Community-based medicine initiatives are considered important for improving healthcare access in West Africa. A systematic synthesis of evidence on the role of local communities in these initiatives, from an African perspective, is required. This systematic review aimed to identify, appraise, and synthesise published literature on the role of local communities in medicine initiatives within West Africa, focusing on their involvement in design, delivery, and governance. A systematic search of multiple electronic databases was conducted following PRISMA guidelines. Peer-reviewed studies published in English and French were included. Titles, abstracts, and full texts were screened independently by two reviewers. Data were extracted and synthesised thematically. Community health worker programmes were a central theme, crucial for medicine distribution and adherence support. Initiatives that formally integrated traditional birth attendants reported increased antenatal clinic attendance. Common barriers to sustainability included inadequate funding, inconsistent remuneration, and insufficient training for community-based actors. Local communities play a critical role in the success of medicine initiatives in West Africa, primarily through trusted community health workers. While active community participation improves healthcare engagement, it requires structured institutional support for long-term impact. Future initiatives should integrate formal remuneration schemes and provide continuous training for community health workers. Policymakers must develop frameworks for sustainable community engagement. Further research should explore hybrid models that combine traditional and allopathic healthcare systems. Community health workers, traditional medicine, public health, healthcare delivery, participatory research, West Africa This review provides a consolidated evidence base for policymakers and practitioners, outlining critical success factors and barriers for community-based medicine programmes in West Africa from a regional perspective.
Chuttoo et al. (Thu,) studied this question.