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Background: Since the launch of mobile phones three decade ago, the latter have been used to support healthcare systems through various mobile health (m-health) applications. In recent years, multiple mobile phone-based health projects and applications have emerged. Despite the great enthusiasm around m-health, few studies have examined the use of cell phones to improve health literacy in Africa. This paper aims to review studies related to the contribution of mobile technologies in improving health literacy in rural areas of Africa. Methods: We performed a four-step systematic review to identify relevant publications: (1) Database selection, (2) Keyword search, (3) Study selection and (4) Data extraction. In addition, manual searching methods were used to find keywords related to m-health initiatives in Africa. Discussion: Our search resulted in the identification of 38 studies and initiatives related to health literacy and mobile technologies in Africa. However, few of these studies focused on health literacy and mobile technologies in rural areas of Africa. We also found that m-health initiatives to date have not been inclusive, with very few integrating local languages in the development of m-health solutions. Our findings thus point to various potential avenues to be investigated in the future.

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The African gaming industry is beginning to flourish as a result of a rise in the availability of inexpensive phones and the number of mobile phone subscribers. It has enabled the development and implementation of mobile serious games to promote healthy behavior change in rural communities. This paper examines the use of mobile serious games in healthcare education, with a particular focus on those designed to increase health literacy in rural Africa. Identifying and addressing the design challenges and issues faced by people living in rural African communities through the use of persuasive mobile games can promote behavior change among these underserved communities. We used PubMed, Scopus, Google Scholar and manual search to identify relevant studies published from 2011 to July 2021. The literature review highlights how the identified challenges affect the implementation of persuasive strategies, suggests design solutions for overcoming them, and discusses how persuasive games can be tailored to suit the target rural African populations. Some of the identified challenges are technical in nature (e.g., access to electricity and internet connectivity), while others are not (e.g., language diversity and low literacy). As the number of serious games for healthcare education and awareness continues to increase, it is essential for the successful implementation of inclusive mobile health technologies in rural Africa to identify and address the specific challenges faced by underserved populations such as rural African communities.

Sub-Saharan Africa is known to feature some of the weakest healthcare systems in the world. The expanding field of mobile technology in healthcare over the past years, commonly known as mHealth, has been considered to have potential leverage for supporting and improving healthcare systems, especially in disadvantaged areas, if people are literate enough to autonomously use them. However, implementing new technologies in African healthcare systems has not always considered local realities. Many African countries are facing challenges to capitalize on these opportunities. For instance, the lack of planning, foresight, and anticipation may affect the resources available for the implementation of mHealth. This chapter argues that exploring future scenarios can be a key point to successfully designing and implementing Health Literacy Mobile technologies for a sustainable healthcare system in Africa. The UNESCO Futures Literacy (FL) approach can contribute as a valuable foresight tool to anticipate “the future” of mobile health in Africa. Being “future literate” empowers the imagination and enhances the ability of African peoples and countries to prepare and co-invent inclusive health technologies that contribute to achieving both the agenda 2063 of the African Union and the UNESCOs 2022-2029 strategy. Overall, FL could become a catalyst to make new technologies tools of “liberation technology” and “justice technology” for Africa.