Health-seeking behaviours of people with osteoarthritis in sub-Saharan Africa: A scoping review

Background: Osteoarthritis (OA) is a common musculoskeletal disorder associated with pain, functional limitation and disability. In sub-Saharan Africa, health-seeking behaviour (HSB) is influenced by beliefs, health literacy, access to services and healthcare systems, yet this evidence has not been synthesised. Objectives: To map and describe evidence on HSBs of people with osteoarthritis in sub-Saharan Africa, identify influencing factors, and highlight implications for physiotherapy practice and research. Method: A scoping review was conducted using the Arksey and O’Malley framework, guided by Levac et al. and the Joanna Briggs Institute population-concept-context approach. Searches were conducted from January 2000 to August 2026 in Google Scholar, PubMed, ScienceDirect and EBSCOhost-hosted databases using keywords and synonyms related to osteoarthritis, HSB and sub-Saharan Africa, combined with Boolean operators. Citation searching was also undertaken. Three reviewers independently screened titles, abstracts and full-text articles, while two reviewers independently extracted data. Findings were synthesised narratively using a socioecological framework. Results: Of 2710 records and one additional citation, five studies met inclusion criteria. Four were conducted in Nigeria and one in South Africa, all in rural settings. Health-seeking behaviour was largely delayed or fragmented. Influencing factors spanned intrapersonal, interpersonal, organisational and community domains. Key barriers included beliefs that osteoarthritis is a normal part of ageing, poor knowledge, limited person-centred care, weak referral pathways, high costs, long waiting times and poor access to rehabilitation. Conclusion: This review found very limited published evidence on the HSBs of people with osteoarthritis in sub-Saharan Africa. Available evidence suggests that delayed and fragmented help-seeking is influenced by interconnected individual, interpersonal, organisational and community factors, highlighting the need to strengthen access to timely, person-centred rehabilitation services. Clinical Implications: Delayed help-seeking and limited access to rehabilitation identified in this review highlight the need for physiotherapists to strengthen patient education, promote self-management, support timely referral pathways and expand community-based rehabilitation, particularly in underserved settings.