# Exploring the quality of life of older people in long-term care facilities in the Sub-Saharan region: a scoping review

## TL;DR

This review explores the quality of life for older people in long-term care in Sub-Saharan Africa, highlighting gaps in research and policy.

## Contribution

The study provides a scoping review of quality of life in long-term care for older people in Sub-Saharan Africa, revealing regional and methodological gaps.

## Key findings

- Most studies focus on South Africa, with limited representation from other Sub-Saharan countries.
- Quality of life is influenced by factors like gender, ethnicity, and socio-economic status across multiple ecological levels.
- There is a lack of structured long-term care policies in the region, necessitating urgent policy development.

## Abstract

Over the past decade, there has been a shift in the family-centered model of care for older people in Sub-Saharan African countries, driven primarily by urbanization and industrialization. As the aging population grows, there is an increasing need for long-term care. However, limited evidence exists on the quality of life of older people in long-term care facilities across the region. This scoping review aims to describe the existing evidence on the quality of life of older people living in long-term care facilities in Sub-Saharan Africa.

A systematic search was conducted from 26 March 2024 to 15 July 2024 on four databases: EBSCOHOST, PubMed, Scopus, Web of Science, and grey literature was included as an additional source of information. This study follows the methodological framework as presented by Arksey and O’Malley and incorporating Levac and colleagues’ recommendations. A total of 360 peer-reviewed articles were identified and screened using CADIMA software. Studies were included if they focused on the quality of life of older people in long-term care facilities in sub-Saharan Africa, were published in English, and involved participants aged 60 and above. Twenty-one articles met the inclusion criteria and were analyzed using data charting process through thematic analysis which involved identifying, synthesizing, and interpreting key themes across the studies to address the review objective.Bronfenbrenner’s ecological systems theory was applied to guide the interpretation and organization of findings, focusing on five interconnected themes: microsystem, mesosystem, exosystem, macrosystem, and chronosystem.

Findings showed underrepresentation of articles from different countries with the 21 studies, spanning five sub-Saharan African countries,and the majority being from South Africa. These studies utilized qualitative approaches such as case studies and phenomenological research. Key tools included interviews and quality of life scales. Most studies were conducted in privately funded long-term care facilities, emphasizing the influence of gender, ethnicity, socio-economic status, and education on quality of life. Findings indicated that multiple factors at different ecological levels (microsystem to chronosystem) affect quality of life in long-term care.

Evidence shows a lack of structured long-term care policy in sub-Saharan Africa. Given the increasing demand for long-term care, there is an urgent need for policies that address factors affecting quality of life and ensure better care for older people in these facilities. A protocol for the scoping review was preregistered on the Open Science Framework Registry on 9th September 2023 (https://osf.io/xm8r5/).

The online version contains supplementary material available at 10.1186/s12877-025-06437-z.