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Cited by 219Health Policy Implementation ScienceGlobal Health and SurgeryHealthcare Systems and Practices

The DOI matches its Crossref record; 78 of the 79 references it cites were found in a registry or an index.

Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework

Open access
Iwelunmor, Juliet, Blackstone, Sarah, Veira, Dorice, Nwaozuru, Ucheoma, Airhihenbuwa, Collins, Munodawafa, Davison, Kalipeni, Ezekiel, Jutal, Antar, Shelley, Donna, Ogedegbe, Gbenga·2015·Implementation Science
DOI 10.1186/s13012-016-0392-8PMC PMC4804528
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Abstract

BACKGROUND: Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions implemented in sub-Saharan Africa are sustained. The purpose of this study was to conduct a systematic review of empirical literature to explore how health interventions implemented in SSA are sustained. METHODS: We searched MEDLINE, Biological Abstracts, CINAHL, Embase, PsycInfo, SCIELO, Web of Science, and Google Scholar for available research investigating the sustainability of health interventions implemented in sub-Saharan Africa. We also used narrative synthesis to examine factors whether positive or negative that may influence the sustainability of health interventions in the region. RESULTS: The search identified 1819 citations, and following removal of duplicates and our inclusion/exclusion criteria, only 41 papers were eligible for inclusion in the review. Twenty-six countries were represented in this review, with Kenya and Nigeria having the most representation of available studies examining sustainability. Study dates ranged from 1996 to 2015. Of note, majority of these studies (30 %) were published in 2014. The most common framework utilized was the sustainability framework, which was discussed in four of the studies. Nineteen out of 41 studies (46 %) reported sustainability outcomes focused on communicable diseases, with HIV and AIDS represented in majority of the studies, followed by malaria. Only 21 out of 41 studies had clear definitions of sustainability. Community ownership and mobilization were recognized by many of the reviewed studies as crucial facilitators for intervention sustainability, both early on and after intervention implementation, while social and ecological conditions as well as societal upheavals were barriers that influenced the sustainment of interventions in sub-Saharan Africa. CONCLUSION: The sustainability of health interventions implemented in sub-Saharan Africa is inevitable given the double burden of diseases, health care worker shortage, weak health systems, and limited resources. We propose a conceptual framework that draws attention to sustainability as a core component of the overall life cycle of interventions implemented in the region.

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Fig. 1 Conceptual framework: defining sustainability
Fig. 1 Conceptual framework: defining sustainabilityCC BY · PubMed Central
Fig. 2 PRISMA diagram of article selection
Fig. 2 PRISMA diagram of article selectionCC BY · PubMed Central
Fig. 3 Conceptual framework of sustainability of interventions implemented in SSA
Fig. 3 Conceptual framework of sustainability of interventions implemented in SSACC BY · PubMed Central

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Research works printed but not linked: 2

  1. HIV/AIDS, J.U.N.P.O. Global report: UNAIDS report on the global AIDS epidemic 2013. Geneva, Switzerland: UNAIDS; 2013. p. 2014.
  2. Akogun O. Sustainable development and malaria illness experience among Nigerian nomads. In: Amoeda R, Lira S, Pinheiro C, editors. Heritage 2010: Heritage and Sustainable Development, Vols 1 and 2. 2001. p. 1257–61.

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Metadata

Authors
Iwelunmor, J., Blackstone, S., Veira, D., Nwaozuru, U., Airhihenbuwa, C., Munodawafa, D., Kalipeni, E., Jutal, A., Shelley, D., & Ogedegbe, G.
Affiliations
  • University of Illinois Urbana-Champaign (US)
  • New York University (US)
  • Saint Louis University (US)
  • World Health Organization Regional Office for Africa (CG)
  • West Virginia University (US)
Corresponding author
Iwelunmor, Juliet
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2015-12
Volume
11
Issue
1
Pages
43-43
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/s13012-016-0392-8
PMC
PMC4804528
OpenAlex
W2305876132
Cited by
219
References
79
Citations by year
2026: 19 · 2025: 17 · 2024: 25 · 2023: 28 · 2022: 23 · 2021: 30 · 2020: 27 · 2019: 23 · 2018: 13 · 2017: 8 · 2016: 4 · 2015: 1
FWCI
1.56
Type
journal article
Language
en
Update notices
correction (2016-04-18)
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Fogarty International Center (R03TW010081)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Practices
Keywords
sub-Saharan Africa, community ownership, community mobilization, HIV/AIDS, malaria, double burden of disease, non-communicable diseases, health care system, conceptual framework, barriers to sustainability
MeSH terms
Chronic Disease, Delivery of Health Care, Health Resources, Humans, Cost of Illness, Africa South of the Sahara

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