Abstract:
OBJECTIVES: To map the evidence and scope of physical
rehabilitation services delivered by community health
workers (CHWs) in sub-Saharan Africa (SSA).
DESIGN: Scoping review
DATA SOURCES: PubMed, Scopus, Cochrane Central and
databases within the EBSCOhost platform. We also
searched other literature sources including reference lists,
conference presentations and organisational websites
such as WHO, Ministries of Health and non-governmental
organisations in SSA.
ELIGIBILIY CRITERIA FPR SELECTION OF STUDIES: Articles
presenting evidence on CHWs’ delivery of physical
rehabilitation services in SSA from September 1978 to
June 2023.
DATA EXTRACTION AND SYNTHESIS: Screening was conducted
by two reviewers and was guided by the inclusion criteria.
Thematic content analysis of data was employed. The
results are presented according to the Preferred Reporting
Items for Systematic Review and Meta-Analysis extension
for scoping reviews.
RESULTS: A total of 6996 articles were identified through
various databases, with only 20 studies qualifying for data
extraction. Evidence was presented by Eritrea, Ethiopia,
Malawi, Mauritius, Namibia, South Africa and Uganda.
Assessments, case management, health education,
community liaison with support, health systems linkage
and administration were the CHWs’ scope of practice
identified. The review identified home-based, community-based, community and facility-based, home and
community-based and facility-based as modes of delivery.
The barriers experienced are resources, societal and
community attitudes, governance, geographical barriers
and delivery capacity, while proximity to the community,
positive job attitude and support with collaboration
facilitated service delivery.
CONCLUSION: Training and integrating CHWs in national
health care systems, with careful selection of existing
CHWs, would minimise the barriers faced.
