Integrating Sexual and Reproductive Health Self-Care Interventions in Sub-Saharan Africa: A Systematic Review

Abstract

Self‑care interventions are increasingly recognized as critical for advancing sexual and reproductive health and rights (SRHR) in Africa, particularly among adolescents and young people (AYP) aged 10–24 years. However, evidence on effective models for integrating these interventions into health systems remains limited. We conducted a systematic review of PubMed, Web of science, and Scopus databases up to June 2025. Eligible studies reported on SRHR self‑care interventions involving AYP in African settings. Data were extracted using a standardized form and synthesized narratively. Methodological quality was appraised with Joanna Briggs Institute (JBI) tools. Of the 124 records screened, 10 primary studies met the inclusion criteria. Interventions included HIV self-testing (HIVST), self-injectable contraception (DMPA-SC), self-management of contraceptives, and multi-disease self-testing for hepatitis and syphilis. Delivery models comprised peer-led, youth-focused, community-based, and digital platforms. HIVST and DMPA-SC demonstrated the strongest evidence, with high feasibility (uptake up to 97.7%; continuation >70%), acceptability (privacy and autonomy as key enablers), and effectiveness (improved linkage to care and contraceptive uptake). Peer-led and digitally supported models enhanced adherence, psychosocial support, and SRHR knowledge, while digital tools expanded reach but raised privacy and equity concerns. No eligible studies were found on abortion self-care or HPV self-sampling, highlighting critical evidence gaps. Findings underscore the need for integrated, contextually appropriate models embedded within supportive policy frameworks and health systems. Scaling sustainable self-care requires attention to privacy, supply chain reliability, and youth-responsive design. These results inform policy and programmatic decisions for integrating self-care into national SRHR strategies.