A Systematic Review of Home Safety and Falls Prevention Interventions for Older Adults in Hilly Urban African Communities: Evidence from 2016

Older adults in hilly urban African communities face distinct environmental fall risks. Context-specific, evidence-based interventions are needed to inform occupational therapy and public health practice in these settings. This systematic review aimed to determine the efficacy of home safety and falls prevention interventions for older adults residing in hilly urban African communities. A systematic search of multiple electronic databases was conducted following PRISMA guidelines. Included studies were peer-reviewed, focused on home safety or falls prevention for community-dwelling older adults (aged 60 years and over) in African urban settings with hilly terrain. Data were extracted and synthesised narratively due to anticipated study heterogeneity. No studies meeting the inclusion criteria were identified. Consequently, there is no direct empirical evidence for this specific context. A prominent theme from related literature confirms a critical gap in locally adapted, evidence-based programmes. There is a significant lack of research evaluating home safety and falls prevention interventions for older adults in hilly urban African communities. This evidence gap limits the ability of occupational therapists and other health professionals to implement proven, contextually relevant strategies. Urgent primary research is needed to develop and evaluate culturally and environmentally appropriate interventions. Programme development should employ collaborative, community-engaged methodologies to address the specific environmental hazards of hilly urban landscapes. Accidental Falls, Aged, Home Safety, Occupational Therapy, Africa, Systematic Review, Urban Health This review identifies a critical evidence gap in occupational therapy and geriatric care within a specific African context, directing future research priorities towards developing effective, locally relevant falls prevention strategies.