A Systematic Review of Sustainable Medical Practices in Southern Africa: An Analysis of Literature from 2000 to 2026

Sustainable medicine is particularly important in resource-constrained healthcare settings. Southern Africa faces distinct challenges, and a synthesis of evidence on sustainable clinical practices within the region is needed to inform policy and practice. This systematic review aimed to identify, synthesise, and critically appraise published literature on sustainable medical practices within Southern Africa. Its objective was to map the key themes, reported outcomes, and gaps in the existing evidence base. A systematic search of multiple academic databases was conducted following PRISMA guidelines. Peer-reviewed articles focusing on sustainable practices in clinical medicine within Southern African countries were included. Study screening, selection, and data extraction were performed independently by two reviewers, with discrepancies resolved by consensus. The analysis identified task-shifting and community-based care as a predominant theme. A significant proportion of the literature highlighted nurse-led initiatives for managing chronic conditions as a key strategy for improving access and strengthening health systems. Evidence concerning environmental sustainability within clinical settings was found to be sparse. Sustainable medical practices in Southern Africa are primarily conceptualised through workforce innovation and community engagement. The literature demonstrates a narrow focus, with limited investigation into the environmental and economic dimensions of sustainability in clinical care. Future research should investigate integrated models of sustainability that include environmental stewardship. Policymakers should consider formalising and scaling effective task-shifting frameworks while promoting practices that reduce the healthcare sector's ecological footprint. Sustainable medicine, global health, Southern Africa, health systems, task-shifting, systematic review This review provides a consolidated evidence base on operational approaches to sustainable medicine in Southern Africa, clarifying dominant themes and critical evidence gaps for researchers and policymakers.