Supported self-management in long-term conditions in an African context.
Leigh Hale, Amanda Wilkinson, Sonti Pilusa and 1 others
PMID 38725967WHAT IT FOUND
Self-management strategies imported from Western contexts often fail in Africa because they ignore collective cultural values like Ubuntu.
Therapists should co-design care with patients and communities, focusing on family and social support rather than just individual compliance.
Key findings
01Western self-management models assume individual autonomy, which conflicts with African collectivist cultures where family and community are central to health.
02Interventions fail in resource-constrained settings when they ignore social barriers like poverty, stigma, and lack of access, rather than focusing solely on patient education.
03Physiotherapists can support self-management by building patient confidence in pain and physical activity, but strategies must be co-designed with local communities to be effective.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review, so it does not provide quantitative evidence of effectiveness. The search was limited to Google Scholar, which may have missed relevant studies. The review focuses on sub-Saharan Africa, and findings may not apply to all African countries or contexts. It does not include literature on traditional African medicine, which the authors note is a significant gap.
Declared interests
The authors declared no funding from public, commercial, or not-for-profit sectors.
The easy way to misread this
Do not read this as evidence that self-management interventions do not work in Africa. It shows that Western models, applied without cultural adaptation, are often inappropriate. Local, co-designed solutions that respect collectivist values may still be effective, but this review does not test them.