Cardiac rehabilitation in Francophone Africa: a cross-sectional survey of availability, capacity, and barriers

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, accounting for nearly 20 million deaths annually, with more than three-quarters occurring in low- and middle-income countries (LMICs).1 Cardiac rehabilitation (CR) is a Class I, guideline-recommended intervention for coronary artery disease and heart failure, associated with significant reductions in mortality and recurrent events.2–4 Despite its cost-effectiveness and adaptability to low-resource settings, CR remains underdeveloped across Africa. Previous global surveys identified only 32 programmes on the continent, largely concentrated in South Africa, with minimal representation from Francophone West and Central Africa.5,6 Contemporary data from these regions are lacking. We conducted a cross-sectional survey between January and June 2024 to assess the availability, characteristics, and barriers of CR programmes in Francophone Africa. Cardiologists were identified through the Association des Cardiologues d’Afrique de l’Ouest et du Centre (ASCAOC) and the alumni network of the interuniversity CR diploma established in Sousse (Tunisia) in collaboration with European and Canadian partners since 2017. A structured online questionnaire was distributed nationally through professional networks.