Implementation of home-based Digital Rehabilitation in sub-Saharan Africa: a scoping review
Abstract
Background: The need for rehabilitation in sub-Saharan Africa is largely unmet due to challenges such as limited access to rehabilitation, lack of healthcare professionals, high costs, challenging geographical distance and poor health infrastructure. Home-based Digital Rehabilitation may offer an opportunity to overcome some challenges. However, little is known about successful implementation of home-based Digital Rehabilitation in sub-Saharan Africa. We aimed to identify the technologies used and the important factors considered for the implementation of home-based Digital Rehabilitation.
Methods: We performed a scoping review according to the framework proposed by Arksey and O’Malley, with improvements made by Levac et al. The search strategy was developed on PubMed and translated to Embase, CINAHL, Cochrane, Web of science, IEEE, Science Direct and SpringerLink to identify literature published from 2018 to 2023 conducted in sub-Saharan African countries. We performed a gray literature search to supplement the results. We extracted data on technology and implementation determinants based on the domains of the Consolidated Framework for Implementation Research 2.0 (CFIR) and summarized them narratively. In addition, 11 key stakeholders were consulted to explore their experiences with digital technologies and their perspectives on factors relevant to the implementation of home-based Digital Rehabilitation.
Results: We included 25 studies in the final set of papers. Technologies such as applications, web-based programs, videoconferencing, short-message-services, television/radio, social media, and 3-D printers are already utilized for rehabilitation in sub-Saharan Africa. Important implementation determinants were identified in three of five CFIR domains, including intervention effectiveness, relative advantages, costs and the design, client acceptability, the use of implementation frameworks, and appropriate implementation strategies. Barriers to and facilitators of implementation were reported across studies, including the need for sufficient technical infrastructure and ongoing technical support to operate the technology.
Conclusion: The results of this study highlight the need to develop and implement sustainable Digital Rehabilitation approaches that consider all domains of the CFIR 2.0, including structural characteristics, religious and cultural factors, local conditions, local policies and legislation, and intervention financing. The implementation of home-based Digital Rehabilitation requires systemic adaptations, such as the development of an appropriate technical infrastructure and reimbursement mechanism, as well as increasing (digital) health literacy in society.
Clinical trial number: Not applicable.
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BibTeX
@article{arntz2026implementation,
title = {{Implementation of home-based Digital Rehabilitation in sub-Saharan Africa: a scoping review}},
author = {Angela Arntz and Mia Vuori and Renée Oltman and Marietta Handgraaf and Franziska Weber and Emmanuel Ngwakongnwi and Matthew Ames and Nassib Tawa and Caroline Mumbi and Kaisa Jokinen and David Tumusiime and Juliette Gasana and Gerard Urimubenshi and Nancy Amaya and Naomi Kingau and Said Khamis Juma and Abdulrahman Khamis and Sarah Harry Mkenda and Asteria Lawrence Menuka and Christian Grüneberg},
journal = {BMC Public Health},
year = {2026},
month = nov,
doi = {10.1186/s12889-026-30180-8},
url = {https://link.springer.com/article/10.1186/s12889-026-30180-8},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Implementation of home-based Digital Rehabilitation in sub-Saharan Africa: a scoping review
AU - Angela Arntz
AU - Mia Vuori
AU - Renée Oltman
AU - Marietta Handgraaf
AU - Franziska Weber
AU - Emmanuel Ngwakongnwi
AU - Matthew Ames
AU - Nassib Tawa
AU - Caroline Mumbi
AU - Kaisa Jokinen
AU - David Tumusiime
AU - Juliette Gasana
AU - Gerard Urimubenshi
AU - Nancy Amaya
AU - Naomi Kingau
AU - Said Khamis Juma
AU - Abdulrahman Khamis
AU - Sarah Harry Mkenda
AU - Asteria Lawrence Menuka
AU - Christian Grüneberg
PY - 2026
DA - 2026/11/06
JO - BMC Public Health
DO - 10.1186/s12889-026-30180-8
UR - https://link.springer.com/article/10.1186/s12889-026-30180-8
AB - Background: The need for rehabilitation in sub-Saharan Africa is largely unmet due to challenges such as limited access to rehabilitation, lack of healthcare professionals, high costs, challenging geographical distance and poor health infrastructure. Home-based Digital Rehabilitation may offer an opportunity to overcome some challenges. However, little is known about successful implementation of home-based Digital Rehabilitation in sub-Saharan Africa. We aimed to identify the technologies used and the important factors considered for the implementation of home-based Digital Rehabilitation. Methods: We performed a scoping review according to the framework proposed by Arksey and O’Malley, with improvements made by Levac et al. The search strategy was developed on PubMed and translated to Embase, CINAHL, Cochrane, Web of science, IEEE, Science Direct and SpringerLink to identify literature published from 2018 to 2023 conducted in sub-Saharan African countries. We performed a gray literature search to supplement the results. We extracted data on technology and implementation determinants based on the domains of the Consolidated Framework for Implementation Research 2.0 (CFIR) and summarized them narratively. In addition, 11 key stakeholders were consulted to explore their experiences with digital technologies and their perspectives on factors relevant to the implementation of home-based Digital Rehabilitation. Results: We included 25 studies in the final set of papers. Technologies such as applications, web-based programs, videoconferencing, short-message-services, television/radio, social media, and 3-D printers are already utilized for rehabilitation in sub-Saharan Africa. Important implementation determinants were identified in three of five CFIR domains, including intervention effectiveness, relative advantages, costs and the design, client acceptability, the use of implementation frameworks, and appropriate implementation strategies. Barriers to and facilitators of implementation were reported across studies, including the need for sufficient technical infrastructure and ongoing technical support to operate the technology. Conclusion: The results of this study highlight the need to develop and implement sustainable Digital Rehabilitation approaches that consider all domains of the CFIR 2.0, including structural characteristics, religious and cultural factors, local conditions, local policies and legislation, and intervention financing. The implementation of home-based Digital Rehabilitation requires systemic adaptations, such as the development of an appropriate technical infrastructure and reimbursement mechanism, as well as increasing (digital) health literacy in society. Clinical trial number: Not applicable.
SN - 1471-2458
ER -