Cardiovascular Disease Healthcare Utilization in Sub-Saharan Africa: A Scoping Review

Abstract

Sub-Saharan African (SSA) countries face a growing burden of cardiovascular disease (CVD), attributed to economic, nutritional, demographic, and epidemiological transitions. These factors increase the prevalence of CVD risk factors, and the CVD burden overlaps with a high prevalence of infectious diseases. This review aimed to understand CVD healthcare utilization determinants and levels in SSA. We conducted a systematic search of the literature on major databases for the period 2008–2018 using exhaustive combinations of CVD and utilization indicators as search terms. Eighteen studies from eight countries were included in this review. Most studies (88.8%) followed the quantitative methodology and largely focused on inpatient stroke care. Two-thirds of patients sought care within 24 h of suffering a stroke, and the length of stay (LOS) in hospital ranged between 6 and 81 days. Results showed a rising trend of CVD admissions within total hospital admissions. Coverage of physiotherapy services was limited and varied between countries. While few studies included rural populations, utilization was found to be negatively associated with rural residence and socioeconomic status. There is a need to extend healthcare provision in SSA to ensure access to the CVD continuum of care.

Cardiovascular disease prevention knowledge and associated factors among adults in Mukono and Buikwe districts in Uganda

“…A study in Cameroon found that beyond high level of education, a high monthly income was associated with moderate-to-good knowledge on CVD [20]. Other studies have also identified urban residence as influential in acquisition of CVD knowledge attributed to access to health information and higher services proximity [33,34]. Moreover, in our study, those who had received health information or advice had higher CVD knowledge.…”

Associations of Neighborhood Walkability with Sedentary Time in Nigerian Older Adults

“…The number of older adults is expected to grow fastest in Africa, where it is projected to increase more than threefold, from 69 to 226 million between the years 2017 and 2050 [2]. Due to weak health care systems in sub-Saharan Africa [3], the cost and burden of age-related non-communicable diseases (NCDs) is expected to be unsustainable in the region if urgent actions are not taken. Reducing population levels of physical inactivity and sedentary behavior is one of the recommended strategies for stemming the growing epidemics of NCDs worldwide [4].…”

“…A recent African study demonstrated the relevance of neighborhood built environment attributes, like availability of roads and walking paths, to sedentary time among people with mental illness in Uganda [29]. Understanding the role of neighborhood built environments on sedentary time among the apparently healthy population is particularly relevant in African countries because chronic disease rates are rising in the region [3,4]. Africa-specific studies can provide more targeted evidence for environmental and urban design policy initiatives aimed at promoting less sitting time and more active living in the African region.…”

Why do We Know So Much and Yet So Little? A Scoping Review of Willingness to Pay for Human Excreta Derived Material in Agriculture

“…Inclusive business models such as the community-based approaches to total sanitation and community-led total sanitation may have the potential to achieve both waste management, resource recovery, and sanitation provision objectives [122]. Examples include the Menengai Waste Recycling Management Group, Nakuru Waste Collectors and Recyclers Management Cooperative Society in Kenya [33,123], the Sustainable Organic Integrated Livelihoods in Haiti, the X-Runner in Peru, and the Clean Team in Ghana and SANERGY in Kenya [18].…”

“…Understanding the demand for nutrients recovered from human waste through the elicitation of farmers' willingness to pay (WTP) may assist in the development of inclusive business models for private sector participation and partnerships with public utilities in line with SDG Goal 17 [17]. It is through these linkages with the global agenda that most researchers and partners in the waste management and sanitation value chain have started paying attention to identifying sustainable viable and business cases and models within the resource recovery and reuse service chain [18][19][20].…”