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

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  • Additional Information
    • Subject Terms:
    • Author-Supplied Keywords:
      Health interventions
      Implementations
      Sub-Saharan Africa
      Sustainability
    • NAICS/Industry Codes:
      541710 Research and development in the physical, engineering and life sciences
    • 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. [ABSTRACT FROM AUTHOR]
    • :
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    • Author Affiliations:
      1Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA
      2School of Medicine, New York University, New York, NY, USA
      3Saint Louis University, Saint Louis, MO, USA
      4World Health Organization Regional Office for Africa, Brazzaville, Congo
      5Department of Geography, University of Illinois Urbana-Champaign, Champaign, Il, USA
      6West Virginia University, Morgantown, WV, USA
    • ISSN:
      1748-5908
    • Accession Number:
      10.1186/s13012-016-0392-8
    • Accession Number:
      114027594
  • Citations
    • ABNT:
      IWELUNMOR, J. et al. Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework. Implementation Science, [s. l.], p. 1–27, 2016. DOI 10.1186/s13012-016-0392-8. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asr&AN=114027594. Acesso em: 28 set. 2020.
    • AMA:
      Iwelunmor J, Blackstone S, Veira D, et al. Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework. Implementation Science. March 2016:1-27. doi:10.1186/s13012-016-0392-8
    • APA:
      Iwelunmor, J., Blackstone, S., Veira, D., Nwaozuru, U., Airhihenbuwa, C., Munodawafa, D., Kalipeni, E., Jutal, A., Shelley, D., & Ogedegebe, G. (2016). Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework. Implementation Science, 1–27. https://doi.org/10.1186/s13012-016-0392-8
    • Chicago/Turabian: Author-Date:
      Iwelunmor, Juliet, Sarah Blackstone, Dorice Veira, Ucheoma Nwaozuru, Collins Airhihenbuwa, Davison Munodawafa, Ezekiel Kalipeni, Antar Jutal, Donna Shelley, and Gbenga Ogedegebe. 2016. “Toward the Sustainability of Health Interventions Implemented in Sub-Saharan Africa: A Systematic Review and Conceptual Framework.” Implementation Science, March, 1–27. doi:10.1186/s13012-016-0392-8.
    • Harvard:
      Iwelunmor, J. et al. (2016) ‘Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework’, Implementation Science, pp. 1–27. doi: 10.1186/s13012-016-0392-8.
    • Harvard: Australian:
      Iwelunmor, J, Blackstone, S, Veira, D, Nwaozuru, U, Airhihenbuwa, C, Munodawafa, D, Kalipeni, E, Jutal, A, Shelley, D & Ogedegebe, G 2016, ‘Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework’, Implementation Science, pp. 1–27, viewed 28 September 2020, .
    • MLA:
      Iwelunmor, Juliet, et al. “Toward the Sustainability of Health Interventions Implemented in Sub-Saharan Africa: A Systematic Review and Conceptual Framework.” Implementation Science, Mar. 2016, pp. 1–27. EBSCOhost, doi:10.1186/s13012-016-0392-8.
    • Chicago/Turabian: Humanities:
      Iwelunmor, Juliet, Sarah Blackstone, Dorice Veira, Ucheoma Nwaozuru, Collins Airhihenbuwa, Davison Munodawafa, Ezekiel Kalipeni, Antar Jutal, Donna Shelley, and Gbenga Ogedegebe. “Toward the Sustainability of Health Interventions Implemented in Sub-Saharan Africa: A Systematic Review and Conceptual Framework.” Implementation Science, March 23, 2016, 1–27. doi:10.1186/s13012-016-0392-8.
    • Vancouver/ICMJE:
      Iwelunmor J, Blackstone S, Veira D, Nwaozuru U, Airhihenbuwa C, Munodawafa D, et al. Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework. Implementation Science [Internet]. 2016 Mar 23 [cited 2020 Sep 28];1–27. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asr&AN=114027594