Headache education in Africa: a narrative review of educational programs, clinical practice implications, and policy opportunities

Abstract

Headache disorders rank among the most prevalent and disabling neurological conditions globally, yet they remain severely under-recognized and undertreated across Africa. Educational deficits at every level of the health system perpetuate misdiagnosis, delayed care, and preventable disability. We conducted a narrative review by searching PubMed, Scopus, Web of Science, Embase, and AJOL. Eligible sources included peer-reviewed articles, systematic reviews, policy documents, and gray literature relating to headache burden, education, and care delivery in Africa. Thematic synthesis was applied across four domains: epidemiology and burden; current educational status; impact of education on clinical practice; and policy, multidisciplinary, and culturally responsive approaches. Africa bears a substantial but under-quantified headache burden driven by data gaps, cultural stigma, limited specialist access, and inadequate training of frontline providers. Structured educational interventions, including the Education in Headache to Healthcare Providers in Africa (EHHPA) symposium, the IHS Regional Outreach Program in Malawi, and the Global Migraine Aid initiative in Kenya, have reported improvements in self-assessed diagnostic confidence and knowledge scores among participants, though robust patient-level outcome data remain limited. Task-shifting to non-physician clinicians and community health workers is feasible and effective. Culturally responsive approaches, engagement of traditional healers, and gender-sensitive frameworks are essential for equitable reach. Education is the lever for improving headache care across Africa. Sustained investment in workforce training, community awareness, digital platforms, policy integration, and locally generated research is urgently needed. Aligning headache education with the WHO Intersectoral Global Action Plan (IGAP) and national non-communicable disease strategies offers the most scalable pathway to reducing the headache burden across the continent.