African Journal of Public Health and Health Systems | 15 June 2021
A Systematic Review of Community-Based Stroke Rehabilitation in Uganda: The Role of Trained Family Volunteers
J, o, s, e, p, h, i, n, e, N, a, l, w, a, d, d, a, ,, D, a, v, i, d, K, a, t, o, M, u, b, i, r, u, ,, H, a, r, r, i, e, t, N, a, k, i, g, a, n, d, a
Abstract
Stroke is a leading cause of adult disability in Uganda, with substantial gaps in access to long-term, formal rehabilitation services. Community-based approaches using family volunteers are viewed as a potential strategy to address this gap in low-resource settings such as Kampala. This systematic review aimed to synthesise evidence on the effectiveness of a specific community-based stroke rehabilitation programme in Kampala that employs trained family volunteers. Its objectives were to evaluate reported outcomes for stroke survivors and to identify key factors influencing implementation. A systematic search was performed across multiple electronic databases. Pre-defined inclusion and exclusion criteria were applied to identify relevant literature. Eligible studies were critically appraised for quality, and data were extracted and synthesised thematically. The search identified a limited number of studies directly evaluating the specified programme. The available evidence, while preliminary, suggests a positive direction of effect on survivors’ functional recovery and quality of life. A consistent theme was the critical importance of comprehensive volunteer training and ongoing supervision. The methodological rigour of the included studies was variable. Community-based stroke rehabilitation using trained family volunteers presents a promising model for Uganda. However, the current evidence base is limited, preventing definitive conclusions on its effectiveness. Further high-quality, longitudinal research is required to robustly establish programme effectiveness. Programme implementers should ensure structured training and support mechanisms for volunteers. Policymakers should consider the integration of such community-led models into national stroke care guidelines. Stroke rehabilitation, community health services, family caregivers, volunteers, Uganda, systematic review This review consolidates preliminary evidence on a locally developed intervention, providing a foundation for future research and programme development within African public health systems.