JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) technologies are increasingly employed in contact tracing and case finding, enhancing and replacing traditional methods for managing infectious diseases such as Ebola, TB, COVID-19, and HIV. However, the variations in their development approaches, implementation scopes, and effectiveness introduce uncertainty regarding their potential to improve public health outcomes.

Objective:

We conducted this systematic review to explore how mHealth technologies are developed, implemented, and evaluated. We aim to deepen our understanding of mHealth's role in contact tracing, enhancing both the implementation and overall health outcomes.

Methods:

We searched and reviewed studies conducted in Africa focusing on TB, Ebola, HIV and COVID-19; published between 1990 and 2023, using PubMed, Scopus, Web of Science, and Google Scholar databases. We followed PRISMA guidelines to review, synthesise, and report the findings from articles that met our criteria.

Results:

We identified 11,943 articles, but only 19 met our criteria, revealing a large gap in technologies specifically aimed at case finding and contact tracing of infectious diseases. These technologies addressed a broad spectrum of diseases, with a predominant focus on Ebola and TB. The type of technologies used ranged from mobile data collection platforms, smartphone applications to advanced GIS and bi-directional communication systems. Technologies deployed in programmatic settings, often developed using design thinking frameworks, were backed by significant funding and often deployed at a large scale but frequently lacked rigorous evaluations. In contrast, technologies used in research settings although providing more detailed evaluation of both technical performance and health outcomes, were constrained by scale and insufficient funding. These challenges not only prevented these technologies from being tested on a wider scale but also hindered their ability to provide actionable and generalisable insights that could inform public health policies effectively.

Conclusions:

Overall, the review underscored a need for organised development approaches and comprehensive evaluations. A significant gap exists between the expansive deployment of mHealth technologies in programmatic settings, which are typically well-funded and rigorously developed versus the more robust evaluations necessary to ascertain their effectiveness. Future research should consider integrating the robust evaluations often found in research settings with the scale and developmental rigour of programmatic implementations. By embedding advanced research methodologies within programmatic frameworks at the design thinking stage, mHealth technologies can potentially become technically viable and effectively meet the specific contact tracing health outcomes to inform policy effectively.