Scoping Review Maps Home-Based Digital Rehabilitation in Sub-Saharan Africa

Rehabilitation access in sub-Saharan Africa is constrained by workforce shortages, cost, distance and limited health infrastructure. This scoping review searched published and gray literature on work conducted in the region from 2018 to 2023, using multiple databases and the Consolidated Framework for Implementation Research (CFIR) 2.0 to organize implementation factors. Eleven stakeholders were also consulted about their experiences and perspectives.

The review included 25 studies. Reported technologies included applications, web-based programs, videoconferencing, text messaging, television and radio, social media, and 3-D printers. Factors identified across three of the five CFIR domains included perceived effectiveness and relative advantage, cost and design, client acceptability, use of implementation frameworks, and the choice of implementation strategies. Sufficient technical infrastructure and continuing technical support were reported as important for operating these technologies.

The authors conclude that sustainable implementation requires attention to local structural, cultural and policy contexts, as well as financing, reimbursement mechanisms and digital health literacy. These findings map implementation considerations rather than establish the clinical effectiveness of any particular technology. The review is limited to literature from 2018–2023 and provides no trial-level efficacy estimates in the supplied report.