Background mHealth can help with healthcare service delivery for various health issues, but there's a significant gap in the availability and use of mHealth systems between sub-Saharan Africa and Europe, despite the ongoing digitalization of the global healthcare system. Objective This work aims to compare and investigate the use and availability of mHealth systems in sub-Saharan Africa and Europe, and identify gaps in current mHealth development and implementation in both regions. Methods The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe. Four databases (Scopus, Web of Science, IEEE Xplore, and PubMed) were used, and articles were evaluated based on predetermined criteria. Details on the mHealth system type, goal, patient type, health concern, and development stage were collected and recorded in a Microsoft Excel worksheet. Results The search query produced 1020 articles for sub-Saharan Africa and 2477 articles for Europe. After screening for eligibility, 86 articles for sub-Saharan Africa and 297 articles for Europe were included. To minimize bias, two reviewers conducted the article screening and data retrieval. Sub-Saharan Africa used SMS and call-based mHealth methods for consultation and diagnosis, mainly for young patients such as children and mothers, and for issues such as HIV, pregnancy, childbirth, and child care. Europe relied more on apps, sensors, and wearables for monitoring, with the elderly as the most common patient group, and the most common health issues being cardiovascular disease and heart failure. Conclusion Wearable technology and external sensors are heavily used in Europe, whereas they are seldom used in sub-Saharan Africa. More efforts should be made to use the mHealth system to improve health outcomes in both regions, incorporating more cutting-edge technologies like wearables internal and external sensors. Undertaking context-based studies, identifying determinants of mHealth systems use, and considering these determinants during mHealth system design could enhance mHealth availability and utilization.

BACKGROUND Mobile health (mHealth) approaches are transforming the way healthcare is delivered to patients. This approach is especially beneficial to Sub-Saharan Africa (SSA), which has a disproportionate disease burden and a scarcity of healthcare workers. Evidence-based data on the use and implementation of mHealth approaches in the region is required to trace implementation and fill the existing gaps. OBJECTIVE The purpose of this study is to determine the current availability of mHealth interventions in SSA, the stage of these interventions, and the health issues mostly addressed by the interventions. METHODS Articles published from 2000 to 2021 were searched in four databases: PUBMED, IEEE, SCOPUS, and Web of Science. A set of inclusion and exclusion criteria was used to evaluate the articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to assess the current evidence on the use and implementation of mHealth in the SSA. Using a data graphing table, data from the included publications were retrieved, and the data was then used and synthesized as the basis for analysis. RESULTS There were a total of 1020 articles found in the literature search. 59 of these have met the criteria for inclusion. The results show the implementation of mHealth interventions in 21 SSA nations. Only one (2%) of the reported interventions used a wearable sensor-based approach. Of these interventions, 13 (22%) were SMS text-based interventions, 17 (29%) were app-based mHealth approaches, 18 (30%) were telemedicine-based approaches, and 10 (17%) were mixed approaches. HIV, cancer, and maternal and child health problems are the most commonly discussed health issues in the literature covering mHealth in SSA. Proof of concept, design and development, a pilot test, a large-scale implementation, and a scale-up level of interventions were the most frequently documented stages of mHealth interventions. CONCLUSIONS Less than half of the 48 SSA countries are making (few) attempts to incorporate mHealth platforms into their health systems indicating the need for further developing mHealth technology in SSA. To encourage the adoption of the health system, mHealth solutions should be designed in a way that is both affordable and simple to use. Integrating wearable sensors into mHealth platforms should get careful consideration in order to monitor physiological indicators in real-time and provide patients with individualized care and treatment.

Introduction The advent of digital systems and global mobile phone availability presents an opportunity for better healthcare access and equity. However, the disparity in the usage and availability of mHealth systems between Europe and Sub-Saharan Africa (SSA) has not been explored in relation to current health, healthcare status, and demographics. Objective This study aimed to compare mHealth system availability and use in SSA and Europe in the above-mentioned context. Methods The study analyzed health, healthcare status, and demographics in both regions. It assessed mortality, disease burden, and universal health coverage. A systematic narrative review was conducted to thoroughly assess available data on mHealth availability and use, guiding future research in the field. Results SSA is on the verge of stages 2 and 3 in the demographic transition with a youthful population and high birth rate. Communicable, maternal, neonatal, and nutritional diseases contribute to high mortality and disease burden, including child mortality. Europe is on the verge of stages 4 and 5 in the demographic transition with low birth and death rates. Europe's population is old, and non-communicable diseases (NCDs) pose major health challenges. The mHealth literature adequately covers cardiovascular disease/heart failure, and cancer. However, it lacks approaches for respiratory/enteric infections, malaria, and NCDs. Conclusions mHealth systems in SSA are underutilized than in Europe, despite alignment with the region's demographics and major health issues. Most initiatives in SSA lack implementation depth, with only pilot tests or small-scale implementations. Europe's reported cases highlight actual implementation and acceptability, indicating a strong implementation depth of mHealth systems.