Low vision services in sub-Saharan Africa: a systematic review

Abstract

Background – Understanding the availability, access, and outcomes of low vision services (LVS) in Sub-Saharan Africa (SSA) is essential to reduce the burden and enhance the quality of life for patients with residual vision. The aim of the study is to systematically evaluate the availability, accessibility, utilization, and functional outcomes of LVS in SSA from both provider and patient perspectives. Methods – A comprehensive systematic search was conducted across five databases—PubMed, Scopus, Web of Science, African Journals Online, and Google Scholar—from inception through June 2025, following PRISMA guidelines. Studies reporting on any aspect of LVS delivery within SSA were eligible for inclusion. Extracted data were synthesized narratively, and methodological quality was rigorously assessed using the Joanna Briggs Institute Critical Appraisal Checklists. Results – Eleven studies from six SSA countries met the inclusion criteria, with an equal number focusing on service providers and patients (including one overlapping study). Overall, LVS were found to be limited and unevenly distributed across the region, with Ghana demonstrating the most comprehensive coverage. While basic clinical assessments were commonly reported, access to advanced diagnostic evaluations and comprehensive rehabilitation services remained scarce. Optical aids such as magnifiers and telescopes were more widely available than non-optical devices or structured training programs. Studies assessing functional outcomes reported significant improvements in visual acuity, particularly for distance vision, following intervention. However, multiple barriers to service delivery were identified, including limited infrastructure, insufficient provider training, high costs of devices, financial constraints, low public awareness, and persistent social stigma surrounding vision impairment. Conclusion – The LVS in SSA are still very limited, even though studies report measurable improvements in visual acuity following intervention. There is an urgent need to invest in training health workers, integrating services, making devices affordable, and increasing public awareness. Improving these services is crucial for fair access to eye care and achieving Universal Health Coverage in the region. Systematic Review Registration – https://www.crd.york.ac.uk/PROSPERO/view/CRD420251112575, PROSPERO CRD420251112575.