Health-related quality of life among caregivers of children with cerebral palsy in Sub-Saharan Africa: A systematic review and meta-analysis

Cerebral palsy (CP) is a group of permanent movement and posture disorders that cause activity limitations, resulting from non-progressive disturbances in the developing fetal or infant brain. Caregivers of children with CP reported higher levels of stress, despair, and back discomfort. In Sub-Saharan Africa (SSA), caregivers of children with CP encounter complex, multidimensional challenges. While individual studies have examined the experiences of CP caregivers in SSA, no comprehensive review has yet synthesized evidence on their Health Related Quality of Life (HRQOL). Therefore, this SRMA aimed to synthesize evidence on the pooled mean estimate of HRQoL of caregivers of children with CP in Sub-Saharan Africa.A systematic search was conducted in PubMed, Scopus, Cochrane Library, and Google Scholar, supplemented by manual reference screening. Studies published between June 20 2000 and May 20 2025 in Sub-Saharan Africa, focusing on caregivers of children with cerebral palsy and their HRQoL, were included. Data were extracted using a standardized form, and quality was assessed via the Newcastle-Ottawa Scale. Random-effects meta-analysis was performed in STATA Version 17, with heterogeneity evaluated using Cochran's Q and I2 statistics. Sensitivity analysis, subgroup analysis, and publication bias assessment (Begg's and Egger's tests) were conducted. The pooled mean of HRQoL of caregivers of cerebral palsy in Sub-Saharan Africa Countries is found to be 41.234 (95% CI: 23.315 to 59.154). The meta-analysis revealed significant regional disparities in HRQOL among CP caregivers in Sub-Saharan Africa. South Africa demonstrated superior and consistent outcomes (pooled mean: 67.52, I2 = 5.39%), attributable to robust healthcare systems.Caregivers of children with cerebral palsy in SSA experience moderate to low HRQoL, with significant regional disparities. Policy interventions such as expanding financial support, mental health programs, and community-based respite care are urgently needed. Strengthening caregiver training and regional disability policies can reduce disparities. Sustained research is essential to develop scalable, culturally appropriate solutions for improving caregiver well-being across SSA.