REVIEW article
Front. Psychol.
Sec. Health Psychology
Measuring health-related quality of life in Africa: a systematic review of validated disease-specific and generic measurement tools
Provisionally accepted
- 1University of Nigeria, Nsukka, Nsukka, Nigeria
- 2Health Policy Research Group, University of Nigeria Nsukka, Enugu, Nigeria
- 3Health Policy Research Group, University of Nigeria Nsukka, Health Policy Research Group, Enugu, Nigeria
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Background: This systematic review examines the evidence on the use of HRQoL tools for African populations and evaluated the psychometric properties, cultural adaptation, and applicability of such tools. Methods: A systematic search was conducted across PubMed, Web of Science, and Scopus and databases grey literature from January 2015-January 2025. The review followed following PRISMA and COSMIN frameworks. Duplicate screening and study selection were independently performed by multiple reviewers. Eligible studies included the development, adaptation, or validation of Eligible studies focused on HRQoL instruments development, adaptation, validation for African populations. Duplicates were removed, and independent reviewers conducted screening, data extraction, and synthesis. The identified tool was assessed for psychometric robustness, translation efforts, and clinical utility..The protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) with identification number CRD42025639055. Results: Forty studies met the inclusion criteria with 31(77.5%) focusing on adults and minimal attention to paediatric population. East Africa had the highest representation 17 (42.5%), while West Africa accounted for 7(17.5%). Iinternal consistency (cronbach's alpha ≥ 0.70 was demonstrated in 33(97.1%) out of the 34 tools. A total of 34 different HRQoL tools were identified, including 12 generic instruments. The SF-12 and WHOQOL-BREF were the most validated tools, whereas the EORTC QLQ-C30 was the most validated disease-specific tool. Cultural adaptation was a major focus, with 32(80.079.49%) of studies incorporating linguistic modifications to enhance contextual relevance. Most studies 28 (70.0%) used cross-sectional designs. Overall, most tools demonstrated good reliability and cultural adaptability, although limitations such as small sample sizes, restricted geographic coverage, and incomplete reporting of responsiveness and test–retest reliability were common. Conclusion: Significant progress has been made in developing and validating HRQoL tools for African populations. However, gaps remain, including the need for longitudinal studies, greater inclusion of children's HRQoL and broader geographic representation. Strengthening research capacity will be pivotal in advancing culturally responsive HRQoL tools and integrating them into healthcare decision-making in Africa.
Keywords: Health related quality of life, Disease-specific Health Related Quality of Life', Africa' Context-specific, cultural adaptation, HRQOL
Received: 18 Aug 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Isah, Ugochukwu, Ikeanyi and Onwujekwe. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ezinwanne Ugochukwu
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