Currently submitted to: JMIR Reviews in Digital Health
Date Submitted: Nov 4, 2026
Open Peer Review Period: Nov 5, 2026 - Dec 31, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Diagnostic Imaging Gaps and the Non-Communicable Disease Burden in Sub-Saharan Africa: A Narrative Review of Challenges, Opportunities, and the Role of Donors in Sustainable Imaging Services
ABSTRACT
Background:
Noncommunicable diseases (NCDs) are an increasing cause of morbidity and mortality in sub-Saharan Africa (SSA), underscoring the need for timely, accurate, and accessible diagnostic services. Diagnostic imaging is essential for NCD detection, diagnosis, treatment planning, and disease monitoring. However, access to imaging services remains highly inequitable across the region, particularly in resource-constrained and underserved settings.
Objective:
This narrative review aimed to examine the capacity, accessibility, utilization, challenges, emerging innovations, and sustainability of diagnostic imaging services in SSA, with particular emphasis on their role in NCD prevention, diagnosis, and management.
Methods:
A structured literature search was conducted across PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar to identify relevant publications from January 2018 to June 2026. The retrieved literature was reviewed and thematically synthesized across five domains: diagnostic imaging capacity and infrastructure, access and utilization, health system and workforce challenges, emerging technological innovations, and sustainability and policy considerations.
Results:
Diagnostic imaging services across SSA remain constrained by shortages of trained imaging professionals, inadequate and poorly maintained equipment, insufficient infrastructure, unreliable electricity supply, high service costs, limited standardization, fragmented governance, and persistent rural–urban disparities. These challenges contribute to diagnostic delays and exacerbate inequities in NCD prevention and management. Emerging technologies, including point-of-care ultrasound, portable imaging systems, teleradiology, artificial intelligence, and other digital health solutions, offer opportunities to expand diagnostic capacity and improve access, particularly in underserved communities. However, their successful implementation depends on local ownership, sustainable domestic financing, effective equipment maintenance, appropriate governance frameworks, workforce development, and alignment with national health priorities.
Conclusions:
Strengthening diagnostic imaging capacity is essential for improving NCD care and advancing equitable healthcare delivery across SSA. Integrating appropriate diagnostic imaging technologies into primary healthcare, universal health coverage strategies, and national NCD programmes, alongside investments in workforce development, infrastructure, governance, and sustainable financing, is critical to building resilient and equitable diagnostic systems across the region. Clinical Trial: N/A
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