Health and economic impact of caregiving on informal caregivers of people with chronic diseases in Sub-Saharan Africa: A systematic review

Abstract Background With a disproportionate burden of chronic diseases and severe shortage of health workers in sub-Saharan Africa (SSA), the region implicitly relies on informal caregivers (ICGs) to support the patients both within and outside the health facilities. The aim of this review is to explore the health and economic impact of caregiving on ICGs of patients with chronic diseases in SSA. Methods Medline (Ovid), CINAHL (EBSCOhost), PsycINFO (Ovid), Embase (Ovid), Global Health and Web of Science databases were systematically searched to identify original articles that considered the economic and/or health impacts of caregiving in SSA. The results from the included studies were synthesised narratively. Results After screening 4,372 articles, 47 were included for synthesis. The articles were from all sub-regions of SSA with more than half (25/47) of the articles focussing on caregivers for patients with cancer. Although the primary motivation for becoming caregivers was love and responsibility, the caring responsibilities described in twenty articles, had profound effects on the caregiver’s lives. Healthwise, ICGs experienced changes in their physical and mental health like developing musculoskeletal problems and depression. Economically, caregiving was expensive, and financially draining. The opportunity cost of caregiving included loss of jobs, loss of income, foregoing planned important activities and missed education opportunities. Conclusion ICGs reported a range of mainly negative health and economic effects of the work they do. Health care systems should consider how to better support ICGs in terms of their own physical and mental wellbeing and governments should consider how to better financially support ICGs.