Evidence of community health workers' delivery of physical rehabilitation services in sub-Saharan Africa: a scoping review.

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. ELIGIBILITY CRITERIA FOR 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.