What are the Environmental Determinants to Participate Among Stroke Survivors in Africa? a Scoping Review

Background Stroke is the main cause of serious long-term disability worldwide, and it is the second commonest cause of death and a leading cause of adult disability. Two-thirds of stroke cases occur in low- and middle-income countries, which all African countries fall. In Africa, the incidence and survival rate of stroke is increasing. Various personal and environmental factors limit the participation of stroke survivors. As a result, in this review, we aimed to review the environmental factors that are influencing the participation of stroke survivors in Africa. Methods Five electronic databases were systematically searched in August 2021 and identified articles were screened by three authors based on predetermined criteria. We followed Arksey and O'Malley (2005) framework and the whole finding is reported using PRISMA-ScR. No date restrictions were imposed, and we included any type of papers including grey literature. Results 584 articles were generated by our search, after removing duplicates, the title and abstract of 497 articles were screened. From the screening, 42 articles were selected for full article review from which 12 met the criteria to be included. We also manually searched and included one more article for the review. Conclusion Studies were mainly conducted in South Africa and assessed the adult population. We followed the International Classification of Functioning, Disability and Health (ICF) framework for the environmental determinants to present our findings. Products and Technology; Natural Environment and Human-Made Changes to Environment; and Services, Systems and Policies found to be a barrier for participation. Conversely, stroke survivors are getting good support from their immediate family and health professionals, which is found to be facilitating. This review could be used by policymakers to understand the environmental barriers that are hindering participation and help to improve the accessibility of the environment so stroke survivors can participate in the community.