Rural sub-Saharan Africa faces limited medical access, healthcare worker shortages, and inadequate health information systems. Mobile health (mHealth) technologies offer potential solutions but remain underdeveloped in these settings. This review aims to explore the sociocultural context of mHealth adoption in rural sub-Saharan Africa to support sustainable implementation. A comprehensive Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) search was conducted in databases like PubMed, MEDLINE, and African Journals Online, covering peer-reviewed literature from 2010 to 2024. Qualitative studies of mHealth interventions were included, with quality assessed via the Critical Appraisal Skills Program (CASP) checklist and data synthesized using a meta-ethnographic approach. Out of 892 studies, 38 met the inclusion criteria. Key findings include sociocultural factors like community trust influencing technology acceptance, local implementation strategies, user empowerment in health decisions, and innovative solutions for infrastructure issues. Challenges include privacy concerns, increased healthcare worker workload, and intervention sustainability. While mHealth can reduce healthcare barriers, success depends on sociocultural alignment and adaptability. Future interventions should prioritize community co-design, privacy protection, and sustainable, infrastructure-aware models.

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