Community-based interventions for non-communicable diseases in Africa: a scoping review of scope, effectiveness, and implementation factors

Abstract

BACKGROUND: The increase of non-communicable diseases (NCDs) across Africa has become a major public health concern, contributing to significant morbidity and mortality which exerts significant strain on the already burdened health systems. Community-based interventions (CBIs) offer a strategy to address these diseases but evidence remains scattered on their effectiveness, contextual factors that enable or hinder their implementation. This review aimed to map existing community-based interventions, assess their outcomes, identify key facilitators and barriers, and highlight gaps in the literature across diseases, populations, and regions. METHODS: The review followed Arksey and O'Malley's scoping review framework and the reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We searched PubMed, Scopus Web of Science, Google Scholar, and additional grey literature sources to identify studies. Results were synthesized thematically and reported using a narrative approach. RESULTS: This review included 100 studies from across 16 African countries, with most conducted in South Africa, Kenya, Uganda, and Nigeria, focusing on community-based interventions for NCDs. The interventions addressed screening, health promotion, integrated care, and Health, targeting mainly hypertension, diabetes, cancers, and mental and neurological disorders. Overall, CBIs enhanced screening, health literacy, and selected clinical outcomes, especially blood pressure control, although continuity and linkage to formal care were inconsistent. Key facilitators included trusted community health workers (CHWs) and culturally tailored approaches, task-shifting, proximity to people, and use of digital technologies. Barriers included equipment/medication shortages, inadequate CHW supervision and incentives, poverty, transport costs, stigma, cultural beliefs, low health literacy, and weak referral and health systems. CONCLUSION: Community-based interventions for NCDs in Africa demonstrate huge potential to counter the rising NCD burden but encounter significant challenges; successful implementation requires resource sensitive and cultural tailored strategies.