Table 2 Detailed classification of evidence supporting the framework for understanding why, for whom, and in what circumstances mHealth interventions work in sub-Saharan Africa

Predisposing characteristics

• Cultural and social acceptance (familiarity/usage of mobile technologies) [38, 40, 41, 46, 53, 55]

• Positive attitude (motivated, self-empowered, activeness) [38, 55]

• Age group (middle/older) [51]

• Language of communication (language of locality) [46, 54, 55]

Suitability and simplicity for:

• (Older) age group [55]

• (Low) literacy, educational levels [50, 55]

• (Poor) socio-economic backgrounds [50]

• Not physically active [50]

• Positive attitude (enthusiastic, motivated, empathetic, interest, dedication, volunteer) [38, 40, 52]

• Prerequisite knowledge (to provide adequate information) [47]

• Simple, relevant, combination of local content and language (interface) [42]

• Positive attitude (positive perception and trust of new technology) [52]

• Basic knowledge (about the technology) [52]

• Fluency in language of locality [46, 54]

• Accessible location of technical support (in-country or local software developers) [52]

• Understandable language of communication (among users and software developers) [52]

Need

• Disease severity and comorbidities [20, 51, 55]

• Barriers to accessing care or information (not affordable, easily, promptly, quality and/or appropriate, limited, long-distance travel, travel cost, waiting time, delaying, presenting late) [20, 42, 45, 46, 48–50, 52, 53, 55]

-

• Lack of capacity to provide needed care (limited training/education, decision-making power/support, point-of-care clinical information, specialized care, specialty referral systems) [36, 38–40, 47, 52]

• Barriers to reporting and accessing supervision [37, 40–42, 47, 51]

• Need to follow guidelines [50, 54, 55]

-

• Lack of human resources (limited specialists, trained or skilled personnel, unequal distributions of professionals, over-burdened workload) [20, 36, 38–41, 43, 45, 47]

• Lack of necessary systems and infrastructure (health facility, referral system, transport) [38]

• Lack of accurate information [46, 47]

• Task shifting to achieve early intervention and low costs of care [42, 43, 49, 54]

• Characteristics of disease conditions (extent, severity) [36, 43]

• Characteristics of diagnostic and treatment tasks (feasibly assess/examine, freely question patient, probe for additional information, conduct special tests) [43, 47, 49]

Enabling resources

• Access to mobile phone [37, 45, 46, 50, 53–55]

• Access to mobile technology infrastructure [45, 48, 52, 55]

• Affordability of services [50, 54, 55]

• Convenience, privacy, autonomy, reduced time and travel cost [20, 43]

• Service/program awareness [38, 40]

• Assistance/support (spouse, partner, friend, family member) [51]

• Familiar and easy-to-use mobile technology (SMS, icons) [53, 55]

• Maintenance (phone recharge, repair, durability, portability) [37, 55]

• Access to phone [41, 45]

• Telecommunication networks (functioning, stable, accessible, available, low-cost) [36, 39, 42, 47]

• Basic infrastructural resources (information, good roads, ambulance services) [41, 47, 52]

• Operating funds and logistics (availability) [38, 40, 52]

• Policy and sustainability (to avoid strike actions, staff turnover rate) [40, 52]

• Continuous training (workshops) and sensitization [47, 52]

• Tolerable burden of workload [40]

• Easy portability and operability (direct, instant, immediate) [36, 39]

• Phone features (quality camera, smartphones) [36, 41]

• Maintenance support (equipment/SIM card/mobile device failure, sporadic power outages, battery power problem, software bugs, theft, medical technology) [45, 52]

• Access to phone networks (in underserved communities) [20]

• Tolerable burden of workload [46, 47]

• Incentives (payment) [47, 55]

• Policy (network or data protection, liability, consent, confidentiality, phone usage, staff job descriptions) [43, 45, 51, 52]

• Phone features (photograph, picture quality, video functionality, interface, text messaging, appropriate screen, zoom, long-lasting battery) [36, 41, 43, 45, 47, 51]

• Suitability and equivalence to existing care processes (face-to-face care, assess nonverbal behaviors) [41, 49, 51, 54]