Nudging Sub-Saharan African Primary Health Care Systems Toward Preventive and Promotional Care: Project Design and Conceptual Framework for the Development of Remote Functions
1
Department of Public Health and Health Systems, University of Limpopo, South Africa, Polokwane, South Africa
2
2 Biomedical Engineering Research Centre, University of Cape Town, Cape Town, South Africa
3
4 Department of Community Medicine, Midland State University, Gweru, Zimbabwe
4
3 College of Medical Sciences, Alex Ekwuene Federal University, Ikwo - Abakaliki, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Primary Health Care (PHC) systems in Sub-Saharan Africa (SSA) remain heavily oriented toward reactive, curative services despite the urgent need to shift toward preventive and proactive care. Although digital health solutions have been expanding, most still reinforce treatment-based models rather than address systemic factors that could facilitate preventive care. This article presents the rationale behind a research project examining the development of a conceptual framework of remote functions - a group of new, hypothetical services delivered to citizens away from healthcare facilities, including (1) Virtual Queuing and Chronic Condition Management, (2) Health and Wellness Promotion, and (3) Local Outbreak and Epidemiological Information Dissemination. The research will be conducted across South Africa, Zimbabwe and Nigeria. The aim is to generate robust, actionable evidence on how preventive - and promotional PHC functions can be incorporated into sub-Saharan African primary health care systems.
METHODS:
The project adopts a muti-study mixed method research design. The overall design integrates comparative case studies, qualitative and quantitative surveys, co-designed and participatory approaches and a Delphi process to capture systemic, workforce, community-level perspectives across sequential and interlinked research phases. Analysis will produce coding protocols, scenario-testing outputs and empirically supported refinements of the framework, linking adoption potential to operational and workforce feasibility considerations; consolidate evidence from all prior phases to validate the conceptual framework and associated pathways.
CONCLUSIONS:
Drawing on the Framework for the Adoption and Scaling of Remote Patient Management Systems (FRPMS), the study will investigate: the intention–expectation gaps among policymakers, providers, and citizens; task–skills fit in the workforce; and sociotechnical norms and imaginaries shaping prevention versus treatment approaches. Findings will generate new practical and empirical insights into determinants and levers of SSA's PHC system transformation. Outputs will include a validated framework supporting broader awareness and uptake of preventive and promotional PHC approaches across SSA.
Primary Health Care (PHC) systems in Sub-Saharan Africa (SSA) remain heavily oriented toward reactive, curative services despite the urgent need to shift toward preventive and proactive care. Although digital health solutions have been expanding, most still reinforce treatment-based models rather than address systemic factors that could facilitate preventive care. This article presents the rationale behind a research project examining the development of a conceptual framework of remote functions - a group of new, hypothetical services delivered to citizens away from healthcare facilities, including (1) Virtual Queuing and Chronic Condition Management, (2) Health and Wellness Promotion, and (3) Local Outbreak and Epidemiological Information Dissemination. The research will be conducted across South Africa, Zimbabwe and Nigeria. The aim is to generate robust, actionable evidence on how preventive - and promotional PHC functions can be incorporated into sub-Saharan African primary health care systems.
METHODS:
The project adopts a muti-study mixed method research design. The overall design integrates comparative case studies, qualitative and quantitative surveys, co-designed and participatory approaches and a Delphi process to capture systemic, workforce, community-level perspectives across sequential and interlinked research phases. Analysis will produce coding protocols, scenario-testing outputs and empirically supported refinements of the framework, linking adoption potential to operational and workforce feasibility considerations; consolidate evidence from all prior phases to validate the conceptual framework and associated pathways.
CONCLUSIONS:
Drawing on the Framework for the Adoption and Scaling of Remote Patient Management Systems (FRPMS), the study will investigate: the intention–expectation gaps among policymakers, providers, and citizens; task–skills fit in the workforce; and sociotechnical norms and imaginaries shaping prevention versus treatment approaches. Findings will generate new practical and empirical insights into determinants and levers of SSA's PHC system transformation. Outputs will include a validated framework supporting broader awareness and uptake of preventive and promotional PHC approaches across SSA.
| eISSN: | 2654-1459 |
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