Mapping Effectiveness Studies of Occupational Therapy in Africa: A Scoping Review.
Nicola Ann Plastow, Monique de Wit, Megan Brown and 4 others
PMID 38034943WHAT IT FOUND
Effectiveness studies of occupational therapy in Africa are emerging, mostly from South Africa.
Most reported positive outcomes, particularly in physical rehabilitation and hand therapy. Paediatric evidence was less consistent. Systematic reviews are now feasible to determine actual strength of evidence.
Key findings
0145 effectiveness studies were identified, with 1957 participants, mostly conducted in South Africa (93%).
02Most studies reported positive effects, with the most consistent findings in physical rehabilitation and hand therapy, while paediatric evidence was less consistent.
03The evidence base lacks high-level studies (no systematic reviews or meta-analyses) and has inconsistent reporting of participant characteristics like race, socioeconomic status, and HIV status.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review only included effectiveness studies, excluding qualitative or descriptive work. 93% of the included studies were from South Africa, limiting generalisability to other African countries. No risk of bias assessment was conducted, so the quality of the included studies is unknown. Participant characteristics like race, socioeconomic status, and HIV status were poorly reported, making it hard to judge if results apply to diverse populations. The heterogeneity in interventions and outcome measures prevents meta-analysis, so the overall effect size of OT in Africa remains unknown.
Declared interests
The authors declared no conflicts of interest. The review protocol was part of an undergraduate research module.
The easy way to misread this
Do not interpret the high number of positive outcomes as proof that occupational therapy is effective in Africa. Most studies had methodological weaknesses, varied widely in design, and were concentrated in South Africa. The review itself calls for more rigorous systematic reviews before strong conclusions can be drawn.