Community-led health interventions are considered important for improving health outcomes in resource-limited settings. In West Africa, where health systems face substantial challenges, understanding the role and efficacy of local initiatives is crucial for sustainable development. This systematic review synthesises evidence on the role of local communities in leading and implementing health interventions in West Africa. It aims to evaluate the reported effectiveness, challenges, and enabling factors of such initiatives from an African perspective. A systematic search of peer-reviewed literature was conducted across multiple electronic databases. Pre-defined inclusion and exclusion criteria were applied to identify relevant studies. The quality of included studies was appraised using standard tools, and data were extracted and analysed thematically. Interventions co-designed with communities demonstrated higher uptake and sustainability. Community health worker programmes were a dominant model, frequently employed for maternal and child health. Key enabling factors included trust, local leadership, and cultural adaptation. Common challenges involved resource constraints, volunteer burnout, and weak integration with formal health systems. Community-led interventions are a valuable mechanism for advancing health in West Africa. Their success is closely linked to genuine community ownership and collaboration with formal health structures. Sustained impact, however, is hindered by unreliable funding and insufficient systemic support. Future initiatives should embed participatory design from the outset. Policymakers and funders should invest in capacity building for community health structures and develop sustainable financing models. Further research is needed to quantify long-term impacts and cost-effectiveness. Community health workers, participatory research, public health, health systems, maternal health, primary healthcare, West Africa This review consolidates an African perspective on community-led health action, providing a synthesised evidence base to inform policy and practice for stakeholders in the region.
Nkosi et al. (2011) studied this question.