Paper-Based and SMS-Based Approaches to Postnatal Care Follow-Up and Coordination in African Health Systems: A Scoping Review (2013-2026)

This scoping review maps the extent, range, and nature of evidence on paper-based and SMS-based tools used to support postnatal care coordination in African health systems from 2013 to 2026. The review is anchored in the PCC (Population, Concept, Context) framework, following Joanna Briggs Institute methodology (Peters et al., 2024). The postnatal period, the six weeks following delivery, carries a disproportionate risk of maternal and neonatal mortality yet remains the most poorly coordinated point in the continuum of care across sub-Saharan Africa. Despite the proliferation of mHealth initiatives, the field lacks a synthesis specifically examining how low-technology coordination tools – discharge records, referral slips, CHW tracking registers, SMS reminders, and two-way messaging platforms – function as mechanisms for follow-up scheduling, client tracking, and facility-to-community communication in the African health system context. This review, therefore, addresses a precise and underexplored gap: not what mHealth does for maternal health knowledge or behaviour change broadly, but how paper and SMS tools operationally coordinate the handover, tracking, and follow-up of postnatal women and their newborns between health actors and across care levels. Population: Postnatal women (≤6 weeks), linked newborns, and health actors involved in coordination. Concept: Paper-based or SMS-based tools supporting at least one of three coordination functions: discharge communication, follow-up scheduling, or client tracking, including community-to-facility referral pathways. Context: African health systems. Study designs: Qualitative, quantitative, mixed methods, implementation research, programme evaluations, and grey literature with operational detail (2013–2026, English full text). Findings will be charted to document coordination processes, implementation characteristics, tool typologies, and the evolution from early paper-based pilots to contemporary hybrid paper-digital systems. This review does not appraise study quality but synthesises breadth of evidence to inform implementation priorities and identify gaps warranting primary research.