Background: Stroke is increasingly becoming a public health problem in Africa as it causes high rates of disability and mortality. Therefore, there is a need to strengthen rehabilitation services within the African healthcare systems in order to improve patient outcomes.
Aim: To gather the scientific evidence on the current status of rehabilitation service delivery for people with stroke in Africa, in light of contextual challenges and opportunities.
Methods: A five-step methodological framework was used to conduct the review which involves (1) identifying the research question, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data and (5) collating, summarising and reporting the results. The WHO service delivery framework was used to report the results.
Findings: A total of 51 studies were reviewed. Most of the studies stemmed from Southern Africa (43%); 37% from Western Africa and 18% from Eastern Africa. Physiotherapy (PT) (82%) was the most reported rehabilitation service whilst clinical psychology (7%), nutrition (14%) and social work (21%) were the least. Comprehensiveness of rehabilitation services was reported by 55% of the studies.
Common barriers were cost of care, lack of appropriate transport, poor referral processes, lack of resources, geographical distance and uneven terrain, variable skills and attitudes of service providers. Common challenges included low service frequency and duration, incomprehensive and fragmented services, lack of trained personnel and infrastructure limitations.
Conclusion: Stroke rehabilitation services in Africa are generally poor, lacking the required components of an effective healthcare service, hence impacting on social and community reintegration of people with stroke.
Copyright © Quinette Louw.