Mapping health-related quality of life measurement tools in Africa: a scoping review

Abstract

BACKGROUND: Health-related quality of life (HRQoL) is an important measure in healthcare that captures the multidimensional effects of health on individuals' lives. While HRQoL measures are widely used globally, there is limited consolidated evidence of their application in Africa. This review aimed to explore and map the available evidence on the utilization of HRQoL measures in Africa, with a focus on understanding their application across diverse populations, health conditions, and geographical regions while identifying gaps, methodological inconsistencies, and opportunities for future research. METHODS: The scoping review was conducted following the Arksey and O'Malley framework. Electronic databases, including Medline, Embase, Emcare, CINAHL, and Cochrane Library, and other sources, were searched from the inception up until August 2025. Results were synthesized narratively with descriptive statistics, presented using tables and graphs. RESULTS: Out of 20,438 records identified, 731 studies met the inclusion criteria. The geographical distribution revealed significant disparities, with over half of the studies originating from Nigeria (21.8%), Ethiopia (14.8%), and South Africa (14.5%). Most studies (74.2%) employed descriptive designs and were conducted in hospital settings (70.3%). HRQoL instruments were used across a wide range of health conditions, with HIV/AIDS (20.5%), cancer (10.1%), and diabetes (7.1%) being the most frequently studied. Generic HRQoL tools such as WHOQOL-BREF (19.7%), SF-36 (16.4%), and EQ-5D (13.1%) were the most commonly utilized, accounting for nearly half of all studies. The analysis of information reporting practices for EQ-5D instruments revealed inconsistencies, with only 30.2% of studies reporting all three components (descriptive profile, index scores, and EQ-VAS). CONCLUSION: This review highlighted the increasing use of HRQoL measures in African health research over the past two decades while identifying significant gaps. Most studies were descriptive, concentrated in a few countries, and primarily conducted in healthcare settings, limiting broader applicability. The frequent use of generic HRQoL instruments underscores their importance and cultural adaptation. Additionally, inconsistencies in reporting practices and methodological limitations hinder the comparability and utility of findings. To advance HRQoL research and its application, it is essential to address these gaps through standardized guidelines, broader geographical representation, and improved methodological rigor.