A Systematic Review of Community-Based Stroke Rehabilitation in Uganda: The Role of Trained Family Volunteers

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.