ABSTRACT
Background and Aims
Effective self-care for hypertension spans medication adherence and lifestyle practices (dietary salt reduction, physical activity, weight control, smoking/alcohol moderation). This scoping review summarizes self-care strategies employed by adults with hypertension in Africa and identifies factors influencing their self-care practices.
Methods
Using the PRISMA-ScR scoping review framework, following the Joanna Briggs Institute manual for scoping review, out of 8084 studies collected from CINAHL, PUBMED, ScienceDirect, PsycINFO, EMBASE, and Google Scholar, 18 studies consisting of 15 quantitative and 3 qualitative were included using the Population, Concept, and Context framework.
Results
Of 8084 records (43 duplicates removed), 8041 titles/abstracts were screened; 134 reports were sought, 118 full texts assessed, and 18 studies included (15 quantitative; 3 qualitative) from Ethiopia (8), Nigeria (3), Ghana (2), and 1 each from Tanzania, Uganda, Egypt, Malawi, and Tunisia. Most studies reported low to moderate adherence across lifestyle domains; medication adherence varied, but inadequate dietary salt control, physical inactivity, and limited weight management were frequent. Education/knowledge, urban residence, and social support were commonly associated with better self-care, whereas medicine stock-outs, self-prescription, traditional remedies, stigma around weight loss, and khat chewing emerged as barriers. Measurement approaches varied, with H-SCALE most frequently used.
Conclusion
Among adults attending African health facilities, self-care practices are suboptimal, particularly for lifestyle behaviors, especially dietary management, weight control, and aerobic exercise. Interventions that bolster patient education, reliable medicine supply, social support, and culturally-sensitive counseling may improve adherence. Future research should standardize measurement and better report context to guide implementation.