Experiences and Burden of Family Caregivers of Older Adults with Chronic Life-Limiting Illnesses in Sub-Saharan Africa: A Scoping Review

Background Population ageing is accelerating across Sub-Saharan Africa, where increasing life expectancy and the growing prevalence of chronic life-limiting illnesses have intensified reliance on family members to provide long-term care. Despite the central role of informal caregivers, evidence describing their experiences remains fragmented across countries, disease conditions, and healthcare settings. A comprehensive synthesis is needed to better understand the challenges faced by caregivers and to inform policies that support healthy ageing and palliative care within the region. Objective This scoping review mapped and synthesized the existing evidence on the experiences of family caregivers providing care to older adults living with chronic life-limiting illnesses in Sub-Saharan Africa. Methods A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Electronic databases were systematically searched for eligible studies published between 2011 and 2025. Studies were included if they were primary empirical research conducted in Sub-Saharan Africa and explored the experiences of informal or family caregivers of older adults living with chronic life-limiting illnesses. Data were extracted, charted, and synthesized using thematic analysis. Results Fifteen studies met the inclusion criteria. The evidence originated from multiple countries across Sub-Saharan Africa and included qualitative, quantitative, and mixed-methods research. Five overarching themes emerged: (1) multidimensional caregiver burden; (2) emotional and psychological experiences; (3) cultural, gender, and family expectations influencing caregiving; (4) coping strategies and sources of resilience; and (5) health system challenges and unmet support needs. Caregivers consistently reported physical exhaustion, emotional distress, financial hardship, and social isolation while providing prolonged care with limited formal support. Nevertheless, caregiving was frequently perceived as a cultural obligation and an expression of familial responsibility, contributing to resilience despite substantial challenges. Conclusion Family caregivers remain the cornerstone of care for older adults with chronic life-limiting illnesses throughout Sub-Saharan Africa, yet they continue to provide this care within health systems that offer limited formal support. Strengthening caregiver support through culturally responsive policies, caregiver education, integrated palliative care services, financial protection, and community-based interventions will be essential to promoting healthy ageing and improving quality of life for both caregivers and care recipients across the region.