A Text-Based Post-Operative Intervention in Voluntary Medical Circumcised Men (VMMC) to Improve Quality of Care and Adverse Events Identification in Sub-Saharan Africa: A Scoping Review Protocol

The World Health Organization (WHO) highlights the importance of providing high-quality care for all post-operative procedures related to VMMC, as it has been shown to effectively lower the chances of heterosexual HIV transmission. The lack of proper follow-up options results in hefty costs for those implementing it, causes delays in spotting any adverse events, and increases health risks for Medically circumcised (MC) patients. The required number of follow-up visits exposes the healthcare system to staff shortages, high patient volumes, and limited healthcare access especially in rural areas. Whereas the rapid expansion of mobile health (mHealth) technologies presents a promising solution to address these gaps. Two-way-texting interventions in VMMC settings successfully enhance communication between patients and nurses while improving post-operative education and enabling early detection of adverse events through remote monitoring. Research shows minimal evidence about how well the intervention works, how patients accept and the benefits it poses to VMMC. This scoping review investigates existing evidence regarding two-way text-based approaches in VMMC post-operative care to analyze their effects on care quality and patient safety while determining best practices for expansion. Healthcare providers and policymakers will obtain essential information from these findings to create evidence-based approaches to integrate digital health solutions into VMMC programs which will enhance health outcomes and service delivery efficiency. This scoping review will be conducted following the Arksey and O’Malley framework and PRISMA-ScR guidelines. Searches will include electronic databases and grey literature, following the Mesh terms and Boolean operators with study selection by two independent reviewers using Covidence. Thematic analysis will be used to synthesize findings. Methodological quality will be assessed using the Mixed Methods Appraisal Tool (MMAT). We anticipate finding relevant evidence through published information reporting about the intervention. Mobile health technology expansion and routine care offers a complementary solution to overcome healthcare system burdens like staff shortages and poor service delivery. This evidence will be presented on different NDOH platforms, conferences and will be published.