Functioning Problems Associated with Health Conditions with Greatest Disease Burden in South Africa: A Scoping Review

Abstract

A notable rise in health-related disability for which evidence-based rehabilitation is beneficial is evident in low-to-middle income countries. This scoping review aimed to systematically identify and map the most common functioning problems associated with health conditions that contribute most to disability in South Africa using the International Classification of Functioning, Disability and Health (ICF) framework. Peer-reviewed evidence published from January 2006 to December 2021 was systematically searched from five databases. Some 268 studies reporting on functioning problems (impairments, activity limitations, and participation restrictions) in South African adults (>18 years) related to 10 health conditions were included. A total of 130 different functioning problems were mapped to the ICF. The most prevalent problems (top 20) were related to mobility, pain, and mental health but spanned across several ICF domains and were mostly in patients at primary care. The high prevalence and wide range of functioning problems may be particularly burdensome on an already strained primary health care (PHC) system. This points towards targeted planning of innovative strategies towards strengthening rehabilitation service delivery at primary care to address these complexities where there is an inadequate rehabilitation workforce.

Factors affecting quality of life in adults with HIV: A local cross-sectional study

“…One of the first qualitative studies to investigate the QOL change beyond 1 year after ART initiation, conducted in South African PWH in the public sector, suggests that changes in QOL and associated problems continue to occur in the longer term (Hanass-Hancock et al 2015 ). Our findings furthermore echo a recent scoping review, which identified problems related to mobility, pain, and mental health as the most common functioning problems contributing to disability in South African adults across various health conditions (including HIV) (Charumbira, Berner & Louw 2022 ). These findings may have significant economic and social implications, given the increasing longevity of PWH because of advanced care.…”

“…Findings in these studies suggest that PWH with impaired mobility function may also have worse QOL. This is of particular concern considering that in South Africa, at least 70% of adults seeking primary care have one or more functioning problem(s) and HIV counts among the top 10 diseases contributing to disability in the country (Charumbira, Berner & Louw 2022 ).…”

Bridging the chasm between patients’ needs and current rehabilitation care: perceptions of adults presenting for primary care in the Eastern Cape

“…Another significant problem affecting the receipt of quality rehabilitation services was the lack of assistive mobility devices. This problem causes challenges for these populations, where mobility-related functioning problems impact their livelihood significantly [ 5 ]. In these poorer populations it may not be possible to source assistive devices, even from private.…”

“…The need is more significant in South Africa's healthcare system, which must cope with the quadruple burden of disease arising from communicable diseases such as HIV and Tuberculosis (TB), maternal and child mortality, injury and trauma, and non-communicable disease (NCDs) [ 4 ]. The health conditions contributing to greatest disease burden in South Africa are associated with significant functioning problems related to mobility, pain and mental health [ 5 ].…”