Cost-Effectiveness of Community-Centred Approaches to Hypertension Management in Sub-Saharan Africa: A Scoping Review
1
Social Science Interest Group, Medical Research Council -The Gambia Unit @LSHTM, Fajara, Gambia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Hypertension remains one of the leading causes of CVD morbidity and mortality, resulting in more than 10 million premature deaths globally. Africa has the highest prevalence of hypertension among all the WHO regions, with an estimated 46% of its population under the age of 25 being hypertensive. The incidence of hypertension is expected to increase in Sub-Saharan Africa (SSA), where health systems face increasing challenges, such as workforce shortages, limited resources, and rising double burdens of diseases (NCDs and CCDs). These hamper existing hypertension interventions and result in a high prevalence of undiagnosed and untreated patients. Community-centered approaches have become promising, suitable strategies as facility-based services struggle to meet the growing demand. This scoping review examined the cost-effectiveness of community-centered approaches for the prevention and management of hypertension across SSA.
METHODS:
The scoping review followed the framework of Arksey and O’Malley (2005). Systematic searches were conducted in PubMed and the grey literature to identify articles on the cost-effectiveness of community-centered hypertension interventions in SSA. Eligible literature was extracted and synthesized to map intervention characteristics, cost findings, and knowledge gaps across various health-system settings.
RESULTS:
Interventions incorporating community health workers (CHWs), peer support groups, mobile outreach, education programs, and community screening demonstrated strong economic value and consistent clinical benefits across a range of community settings. Most of these interventions showed that early detection, improved treatment adherence, and the avoidance of expensive cardiovascular complications reduced the burden on the healthcare system. In situations where resources are limited, task-shifting to qualified community providers has proven to be an exceptionally effective tactic. However, variation in evaluation methods, short time spans, and inconsistent cost metrics limit comparison across studies.
CONCLUSIONS:
In Sub-Saharan Africa, community-centered hypertension care is not only feasible and impactful, but it also offers a highly cost-effective route to universal health coverage.
Hypertension remains one of the leading causes of CVD morbidity and mortality, resulting in more than 10 million premature deaths globally. Africa has the highest prevalence of hypertension among all the WHO regions, with an estimated 46% of its population under the age of 25 being hypertensive. The incidence of hypertension is expected to increase in Sub-Saharan Africa (SSA), where health systems face increasing challenges, such as workforce shortages, limited resources, and rising double burdens of diseases (NCDs and CCDs). These hamper existing hypertension interventions and result in a high prevalence of undiagnosed and untreated patients. Community-centered approaches have become promising, suitable strategies as facility-based services struggle to meet the growing demand. This scoping review examined the cost-effectiveness of community-centered approaches for the prevention and management of hypertension across SSA.
METHODS:
The scoping review followed the framework of Arksey and O’Malley (2005). Systematic searches were conducted in PubMed and the grey literature to identify articles on the cost-effectiveness of community-centered hypertension interventions in SSA. Eligible literature was extracted and synthesized to map intervention characteristics, cost findings, and knowledge gaps across various health-system settings.
RESULTS:
Interventions incorporating community health workers (CHWs), peer support groups, mobile outreach, education programs, and community screening demonstrated strong economic value and consistent clinical benefits across a range of community settings. Most of these interventions showed that early detection, improved treatment adherence, and the avoidance of expensive cardiovascular complications reduced the burden on the healthcare system. In situations where resources are limited, task-shifting to qualified community providers has proven to be an exceptionally effective tactic. However, variation in evaluation methods, short time spans, and inconsistent cost metrics limit comparison across studies.
CONCLUSIONS:
In Sub-Saharan Africa, community-centered hypertension care is not only feasible and impactful, but it also offers a highly cost-effective route to universal health coverage.
| eISSN: | 2654-1459 |
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