Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review

Dorothy Mushi; Joel M Francis; Candida Moshiro; Charlotte Hanlon; Solomon Teferra

doi:10.3389/fpsyt.2022.822791

Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review

Front Psychiatry. 2022 Mar 15:13:822791. doi: 10.3389/fpsyt.2022.822791. eCollection 2022.

Authors

Dorothy Mushi^{1

2

3}, Joel M Francis^{4

5}, Candida Moshiro⁵, Charlotte Hanlon^{1

2

6}, Solomon Teferra¹

Affiliations

¹ Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
² Centre for Innovative Drug Development and Therapeutics Trial for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
³ Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania.
⁴ Department of Family Medicine and Primary Care, Faculty of Health Sciences, Witwatersrand University, Johannesburg, South Africa.
⁵ Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania.
⁶ Centre for Global Mental Health, Health Service and Population Research Department and WHO Collaborating Centre for Mental Health and Training, Institute of Psychiatry, Psychology, and Neuroscience, King's College University, London, United Kingdom.

Abstract

Introduction: Alcohol use disorder (AUD) is among the leading cause of morbidity and mortality in sub-Saharan Africa. Despite this, AUD is often not detected in health care settings, which contributes to a wide treatment gap. Integrating services for mental, neurological, and substance use disorders in general health care settings is among the recommended strategies to narrow this treatment gap. This scoping review aimed to map the available evidence on integration of AUD interventions in general health care settings in sub-Saharan Africa.

Methods: We searched four databases (PubMed, PsycINFO, CINAHL, and Africa Wide Information) for publications up to December 2020. The search strategy focused on terms for alcohol use, alcohol interventions, and sub-Saharan African countries. Studies that reported AUD interventions in general health care settings in sub-Saharan Africa were eligible for inclusion. Over 3,817 potentially eligible articles were identified. After the removal of duplicates and screening of abstracts, 56 articles were included for full article review. Of these, 24 papers reporting on 22 studies were eligible and included in a narrative review.

Results: Of the 24 eligible articles, 19 (80%) described AUD interventions that were being delivered in general health care settings, 3 (12%) described plans or programs for integrating AUD interventions at different levels of care, including in health facilities, and 2 (8%) studies reported on AUD interventions integrated into general health care settings.

Conclusions: This review shows that there is limited evidence on the integration of AUD interventions in health care settings in sub-Saharan Africa. There is an urgent need for studies that report systematically on the development, adaptation, implementation, and evaluation of integrated AUD interventions in health care settings in sub-Saharan Africa.

Keywords: alcohol use disorder intervention; brief intervention; general health care; integration of intervention for alcohol use disorder; mental health plan; screening; sub-Saharan Africa.

Publication types

Systematic Review