Congenital heart disease in Africa: a scoping review of socioeconomic impact and strategic recommendations

Abstract

Abstract Introduction Congenital heart disease (CHD) poses a significant yet under recognized public health challenge in Africa. Despite advancements in diagnosis and treatment globally, many African countries still have significantly high mortality due to limited facilities of health care, inadequate infrastructure and delays in the diagnosis and management. This scoping review explores the socioeconomic impact of CHD on families across Africa and evaluates current policies, healthcare interventions, and systemic challenges. Methods A comprehensive scoping review was conducted using multiple academic databases, focusing on studies published in international and national articles in English that examined the socioeconomic, psychosocial, and healthcare dimensions of CHD in African settings. Thematic synthesis was applied to interpret findings and compare them with trends in other low-, middle-, and high-income countries. Results Families affected by CHD in Africa face significant financial burdens due to out-of-pocket healthcare expenses, long travel distances for treatment, and insufficient health insurance coverage. These challenges often lead to catastrophic health expenditures, debt, and delayed treatment. Caregivers face of patients faces significant psychosocial distress, with elevated rates of anxiety, depression, and social isolation. Geographic and systemic disparities result in long wait times for surgery and limited access to cardiac care. Although successful models such as cardiac surgery missions, NGO-public partnerships, and regional training centers exist, their reach and sustainability remain limited. Current health policies by government lack integration of routine screening methods such as pulse oximetry, and most African nations lack national CHD registries and dedicated pediatric cardiac programs. Conclusion CHD presents a major challenge in Africa, with profound financial, emotional, and systemic impacts on children and families. This review highlights the urgent need for improved infrastructure, early screening, and specialized care. Policy reforms, local cardiac centers, and involvement of stakeholders—including cultural leaders and international partners—are essential. Strengthening research on CHD outcomes and its socioeconomic effects will guide effective, equitable healthcare strategies across the continent.