Telemedicine and Cultural Competency in Dementia Care: Mapping Stakeholder Roles in Digital Toolkit Development in SSA: A Systematic Review

远程医疗与痴呆症护理中的文化能力:撒哈拉以南非洲地区数字工具包开发中利益相关者的角色分析:系统性综述

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Abstract

BACKGROUND: Dementia is a growing concern in Sub-Saharan Africa (SSA), particularly Nigeria, where care is hindered by weak infrastructure, stigma, and limited culturally responsive services. Telemedicine offers promise but faces adoption challenges in low-resource settings. OBJECTIVE: To evaluate digital interventions for dementia care in SSA and examine how culturally tailored telemedicine is shaped by stakeholder input, it may reduce caregiver burden and improve care delivery. METHODS: Following PRISMA guidelines, 1650 records were screened: across PubMed, Scopus, PsycINFO, and Google Scholar; 20 studies met inclusion criteria. Thematic analysis identified trends across intervention types, populations, and barriers. RESULTS: Five core themes emerged: barriers to care (30%), telemedicine opportunities (25%), stakeholder involvement (23%), cultural influences (20%) and technological feasibility (17%). Mobile health tools showed potential when culturally adapted. However, poor infrastructure, digital literacy and traditional beliefs constrained adoption. Engaging caregivers, clinicians and community leaders improved solution relevance and uptake. CONCLUSIONS: Culturally informed, co-designed telemedicine models can strengthen dementia care delivery in SSA, stakeholder-driven digital models may serve as a scalable blueprint for other low-resource contexts. PATIENT OR PUBLIC CONTRIBUTION: This review incorporated studies that engaged patients, informal caregivers, clinicians, policymakers and community leaders in the codesign and implementation of digital dementia care tools. Their lived experiences and cultural insights informed the development of interventions that are not only technologically feasible but also socially and "culturally appropriate".

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