Level of willingness to receive mHealth services and associated factors among patients with diabetes in Ethiopia: systematic review and meta-analysis

Mobile health (mHealth) technologies are increasingly recognized as a cost-effective and convenient means of delivering high-quality healthcare services to patients with diabetes. Therefore, this study aimed to assess the level of willingness to receive mHealth services and associated factors among patients with diabetes in Ethiopia. A systematic review and meta-analysis following PRISMA and MOOSE guidelines was conducted and registered with PROSPERO (Registration Number: CRD420251055460). Observational studies in English reporting the level of willingness to receive mHealth services and associated factors among patients with diabetes in Ethiopia, published before May 1, 2025, were included. Searches were performed across Embase, PubMed, Cochrane libraries, HINARI, Scopus, African Journal Online, and Google Scholar. Cochrane’s Q and I 2 tests were used to evaluate the studies’ heterogeneity. To determine the pooled level of willingness to receive mHealth services among patients with diabetes, a random-effects model was employed. To assess publication bias, Egger’s test was used. Seven publications that met the inclusion criteria were retained for the final meta-analysis after reviewing 2474 articles. Among patients with diabetes, the pooled level of willingness to receive mHealth services was 58% (95% CI: 47%- 70%). Factors that include: age below 35 years old (AOR: 2.43; 95% CI: 1.05–3.81), having attended formal education (AOR: 2.69; 95% CI: 1.26–4.12), having internet access (AOR: 2.84; 95% CI: 1.32–4.37), use of oral medication (AOR: 3.08; 95% CI: 1.23–4.9), perceived ease of use of mHealth services (AOR: 3.15; 95% CI: 1.85–4.46), and perceived usefulness of mHealth services (AOR: 4.67; 95% CI: 3.22–6.11) were significantly associated with willingness to receive mHealth services among patients with diabetes. In general, this meta-analysis reveals a significant willingness to adopt mHealth services among diabetic patients in Ethiopia, with a pooled willingness rate of 58%. The findings highlight critical factors influencing willingness, including younger age, having formal education, internet access, use of oral medication, and perceptions of the ease and usefulness of mHealth services. Strengthening digital literacy, improving internet access, and developing patient-centered, user-friendly mHealth services may enhance adoption and improve diabetes management.