Sustainable Approaches to Medicine in Southern Africa: A Review of Innovations and Challenges in Cape Verde,

Southern Africa faces challenges in delivering equitable and resilient healthcare. Cape Verde, a small island developing state, serves as a pertinent case study for examining sustainable medical practices within resource-constrained settings. This review aims to synthesise evidence on sustainable medical approaches implemented in Cape Verde, assessing their innovations, effectiveness, and the persistent challenges to their long-term viability. A narrative review was conducted, analysing peer-reviewed literature, government reports, and grey literature. Thematic analysis was used to identify predominant models, outcomes, and barriers. Community-based primary care and telemedicine were central to improving healthcare access. A significant innovation was the integration of traditional birth attendants into the formal maternal health system, which contributed to increased supervised deliveries. Persistent challenges included health worker migration, fragile supply chains, and dependency on external donor funding, which threaten sustainability. Cape Verde has developed adaptable, community-focused medical models that provide valuable lessons for similar settings. However, the long-term sustainability of these approaches remains precarious due to systemic vulnerabilities. Future strategies should prioritise local health workforce retention, explore regional pharmaceutical manufacturing, and transition towards domestically financed health programmes. Further research into the cost-effectiveness of integrated care models is needed. Sustainable medicine, global health, health systems, Cape Verde, maternal health, telemedicine, primary healthcare This review consolidates dispersed knowledge on Cape Verde's medical innovations, providing a structured analysis for policymakers and practitioners seeking to implement sustainable healthcare solutions in Southern Africa.