotes

Acknowledgements

The authors wish to thank the Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development.

ORCID iD

Ernest Osei

Consent to participants

This study will not involve human or animal participants; hence, it does not require ethical approval.

Contributorship

EO conceptualized this study and the methodology. EO wrote the first draft, and LSA, SAW, and PMA critically reviewed the manuscript. All authors (EO, LSA, SAW, and PMA) reviewed the final drafted manuscript and approved it.

Data availability statement

All articles used in this study will be included in the reference list.

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Digital health interventions for managing medication and healthcare service delivery by health professionals in Sub-Saharan Africa: A scoping review protocol

Abstract

Background

Methods

Conclusion

Keywords

Introduction

Methodology

Protocol design

Step 1: Identify the research question

Step 2: Identification of the relevant studies

Inclusion criteria

Exclusion criteria

Step 3: Selection of eligible studies

Step 4: Data charting

Quality appraisal of studies

Step 5: Collating, summarizing, and reporting the results

Discussion

Conclusion

Footnotes

Acknowledgements

ORCID iD

Consent to participants

Contributorship

Data availability statement

Declaration of conflicting interests

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