![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
ABSTRACT
Background
Changed health behaviours can contribute significantly to improved health. Consequently, significant investments have been channelled towards health behaviour change initiatives in Africa. Health behaviour change initiatives that address social, economic and environmental levers for behaviour change can create more sustained impact.
Objectives
Through a scoping study of the literature, we explored the literature on behaviour change initiatives in Africa, to assess their typologies. We explored whether the availability of initiatives reflected country demographic characteristics, namely life expectancy, gross domestic product (GDP), and population sizes. Finally, we assessed topical themes of interventions relative to frequent causes of mortality.
Methods
We used the Behaviour Change Wheel intervention categories to categorise each paper into a typology of initiatives. Using Pearson’s correlation coefficient, we explored whether there was a correlation between the number of initiatives implemented in a country in the specified period, and socio-demographic indicators, namely, GDP per capita, total GDP, population size, and life expectancy.
Results
Almost 64% of African countries were represented in the identified initiatives. One in five initiatives was implemented in South Africa, while there was a dearth of literature from Central Africa and western parts of North Africa. There was a positive correlation between the number of initiatives and GDP per capita. Most initiatives focused on addressing sexually transmitted infections and were short-term trials and/or pilots. Most initiatives were downstream focused e.g. with education and training components, while upstream intervention types such as the use of incentives were under-explored.
Conclusion
We call for more emphasis on initiatives that address contextual facilitators and barriers, integrate considerations for sustainable development, and consider intra-regional deprivation.
Responsible Editor
Jennifer Stewart Williams
Responsible Editor
Jennifer Stewart Williams
Acknowledgments
We also acknowledge the contributions of Esther Chiamaka (Department of Physiotherapy, University of Ibadan) to the definition of the study scope as well as the title and abstract screening.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Authors contributions
EM conceptualized the study focus, developed a preliminary protocol, recruited the study team, and developed training materials on the subject matter and methodology. EM, SS, OAP, NI, OA, MA, AE, BA, BS, and AA contributed to the refinement of the methodology, brainstorming on search terms, as well as the inclusion and exclusion criteria. EM and SS refined the extraction template, supported by SS’ review of theoretical approaches to inform the manuscript. EM piloted a literature search and SS adapted the search to other databases. EM, SS, OAP, NI, OA, MA, AE, BA, TA, JN, AO and AA contributed to the screening and coding of the manuscripts. EM reviewed all articles’ extraction templates to ensure data was thoroughly collected. OA-P, AE, MA, BA, OA, JA, NI, AO, & SS reviewed entries at random to ensure coding was agreed upon. All authors reviewed the identified and categorized articles based on the intervention typology. EM prepared the first draft. All authors contributed to substantially strengthening and revising the manuscript and approved the final manuscript.
Biographical note
We are a group of public health practitioners, public health researchers, as well as medical trainees and practitioners with a keen interest, work and lived experience in impactful strategies to effectively improve health and wellbeing in African countries. Our institutions represent actors at the local, national, and regional levels.
Ethics and consent
Ethical approval was not required for this study given that we were analysing already published studies from peer-reviewed databases.
Geolocation information
Nigeria
Paper context
Our paper investigates the landscape of literature on behaviour change initiatives in Africa to understand the spread of initiatives across typologies, scope, locations, and socioeconomic regions. We found that downstream intervention types, namely education and training, were the most common. We also found a positive correlation between Gross Domestic Product and the number of initiatives identified in each country. This implies the need for durable behaviour change initiatives which also consider intra-regional equity.