Rarity and limited geographical coverage of individual level alcohol interventions in sub Saharan Africa: findings from a scoping review

Francis, Joel M.; Cook, Sarah; Morojele, Neo K.; Swahn, Monica H.

doi:10.1080/14659891.2019.1664662

Cited by 27Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsHealth Policy Implementation Science

Rarity and limited geographical coverage of individual level alcohol interventions in sub Saharan Africa: findings from a scoping review

Francis, Joel M., Cook, Sarah, Morojele, Neo K., Swahn, Monica H.·2020·Journal of Substance Use

DOI 10.1080/14659891.2019.1664662

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Abstract

Introduction: A previous review on brief alcohol interventions in sub-Sahara Africa showed most of the interventions were implemented in East and Southern Africa. We carried a scoping review to assess the current amount and types of alcohol interventions in SSA.Methods: We searched six databases (MEDLINE, EMBASE, Global Health, Africa-wide, CINAHL and PsycINFO) for publications prior to June 2018. We used the search terms for alcohol use, alcohol intervention and African countries’ names. We identified 59 papers on alcohol interventions of which 26 were eligible for inclusion in the final analysis.Results: Of the 26 eligible papers, 18(69 %) were carried out in South Africa. Majority 15(58%) of the interventions were randomized clinical trial, followed by seven (27%) quasi-experimental and evaluation of the intervention and five (19%) cluster randomized trials. Most of the studies targeted patients and pregnant women. Only a few studies focused on sex workers and students.Conclusions: Our findings show that the assessment of effectiveness of individual level alcohol interventions is rare in SSA. In addition, these interventions were polarized in two countries. There is an urgent need for an evidence base on the effectiveness of alcohol interventions commensurate with the scope of the problem in SSA.

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Most current literature on brief interventions is limited to high-income countries, with relatively limited studies conducted in low- and middle-income countries or underserved populations.
“However, most of the current literature on BIs is limited to high-income countries, with a relatively limited number of studies conducted in LMICs or underserved populations [13,14].”
From Effectiveness of a brief intervention and text-based booster in the emergency department to reduce harmful and hazardous alcohol use: A pragmatic randomized adaptive clinical trial in Moshi, Tanzania (2025) · cites this paper as [13]
The Conclusions (p. 2) say that published assessments of individual-level alcohol interventions are rare in sub-Saharan Africa, and the Results (p. 2) report few studies focused on sex workers or students. The paper does not establish that most brief-intervention literature comes from high-income countries or that studies are scarce across LMICs generally. (LLM, conf=0.86)
Experimental — accuracy not yet measured
The review findings are in keeping with previous reviews that reported a paucity of interventions to address problematic alcohol use in sub-Saharan Africa.
“Our review findings are in keeping with previous reviews that reported a paucity of interventions to address problematic alcohol use in SSA (60, 61).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [61]

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Background
Prevalence and correlates of alcohol use and alcohol use disorder among undergraduate students in Johannesburg, South Africa: a cross-sectional studyPreprint
Chen, C., Mpinganjira, M. G., Motilal, A., Matukane, S., Letsoalo, R., McKee, T., Ntombela, Z., Mbulaheni, L., Hargovan, T., & Francis, J. M. (2022) · Research Square · doi:10.21203/rs.3.rs-2296169/v1
Self-citation
Inertia or unanticipated bottlenecks? Exploring the implementation determinants of the national alcohol policy five years post-enactment in ZambiaPreprint
Silumbwe, A., Sebastiån, M. S., Zulu, J. M., Michelo, C., & Johansson, K. (2024) · Research Square · doi:10.21203/rs.3.rs-4409767/v1
Evidence-Based Substance Use Prevention With Adolescents in Sub-Saharan Africa: Challenges and Opportunities
Marsiglia, F. F., Huang, C.-K., Williams, J. H., Munyuwiny, S., Makunyane, L., Molobe, I. D., Freeman, R. J., Kulis, S., Ogbonnaya, I. N., & Lightfoot, E. (2025) · Substance Use &amp Addiction Journal · doi:10.1177/29767342251350757
Inertia or unanticipated bottlenecks? Exploring stakeholder perspectives on the implementation determinants of the national alcohol policy five years post-enactment in Zambia
Silumbwe, A., Sebastiån, M. S., Zulu, J. M., Michelo, C., & Johansson, K. (2025) · Archives of Public Health · doi:10.1186/s13690-025-01737-7
Additional file 1 of Provider perceptions of young people living with HIV and unhealthy alcohol use in Southwestern Uganda: a qualitative study
Odokonyero, R. F., Nakasujja, N., Turiho, A. K., Sanyu, N., Muyindike, W. R., Nansera, D., Semitala, F., Kamya, M. R., Katahoire, A., Hahn, J. A., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26945217
Additional file 1 of Prevalence and correlates of alcohol use and risky drinking among undergraduate students in Johannesburg, South Africa: a cross-sectional study
Chen, C., Mpinganjira, M. G., Motilal, A., Matukane, S., Letsoalo, R., McKee, T., Ntombela, Z., Mbulaheni, L., Hargovan, T., & Francis, J. M. (2023) · Figshare · doi:10.6084/m9.figshare.23819844
Self-citation
Additional file 1 of PRACT: a pragmatic randomized adaptive clinical trial protocol to investigate a culturally adapted brief negotiational intervention for alcohol use in the emergency department in Tanzania
Staton, C. A., Zadey, S., O’Leary, P., Phillips, A. J., Minja, L., Swahn, M. H., Hirshon, J. M., Boshe, J., Sakita, F. M., Vissoci, J. R. N., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19129045
Self-citation

Brief Intervention of Alcohol Problems in Sub-Saharan Africa: A Review
Peltzer, K. (2009) · Journal of Psychology in Africa · doi:10.1080/14330237.2009.10820310 · Cited by 11 · see citing works
Psychosocial interventions for reducing alcohol consumption in sub-Saharan African settings: a systematic review and meta-analysis
Sileo, K. M., Miller, A. P., Wagman, J. A., & Kiene, S. M. (2021) · Addiction · doi:10.1111/add.15227 · Cited by 47 · see citing works
HIV-Alcohol Risk Reduction Interventions in Sub-Saharan Africa: A Systematic Review of the Literature and Recommendations for a Way Forward
Carrasco, M., Esser, M. B., Sparks, A. C., & Kaufman, M. R. (2015) · AIDS and Behavior · doi:10.1007/s10461-015-1233-5 · Cited by 42 · see citing works
Non-Pharmacological Interventions for Reducing Alcohol Consumption in Sub-Saharan African Settings: A Systematic Review and Meta-AnalysisPreprint
Sileo, K. M., Miller, A. P., Wagman, J. A., & Kiene, S. M. (2019) · SSRN Electronic Journal · doi:10.2139/ssrn.3496929 · Cited by 1 · see citing works
Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review
Mushi, D., Francis, J. M., Moshiro, C., Hanlon, C., & Teferra, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.822791 · Cited by 21 · see citing works
Self-citation

Authors: Francis, J. M., Cook, S., Morojele, N. K., & Swahn, M. H.
Affiliations: Muhimbili University of Health and Allied Sciences (TZ)
London School of Hygiene & Tropical Medicine (GB)
South African Medical Research Council (ZA)
Georgia State University (US)
Corresponding author: Francis, Joel M.
ORCID: Francis, Joel M.
Cook, Sarah
Morojele, Neo K.
Swahn, Monica H.
Venue: Journal of Substance Use
Publisher: Informa UK Limited
Published: 2019-09-19
Volume: 25
Issue: 1
Pages: 11-19
ISSN: 1465-9891 (ISSN-L)
1475-9942
DOI: 10.1080/14659891.2019.1664662
OpenAlex: W2974508038
Semantic Scholar: 3cfd8ef1a3ba236aa5e5ac9a23c89699f64e497b
Cited by: 26
References: 45
Citations by year: 2025: 4 · 2024: 3 · 2023: 7 · 2022: 7 · 2021: 4 · 2020: 1
FWCI: 2.30
Type: journal article
Language: en
Open access: closed
Locations: Journal of Substance Use (publishedVersion)
LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
DigitalCommons - Kennesaw State University (Kennesaw State University) (submittedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords: alcohol interventions, brief alcohol intervention, sub-Saharan Africa, intervention effectiveness, evidence base, pregnant women, sex workers, students, South Africa

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Rarity and limited geographical coverage of individual level alcohol interventions in sub Saharan Africa: findings from a scoping review

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