Adopting telehealth for mental health support in stroke rehabilitation in Sub-Saharan Africa: A conceptual analysis using Rogers’ Diffusion of Innovation Theory

Stroke rehabilitation in Sub-Saharan Africa (SSA) faces persistent gaps in mental health service integration. Post-stroke depression, anxiety, and cognitive impairments remain underdiagnosed due to workforce shortages, stigma, and infrastructural constraints. Telehealth technologies offer a potential mechanism to expand access to psychological care, yet adoption across SSA remains uneven. This paper provides a conceptual, theory-driven synthesis exploring telehealth adoption for mental health support in stroke rehabilitation across SSA, guided by Rogers' Diffusion of Innovation Theory. A structured conceptual review was conducted using literature from PubMed, Scopus, AJOL, and Google Scholar (2005-2024). Inclusion criteria focused on SSA studies addressing telehealth or mHealth in mental health or rehabilitation contexts. Thematic synthesis was guided by Rogers' five innovation attributes, relative advantage, compatibility, complexity, trialability, and observability, to assess adoption facilitators and barriers. Telehealth adoption is influenced by cultural compatibility, simplicity of design, perceived relative advantage, observable benefits through pilot projects, and supportive policy environments. Successful initiatives in Ghana, Kenya, Nigeria, and Uganda demonstrate the importance of localized adaptation and user engagement. Telehealth provides a scalable pathway to address post-stroke mental health needs in SSA. Effective adoption requires culturally responsive design, targeted capacity-building, and policy alignment with national and regional digital health strategies.