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Published in: Globalization and Health 1/2014

Open Access 01-12-2014 | Research

Mobile health for non-communicable diseases in Sub-Saharan Africa: a systematic review of the literature and strategic framework for research

Authors: Gerald S Bloomfield, Rajesh Vedanthan, Lavanya Vasudevan, Anne Kithei, Martin Were, Eric J Velazquez

Published in: Globalization and Health | Issue 1/2014

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Abstract

Background

Mobile health (mHealth) approaches for non-communicable disease (NCD) care seem particularly applicable to sub-Saharan Africa given the penetration of mobile phones in the region. The evidence to support its implementation has not been critically reviewed.

Methods

We systematically searched PubMed, Embase, Web of Science, Cochrane Central Register of Clinical Trials, a number of other databases, and grey literature for studies reported between 1992 and 2012 published in English or with an English abstract available. We extracted data using a standard form in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results

Our search yielded 475 citations of which eleven were reviewed in full after applying exclusion criteria. Five of those studies met the inclusion criteria of using a mobile phone for non-communicable disease care in sub-Saharan Africa. Most studies lacked comparator arms, clinical endpoints, or were of short duration. mHealth for NCDs in sub-Saharan Africa appears feasible for follow-up and retention of patients, can support peer support networks, and uses a variety of mHealth modalities. Whether mHealth is associated with any adverse effect has not been systematically studied. Only a small number of mHealth strategies for NCDs have been studied in sub-Saharan Africa.

Conclusions

There is insufficient evidence to support the effectiveness of mHealth for NCD care in sub-Saharan Africa. We present a framework for cataloging evidence on mHealth strategies that incorporates health system challenges and stages of NCD care. This framework can guide approaches to fill evidence gaps in this area. Systematic review registration: PROSPERO CRD42014007527.
Appendix
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Literature
1.
go back to reference Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, Cueto M, Dare L, Dussault G, Elzinga G, Fee E, Habte D, Hanvoravongchai P, Jacobs M, Kurowski C, Michael S, Pablos-Mendez A, Sewankambo N, Solimano G, Stilwell B, de Waal A, Wibulpolprasert S: Human resources for health: overcoming the crisis. Lancet. 2004, 364 (9449): 1984-1990.PubMedCrossRef Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, Cueto M, Dare L, Dussault G, Elzinga G, Fee E, Habte D, Hanvoravongchai P, Jacobs M, Kurowski C, Michael S, Pablos-Mendez A, Sewankambo N, Solimano G, Stilwell B, de Waal A, Wibulpolprasert S: Human resources for health: overcoming the crisis. Lancet. 2004, 364 (9449): 1984-1990.PubMedCrossRef
2.
go back to reference World Health Organization: Preventing Chronic Diseases: A Vital Investment. 2005, Geneva: WHO World Health Organization: Preventing Chronic Diseases: A Vital Investment. 2005, Geneva: WHO
3.
go back to reference Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C: A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380 (9859): 2224-2260.PubMedPubMedCentralCrossRef Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C: A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380 (9859): 2224-2260.PubMedPubMedCentralCrossRef
4.
go back to reference Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380 (9859): 2197-2223.PubMedCrossRef Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380 (9859): 2197-2223.PubMedCrossRef
5.
go back to reference World Health Organization: Innovative care for chronic conditions: Building blocks for action. 2002, Geneva: WHO World Health Organization: Innovative care for chronic conditions: Building blocks for action. 2002, Geneva: WHO
6.
go back to reference World Health Organizations Zero Draft: Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020. 2012, Geneva: WHO World Health Organizations Zero Draft: Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020. 2012, Geneva: WHO
7.
go back to reference International Telecommunication Union: The World in 2013: ICT Facts and Figures. 2013, Geneva: WHO International Telecommunication Union: The World in 2013: ICT Facts and Figures. 2013, Geneva: WHO
8.
go back to reference Gurman TA, Rubin SE, Roess AA: Effectiveness of mHealth behavior change communication interventions in developing countries: a systematic review of the literature. J Health Commun. 2012, 17 (Suppl 1): 82-104.PubMedCrossRef Gurman TA, Rubin SE, Roess AA: Effectiveness of mHealth behavior change communication interventions in developing countries: a systematic review of the literature. J Health Commun. 2012, 17 (Suppl 1): 82-104.PubMedCrossRef
9.
go back to reference World Health Organization: mHealth: New horizons for health through mobile technologies: second global survey on eHealth. 2011, Geneva: WHO World Health Organization: mHealth: New horizons for health through mobile technologies: second global survey on eHealth. 2011, Geneva: WHO
10.
go back to reference Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M: Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380 (9859): 2095-2128.PubMedCrossRef Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M: Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380 (9859): 2095-2128.PubMedCrossRef
11.
go back to reference Omran AR: The epidemiologic transition: a theory of the epidemiology of population change. Milbank Mem Fund Q. 1971, 49 (4): 509-538.PubMedCrossRef Omran AR: The epidemiologic transition: a theory of the epidemiology of population change. Milbank Mem Fund Q. 1971, 49 (4): 509-538.PubMedCrossRef
12.
go back to reference Boutayeb A: The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006, 100 (3): 191-199.PubMedCrossRef Boutayeb A: The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006, 100 (3): 191-199.PubMedCrossRef
13.
go back to reference Remais JV, Zeng G, Li G, Tian L, Engelgau MM: Convergence of non-communicable and infectious diseases in low- and middle-income countries. Int J Epidemiol. 2013, 42 (1): 221-227.PubMedPubMedCentralCrossRef Remais JV, Zeng G, Li G, Tian L, Engelgau MM: Convergence of non-communicable and infectious diseases in low- and middle-income countries. Int J Epidemiol. 2013, 42 (1): 221-227.PubMedPubMedCentralCrossRef
14.
go back to reference Mbanya JCN, Motala AA, Sobngwi E, Assah FK, Enoru ST: Diabetes in sub-Saharan Africa. Lancet. 2010, 375 (9733): 2254-2266.PubMedCrossRef Mbanya JCN, Motala AA, Sobngwi E, Assah FK, Enoru ST: Diabetes in sub-Saharan Africa. Lancet. 2010, 375 (9733): 2254-2266.PubMedCrossRef
18.
go back to reference Nolte E, McKee M: Caring for people with chronic conditions: A health systems perspective. 2008, Geneva: World Health Organization on behalf of the European Observatory on Health Systems and Policies Nolte E, McKee M: Caring for people with chronic conditions: A health systems perspective. 2008, Geneva: World Health Organization on behalf of the European Observatory on Health Systems and Policies
19.
go back to reference Labrique AB, Vasudevan L, Kochi E, Fabricant R, Mehl G: mHealth innovations as health system strengthening tools: 12 common applications and a visual framework. Global Health: Science and Practice. 2013, 1 (2): 160-171. 10.9745/GHSP-D-13-00031. Labrique AB, Vasudevan L, Kochi E, Fabricant R, Mehl G: mHealth innovations as health system strengthening tools: 12 common applications and a visual framework. Global Health: Science and Practice. 2013, 1 (2): 160-171. 10.9745/GHSP-D-13-00031.
20.
go back to reference Karanja S, Mbuagbaw L, Ritvo P, Law J, Kyobutungi C, Reid G, Ram R, Estambale B, Lester R: A workshop report on HIV mHealth synergy and strategy meeting to review emerging evidence-based mHealth interventions and develop a framework for scale-up of these interventions. Pan Afr Med J. 2011, 10: 37-PubMedPubMedCentral Karanja S, Mbuagbaw L, Ritvo P, Law J, Kyobutungi C, Reid G, Ram R, Estambale B, Lester R: A workshop report on HIV mHealth synergy and strategy meeting to review emerging evidence-based mHealth interventions and develop a framework for scale-up of these interventions. Pan Afr Med J. 2011, 10: 37-PubMedPubMedCentral
21.
go back to reference Chindo L, Hesseling P, Mccormick P, Mbah G, Wharlin P, Kidd M: Mobile phone use in rural Cameroon from 2007 to 2010: An increasingly useful tool for follow-up in Burkitt Lymphoma. Pediatric Blood and Cancer. 2011, 57 (5): 775- Chindo L, Hesseling P, Mccormick P, Mbah G, Wharlin P, Kidd M: Mobile phone use in rural Cameroon from 2007 to 2010: An increasingly useful tool for follow-up in Burkitt Lymphoma. Pediatric Blood and Cancer. 2011, 57 (5): 775-
22.
go back to reference Pastakia SD, Karwa R, Kahn CB, Nyabundi JS: The evolution of diabetes care in the rural, resource-constrained setting of western Kenya. The Annals of pharmacotherapy. 2011, 45 (6): 721-726.PubMedCrossRef Pastakia SD, Karwa R, Kahn CB, Nyabundi JS: The evolution of diabetes care in the rural, resource-constrained setting of western Kenya. The Annals of pharmacotherapy. 2011, 45 (6): 721-726.PubMedCrossRef
23.
go back to reference Parham GP, Mwanahamuntu MH, Pfaendler KS, Sahasrabuddhe VV, Myung D, Mkumba G, Kapambwe S, Mwanza B, Chibwesha C, Hicks ML, Stringer JSA: eC3–a modern telecommunications matrix for cervical cancer prevention in Zambia. J Low Genit Tract Dis. 2010, 14 (3): 167-173.PubMedCrossRef Parham GP, Mwanahamuntu MH, Pfaendler KS, Sahasrabuddhe VV, Myung D, Mkumba G, Kapambwe S, Mwanza B, Chibwesha C, Hicks ML, Stringer JSA: eC3–a modern telecommunications matrix for cervical cancer prevention in Zambia. J Low Genit Tract Dis. 2010, 14 (3): 167-173.PubMedCrossRef
24.
go back to reference Odigie VI, Yusufu LM, Dawotola DA, Ejagwulu F, Abur P, Mai A, Ukwenya Y, Garba ES, Rotibi BB, Odigie EC: The mobile phone as a tool in improving cancer care in Nigeria. Psychooncology. 2012, 21 (3): 332-335.PubMedCrossRef Odigie VI, Yusufu LM, Dawotola DA, Ejagwulu F, Abur P, Mai A, Ukwenya Y, Garba ES, Rotibi BB, Odigie EC: The mobile phone as a tool in improving cancer care in Nigeria. Psychooncology. 2012, 21 (3): 332-335.PubMedCrossRef
25.
go back to reference Rotheram-Borus MJ, Tomlinson M, Gwegwe M, Comulada WS, Kaufman N, Keim M: Diabetes buddies: peer support through a mobile phone buddy system. Diabetes Educ. 2012, 38 (3): 357-365.PubMedPubMedCentralCrossRef Rotheram-Borus MJ, Tomlinson M, Gwegwe M, Comulada WS, Kaufman N, Keim M: Diabetes buddies: peer support through a mobile phone buddy system. Diabetes Educ. 2012, 38 (3): 357-365.PubMedPubMedCentralCrossRef
26.
go back to reference Guy R, Hocking J, Wand H, Stott S, Ali H, Kaldor J: How effective are short message service reminders at increasing clinic attendance? A meta-analysis and systematic review. Health Serv Res. 2012, 47 (2): 614-632.PubMedPubMedCentralCrossRef Guy R, Hocking J, Wand H, Stott S, Ali H, Kaldor J: How effective are short message service reminders at increasing clinic attendance? A meta-analysis and systematic review. Health Serv Res. 2012, 47 (2): 614-632.PubMedPubMedCentralCrossRef
27.
go back to reference Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, Patel V, Haines A: The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med. 2013, 10 (1): e1001363-PubMedPubMedCentralCrossRef Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, Patel V, Haines A: The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med. 2013, 10 (1): e1001363-PubMedPubMedCentralCrossRef
28.
go back to reference Krishna S, Boren SA, Balas EA: Healthcare via cell phones: a systematic review. Telemedicine and e-Health. 2009, 15 (3): 231-240. 10.1089/tmj.2008.0099.PubMedCrossRef Krishna S, Boren SA, Balas EA: Healthcare via cell phones: a systematic review. Telemedicine and e-Health. 2009, 15 (3): 231-240. 10.1089/tmj.2008.0099.PubMedCrossRef
29.
go back to reference Beratarrechea A, Lee AG, Willner JM, Jahangir E, Ciapponi A, Rubinstein A: The impact of mobile health interventions on chronic disease outcomes in developing countries: a systematic review. Telemed J E Health. 2014, 20 (1): 75-82.PubMedPubMedCentralCrossRef Beratarrechea A, Lee AG, Willner JM, Jahangir E, Ciapponi A, Rubinstein A: The impact of mobile health interventions on chronic disease outcomes in developing countries: a systematic review. Telemed J E Health. 2014, 20 (1): 75-82.PubMedPubMedCentralCrossRef
30.
go back to reference Martínez-Pérez B, de la Torre-Díez I, López-Coronado M: Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis. J Med Internet Res. 2013, 15 (6): e120-PubMedPubMedCentralCrossRef Martínez-Pérez B, de la Torre-Díez I, López-Coronado M: Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis. J Med Internet Res. 2013, 15 (6): e120-PubMedPubMedCentralCrossRef
31.
go back to reference Labrique A, Vasudevan L, Chang LW, Mehl G: H_pe for mHealth: more "y" or "o" on the horizon?. Int J Med Inform. 2013, 82 (5): 467-469.PubMedCrossRef Labrique A, Vasudevan L, Chang LW, Mehl G: H_pe for mHealth: more "y" or "o" on the horizon?. Int J Med Inform. 2013, 82 (5): 467-469.PubMedCrossRef
33.
go back to reference Califf RM, Platt R: Embedding cardiovascular research into practice. JAMA. 2013, 310 (19): 2037-2038.PubMedCrossRef Califf RM, Platt R: Embedding cardiovascular research into practice. JAMA. 2013, 310 (19): 2037-2038.PubMedCrossRef
34.
go back to reference Dalal S, Beunza JJ, Volmink J, Adebamowo C, Bajunirwe F, Njelekela M, Mozaffarian D, Fawzi W, Willett W, Adami HO, Holmes MD: Non-communicable diseases in sub-Saharan Africa: what we know now. Int J Epidemiol. 2011, 40 (4): 885-901.PubMedCrossRef Dalal S, Beunza JJ, Volmink J, Adebamowo C, Bajunirwe F, Njelekela M, Mozaffarian D, Fawzi W, Willett W, Adami HO, Holmes MD: Non-communicable diseases in sub-Saharan Africa: what we know now. Int J Epidemiol. 2011, 40 (4): 885-901.PubMedCrossRef
35.
39.
go back to reference DeRenzi B, Lesh N, Parikh T, Sims C, Maokla W, Chemba M, Hamisi Y, Mitchell M, Borriello G: Improving pediatric health care in low-income countries. Proceedings of the SIGCHI conference on human factors in computing systems: 2008. 2008, 753-762. Florence, Italy: ACM DeRenzi B, Lesh N, Parikh T, Sims C, Maokla W, Chemba M, Hamisi Y, Mitchell M, Borriello G: Improving pediatric health care in low-income countries. Proceedings of the SIGCHI conference on human factors in computing systems: 2008. 2008, 753-762. Florence, Italy: ACM
41.
go back to reference Blank E, Tuikong N, Misoi L, Kamano J, Hutchinson C, Kimaiyo S, Fuster V, Were M, Vedanthan R: Usability of implementing a tablet-based decision support and integrated record- keeping (DESIRE) tool in the nurse management of hypertension in rural Kenya. Stud Health Technol Inform. 2013, 192: 1002-PubMedPubMedCentral Blank E, Tuikong N, Misoi L, Kamano J, Hutchinson C, Kimaiyo S, Fuster V, Were M, Vedanthan R: Usability of implementing a tablet-based decision support and integrated record- keeping (DESIRE) tool in the nurse management of hypertension in rural Kenya. Stud Health Technol Inform. 2013, 192: 1002-PubMedPubMedCentral
42.
go back to reference Colven R, Shim MH, Brock D, Todd G: Dermatological diagnostic acumen improves with use of a simple telemedicine system for underserved areas of South Africa. Telemed J E Health. 2011, 17 (5): 363-369.PubMedPubMedCentralCrossRef Colven R, Shim MH, Brock D, Todd G: Dermatological diagnostic acumen improves with use of a simple telemedicine system for underserved areas of South Africa. Telemed J E Health. 2011, 17 (5): 363-369.PubMedPubMedCentralCrossRef
44.
go back to reference VillageReach: Starting at the last mile: Rethinking medical supply chain in low-income countries. 2012, Seattle: VillageReach VillageReach: Starting at the last mile: Rethinking medical supply chain in low-income countries. 2012, Seattle: VillageReach
45.
go back to reference Vedanthan R, Kamano JH, Naanyu V, Delong AK, Were MC, Finkelstein EA, Menya D, Akwanalo CO, Bloomfield GS, Binanay CA, Velazquez EJ, Hogan JW, Horowitz CR, Inui TS, Kimaiyo S, Fuster V: Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial. Trials. 2014, 15 (1): 143-157.PubMedPubMedCentralCrossRef Vedanthan R, Kamano JH, Naanyu V, Delong AK, Were MC, Finkelstein EA, Menya D, Akwanalo CO, Bloomfield GS, Binanay CA, Velazquez EJ, Hogan JW, Horowitz CR, Inui TS, Kimaiyo S, Fuster V: Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial. Trials. 2014, 15 (1): 143-157.PubMedPubMedCentralCrossRef
46.
go back to reference Vervloet M, Linn AJ, van Weert JC, de Bakker DH, Bouvy ML, van Dijk L: The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. J Am Med Inform Assoc. 2012, 19 (5): 696-704.PubMedPubMedCentralCrossRef Vervloet M, Linn AJ, van Weert JC, de Bakker DH, Bouvy ML, van Dijk L: The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. J Am Med Inform Assoc. 2012, 19 (5): 696-704.PubMedPubMedCentralCrossRef
51.
go back to reference Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL: Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011, 34 (9): 1934-1942.PubMedPubMedCentralCrossRef Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL: Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011, 34 (9): 1934-1942.PubMedPubMedCentralCrossRef
52.
go back to reference Rajput ZA, Mbugua S, Amadi D, Chepngeno V, Saleem JJ, Anokwa Y, Hartung C, Borriello G, Mamlin BW, Ndege SK, Were MC: Evaluation of an Android-based mHealth system for population surveillance in developing countries. J Am Med Inform Assoc. 2012, 19 (4): 655-659.PubMedPubMedCentralCrossRef Rajput ZA, Mbugua S, Amadi D, Chepngeno V, Saleem JJ, Anokwa Y, Hartung C, Borriello G, Mamlin BW, Ndege SK, Were MC: Evaluation of an Android-based mHealth system for population surveillance in developing countries. J Am Med Inform Assoc. 2012, 19 (4): 655-659.PubMedPubMedCentralCrossRef
Metadata
Title
Mobile health for non-communicable diseases in Sub-Saharan Africa: a systematic review of the literature and strategic framework for research
Authors
Gerald S Bloomfield
Rajesh Vedanthan
Lavanya Vasudevan
Anne Kithei
Martin Were
Eric J Velazquez
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2014
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/1744-8603-10-49

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