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mHealth interventions to increase HIV non-occupational post-exposure prophylaxis uptake, adherence and linkage to pre-exposure prophylaxis services in Sub-Saharan Africa: a scoping review protocol

Por: Segomotso · N. L. P. · Mokgatle · M. M. · Oladimeji · O. · Swanepoel · J.
Introduction

Non-occupational post-exposure prophylaxis (nPEP) and pre-exposure prophylaxis (PrEP) are effective HIV prevention methods, but their use is low in Sub-Saharan Africa (SSA). Mobile applications (apps) could increase uptake and adherence to these interventions, yet research on their use in communities is limited. Furthermore, there is limited information on the design and development of these apps, impacting their implementation. This scoping review aims to identify, analyse and evaluate mobile apps designed to improve nPEP uptake, adherence and linkage to PrEP services focusing on key features, barriers and facilitators. It also seeks to address gaps in studies assessing the feasibility, usability and acceptability of these apps, with the goal of informing future research, healthcare policies and public health strategies to reduce the HIV burden in Sub-Saharan Africa.

Methods and analysis

This review will follow the Arksey and O'Malley framework and search databases such as PubMed, Scopus and Web of Science for relevant studies. Two independent reviewers will screen and assess full-text studies. Primarily, the review will include studies on digital interventions for nPEP and PrEP, excluding opinion papers, narrative reviews and sub-studies. Grey literature from sources like Google Scholar will also be considered. Data will be captured using a charting form, and results will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews framework. Completion is expected in December 2025.

Ethics and dissemination

No ethical approval is required as publicly available materials will be used. Results will be shared through peer-reviewed journals, conferences and with policymakers to inform HIV prevention strategies.

Feasibility, efficacy and effectiveness of community health worker-facilitated hearing aid provision: a systematic review

Por: Frisby · C. · Manchaiah · V. · Swanepoel · D. W.
Objectives

The WHO recommends task-sharing with community health workers (CHWs) to help overcome the limited access to hearing healthcare and hearing aids in low-income and middle-income settings (LMIs). This systematic review examined the feasibility, efficacy and effectiveness of CHW-facilitated hearing aid provision.

Design

Systematic review guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.

Data sources

PubMed, Scopus and Web of Science were searched through 4 June 2025.

Eligibility criteria

Studies in which CHWs facilitated hearing aid provision in any context.

Data extraction and synthesis

Data on study characteristics, CHW training and roles, hearing-aid outcomes and implementation factors were extracted. Study quality was determined using the National Institute of Health quality assessment tool, and level of evidence was determined using the Centre for Evidence-Based Medicine. A narrative synthesis was conducted.

Results

Six studies published between 2013 and 2025 were included. Two were conducted in high-income countries but implemented in LMI communities. Four studies were conducted in LMI countries. All provided CHW training, though content and duration varied; only one used WHO-endorsed materials. Sustained device use was high as reported at follow-ups, though only one included 12-month outcomes. All studies included validated outcome measures, including the International Outcome Inventory for Hearing Aids, Hearing Handicap Inventory for the Elderly–Screening version, Abbreviated Profile of Hearing Aid Benefit and Self-Efficacy for Situational Communication Management Questionnaire. Implementation facilitators included use of local CHWs, delivery in participants’ home languages, comprehensive CHW training and employing mHealth tools. Barriers included CHW scope constraints and unfamiliarity with outcome subscales in rural contexts. Only two studies used formal feasibility frameworks.

Conclusions

CHW-facilitated hearing aid provision is feasible and effective. However, variation in training and implementation highlights the need for standardised training materials, supervision models and culturally adapted outcome measures. Further research should examine long-term outcomes, cost-effectiveness and scalability using formal implementation frameworks.

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