# Supported self-management in long-term conditions in an African context

## TL;DR

This paper reviews how supported self-management for long-term health conditions is understood and applied in African contexts, emphasizing the need for locally adapted solutions.

## Contribution

The paper highlights the importance of embedding supported self-management in traditional African health systems rather than relying on Western concepts.

## Key findings

- Sixteen studies from sub-Saharan Africa show diverse perceptions of supported self-management.
- Western concepts of self-management are often imported without considering local health systems.
- Locally derived solutions are needed to improve long-term condition management in Africa.

## Abstract

Self-management is an important strategy to improve quality of life, appropriately manage long-term health conditions, and reduce the economic burden of long-term health conditions. However, equitable healthcare access remains an issue, and the focus on ‘self’ in self-management is problematic. Our review aims to explore the conceptualisation and evolution of supported self-management in an African context and its relevance to physiotherapy. A state-of-the-art review of the literature was undertaken by the authors. The authors knowledge of the subject area and a database search retrieved recent articles exploring patients’ and healthcare providers’ understanding of supported self-management in Africa. Relevant articles were read, and data summaries of included studies were extracted and tabulated. Findings were organised deductively. Sixteen studies, 11 primary research, and 5 reviews (2016–2023) undertaken in a variety of sub-Saharan countries with healthcare workers (~n = 177) and people (~n = 16 115) living with a mix of non-communicable and communicable conditions were considered in this state-of-the-art review. Self-management perceptions were drawn from Western authors spanning development research and understanding of the concepts in Western thinking. We conclude that imported concepts, such as supported self-management for long-term conditions, should be considered within local health delivery solutions. These should be embedded in an understanding of traditional African health systems.

There is a need to develop locally derived African solutions. Self-management strategies for long-term health conditions should be developed, considering traditional holistic African health systems.