Chronic care models and opportunities for improving health care practice and outcomes in Sub-Saharan Africa: Protocol for systematic review

Document Type



Internal Medicine (East Africa)


Background: The rising burden of chronic diseases in sub-Saharan Africa (SSA) where health care systems are least developed has led to recent calls for increased investment in chronic care models (CCM) appropriate for low-resource settings. In SSA, limited resources are often allocated to treating acute diseases thus management of chronic conditions is a major challenge for health care systems. A large diversity of CCM exist in the literature but evidence supporting their use has been derived from high income settings. This is the motivation for conducting a systematic review to identify the existing CCM and their relevance and applicability in SSA. Methods and analysis: All peer-reviewed published and grey literature on CCM will be included. PubMed/MEDLINE, Embase, Scopus, Web of Science and Global Health Cinahl, African Journals Online, Informit Online, and PsycINFO will be searched to identify relevant articles. OpenSIGLE will be reviewed for grey literature. The articles retrieved will be independently screened for inclusion by two independent investigators while a third reviewer will arbitrate the disagreements. An independent critical appraisal of retrieved studies will be performed using standardized critical appraisal checklists. The data will be extracted from the key elements of CCM. Outcome measures for the effectiveness of the models in the context of SSA will include any reported improvement to the health care service delivery or changes in the health outcomes of patients with chronic illnesses. The study ndings will be reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA). Discussion: This systematic review is expected to generate crucial evidence on the applicability of CCM in
SSA and unearth the CCM components that are suitable for different levels of health care delivery
systems and the emerging needs of the people living with comorbidities and multimorbidities in SSA.
Systematic review registration: This review is registered in PROSPERO International Prospective Register
of Systematic reviews CRD42020187756.


Pre-print (protocol)

Publication (Name of Journal)

Research Square