Adoption and Usability of Mobile Health Applications for Chronic Disease Management in Sub-Saharan and North Africa

Abstract

Background: The burden of chronic non-communicable diseases, including diabetes, hypertension, and HIV/AIDS, continues to rise across Sub-Saharan and North Africa while health system resources remain strained. Mobile health (mHealth) applications have attracted growing interest as scalable interventions to bridge care delivery gaps, yet adoption remains uneven and sustained clinical impact limited. Existing literature examines the two sub-regions largely in isolation, leaving cross-regional comparison absent. Objectives: This paper aims to examine the adoption dynamics, usability challenges, and clinical outcomes associated with mHealth applications for chronic disease management across Sub-Saharan and North Africa, and to identify the factors that facilitate or impede their sustained use within these contexts. Methods: A convergent mixed-methods design was adopted, combining a systematic literature review of 68 peer-reviewed and grey literature sources with five purposively selected case studies from Kenya, Nigeria, Ghana, Morocco, and Egypt. The Unified Theory of Acceptance and Use of Technology (UTAUT) framework was applied to identify key determinants of adoption. Results: mHealth tools demonstrate significant potential for improving patient engagement, medication adherence, and remote monitoring. However, adoption is consistently hampered by infrastructure deficits, low digital literacy, linguistic barriers, and culturally unadapted interfaces. Platforms embedded in formal care pathways and co-designed with target communities showed stronger and more sustained uptake than standalone tools. Conclusions: Well-designed, contextually adapted, and health-system-integrated mHealth solutions can improve chronic disease outcomes across both sub-regions. Distinct policy recommendations are offered for North Africa and Sub-Saharan Africa, targeting policymakers, app developers, and healthcare institutions aiming to scale mHealth equitably and sustainably.