Keywords
Non-communicable diseases (NCDs), diabetes, cardiovascular diseases, risk factors, public health, mortality, morbidity, South Africa.
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Ogbodu OM and Sewani-Rusike C. A Scoping Review Protocol to explore the growing burden of non-communicable diseases in South Africa and their implications for public health [version 1; peer review: awaiting peer review]. F1000Research 2025, 14:945 (https://doi.org/10.12688/f1000research.169734.1)
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Study Protocol
A Scoping Review Protocol to explore the growing burden of non-communicable diseases in South Africa and their implications for public health
[version 1; peer review: awaiting peer review]
PUBLISHED 19 Sep 2025
OPEN PEER REVIEW
REVIEWER STATUS
Abstract
Corresponding author:
Olubunmi Margaret Ogbodu
Competing interests:
No competing interests were disclosed.
Grant information:
The author(s) declared that no grants were involved in supporting this work.
Copyright:
© 2025 Ogbodu OM and Sewani-Rusike C.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: Ogbodu OM and Sewani-Rusike C. A Scoping Review Protocol to explore the growing burden of non-communicable diseases in South Africa and their implications for public health [version 1; peer review: awaiting peer review]. F1000Research 2025, 14:945 (https://doi.org/10.12688/f1000research.169734.1)
First published: 19 Sep 2025, 14:945 (https://doi.org/10.12688/f1000research.169734.1)
Latest published: 19 Sep 2025, 14:945 (https://doi.org/10.12688/f1000research.169734.1)
Introduction
Just like other countries across the globe, South Africa is facing an increasing crisis with non-communicable diseases (NCDs) that are significantly impacting public health and the economy. In South Africa, NCDs are already among the top causes of death (Nojilana et al., 2016a). According to the World Health Organization, by 2030, NCDs will be the biggest cause of death in this region (Nojilana et al., 2016b). With a high prevalence of NCDs, cardiovascular diseases (CVD), diabetes, chronic respiratory diseases, and cancer, addressing this challenge will require a multi-faceted approach involving non-health and health actors that are critical (Samodien et al., 2021). The authors further posited that the approach would include health system strengthening policies and practices, public awareness campaigns, and addressing social determinants like poverty, inequality, and unhealthy living conditions that worsen the risk of developing NCDs. Different authors have described multiple factors implicated in the development of NCDs. According to Budreviciute et al. (2020), the associated risk factors of NCDs can be classified into the categories of self-management, genetic factors, environmental factors, factors of medical conditions, and socio-demographic factors. The authors argue that the most effective preventive strategy for NCD control is one that leads to changes in lifestyle with respect to diet, physical activities, cessation of smoking, and the control of metabolic disorders. Correspondingly, the importance of lifestyle risk factors in LMICs for NCDs, as described by Dieteren & Bonfrer (2021) and Lawana et al. (2020), asserts that there is a significant indirect impact of obesity, physical activity, and alcohol consumption on non-communicable diseases, just as different factors, ranging from modifiable lifestyle choices, environmental factors, and socioeconomic differences, contribute to NCDs. This scoping review aims to provide a comprehensive overview of the existing evidence on NCDs in South Africa, the prevalence of NCDs, associated risk factors, prevention and control strategies, identify knowledge gaps, and identify areas for further research and intervention. The expected primary outcomes of this scoping review are a comprehensive map of the existing evidence on NCDs in South Africa and an assessment of the effectiveness of current NCD prevention and control strategies while the secondary outcomes are recommendations for developing targeted public health policies and interventions for NCDs in South Africa and improving access to quality healthcare, particularly for primary care and early diagnosis of NCDs.
Rationale for scoping review
There is growing research on NCDs in South Africa; however, there is a need to map the existing evidence base, identify knowledge gaps, and understand the types of studies being conducted. According to Mayosi and Benatar (2014), since South Africa underwent a peaceful transition from apartheid to a constitutional democracy, the growing burden of non-communicable diseases (NCDs) in South Africa became a significant public health concern in the early 2000s, with a notable increase in deaths attributed to NCDs starting in the late 1990s. The rise in NCDs, including cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases, has placed a significant strain on the healthcare system and worsened existing inequalities. The growing burden of NCDs in South Africa calls for a thorough assessment of the current research landscape to understand the scope of the problem and identify potential and effective solutions and or interventions to identify effective interventions and areas where scarce resources need to be allocated to address the NCD burden. This scoping review, amongst other reasons, will aid in identifying the barriers and facilitators to effective NCD management, including access to care, resource allocation, and the integration of NCD services into the existing healthcare system of areas where further research is needed to address the NCD crisis effectively. Therefore, an understanding of the current state of NCD research in South Africa is necessary to identify knowledge gaps and inform targeted and region-specific public health action to address this growing public health crisis in the country.
Method
To synthesize evidence from literature and other studies, including study designs in both peer-reviewed and grey literature, the proposed scoping review will adhere to the Joanna Briggs Institute (JBI) method for scoping reviews as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines and checklist (Peters et al., 2022; Peters et al., 2020; Tricco et al., 2018). The JBI technique offers a formal framework that guarantees transparency, reproducibility, and rigor in scoping reviews; the authors chose it. The PRISMA-ScR checklist helps authors, reviewers, and readers understand the essential components that should be included in a scoping review’s methodology and findings by offering a thorough and methodical approach to evidence synthesis. By increasing transparency and consistency in reporting, this checklist promotes thorough reporting of procedures and results that contribute to the improvement of scoping review quality.
The study will be completed in over five stages: (1) determining the research question, (2) comprehensive database search, (3) inclusion criteria, (4) data extraction, and (5) analyzing and presenting the results. There will be no quality assessment for this scoping review. However, there will be a description of the study designs of all included studies when reporting the results.
Determining the research question
The research questions for this scoping review were developed in consultation with our team of multidisciplinary pharmacy, medicine, and public health disciplines. The NCDs of interest for this review are: cardiovascular diseases, obesity, diabetes, and chronic respiratory diseases. This review will answer the following research questions:
Comprehensive database search
After careful consideration by the reviewers, a comprehensive search across multiple databases, including PubMed, Scopus, and Google Scholar, will be led by a librarian, using relevant keywords related to NCDs, risk factors, South Africa, and public health. After careful examination by the review committee, a carefully crafted combination of keywords and search terms will be used for the electronic database search to guarantee the inclusion of the most pertinent studies. Boolean operators (“OR/AND”) and particular keywords or Medical Subject Headings (MeSH) terms will be used. These search terms will include the study keywords and phrases such as “non-communicable diseases” AND “public health in South Africa” OR “public health effects OR health system impacts of non-communicable diseases in South Africa” AND “vulnerable populations to non-communicable diseases in South Africa”. Peer-reviewed articles published from 2000 to 2025 will be considered. A grey literature search of relevant non-indexed literature, including government publications and published relevant scientific conference proceedings, will be conducted. Reference lists of included studies and review articles on study objectives, including websites such as the World Health Organisation (WHO), Institutional Research Information System (IRIS), and the United Nations, will be selected. To ensure the database is free of duplicates, EndNote 20 (Clarivate), a reference management software program, will be utilized. It is expected that the selection of papers for the review will be finished in ten weeks, closely following the PRISMA-ScR checklist’s recommendations (Peters et al., 2022). To encourage cooperation among coauthors during screening and extraction, the data will be uploaded into Covidence, a knowledge synthesis management platform (Covidence systematic review software (2024), Veritas Health Innovation, Melbourne, Australia), after all identified records have been extracted from all databases and duplicates have been eliminated. Table 1 below displays the basic search technique developed in the electronic databases.
Table 1. Initial search results on the electronic databases – Scoping review protocol on NCDs in South Africa.
Inclusion and exclusion criteria
Having a clearly defined inclusion criterion ensures a systematic, transparent, and reproducible selection process in a scoping review. They establish boundaries, capture diverse evidence, and enhance replicability, allowing future researchers to validate findings for further exploration (Peters et al., 2021). The inclusion criteria will follow the Population, Concept, and Context (PCC) framework detailed below. The timeline for this study will span 10 weeks, from 15 October to 31 December 2025, and eligible studies will be selected from 2000 to 2025.
Population
The population of interest will be all the adults, aged 18 – 65, resident in all of South Africa’s provinces, with any or at least one of the following non-communicable diseases: cardiovascular diseases, diabetes, and chronic respiratory diseases.
Concept
All NCDs of interest, cardiovascular diseases, diabetes, and chronic respiratory diseases and their risk factors, influence on mortality and morbidity, and the public health consequences in South Africa. The concept will also include public health interventions such as public health advocacy campaigns on regular health check-ups, early detection of NCDs, training healthcare professionals, evidence-based interventions to address social determinants, and policy interventions.
Context
All South African provinces, rural and urban, with adult populations living with the NCDs of study interest will be considered.
Inclusion criteria
Studies that focus on NCDs in adult populations in all provinces in South Africa, published in the English Language and relevant to the review’s objectives, and within the set time frame will be included.
Exclusion criteria
Conversely, studies will be excluded if they are on NCDs but in countries other than South Africa, are not in English, or are not relevant to the review’s objectives.
Data extraction
A standardized charting form will be used to extract data from the included studies. The charting form will include information on the author, year of publication, study design, population, NCD type, risk factors, interventions, and outcomes of the study. Two reviewers (OMO and CSR) will independently extract data from each study using a standardized form to ensure a systematic and transparent process. Abstract and full-text screening will be conducted independently in two stages by the two reviewers. Any disagreement will be resolved through discussion and consensus. The extraction process will occur in two stages: an initial phase, in which both reviewers collect data independently, and a verification phase, in which both reviewers assess completeness and correctness.
Data analysis and presenting the results
The quantitative data analysis will involve summarizing and presenting numerical data from included studies in a descriptive and organized manner, often through tables, charts, and narrative summaries, while the qualitative data analysis will focus on identifying, extracting, and synthesizing key concepts, themes, and characteristics from included studies’ thematic analysis.
Conclusion
Given the rising incidence of NCDs in South Africa, a synthesis of current and emerging evidence will identify gaps in knowledge and inform tailored public health interventions for NCDs in South Africa and policy recommendations to encourage healthy living and healthier populations, achieving a reduction in the burden of NCDs in South Africa.
Ethical considerations
Ethical approval is not required for this scoping review because it does not involve human participation, and it is based on publicly available research. One of the potential limitations of scoping reviews is the lack of a critical appraisal of evidence synthesis, which is acknowledged for this study.
Dissemination
The findings of this scoping review will be disseminated through presentations at relevant academic conferences, research feedback workshops, and peer-reviewed publications. Additionally, the findings will be shared with policymakers, healthcare professionals, specialists in the specialty fields of NCDs, and other stakeholders involved in NCD prevention and control in South African provinces.
Strengths and limitations of the study
▪ The review will follow a well-established and rigorous scoping review methodology by the Joanna Briggs Institute to produce a high-quality review.
▪ The selection of articles will cover published articles over the last two decades (2005–2025); enabling the mapping of old and current evidence from literature.
▪ The inclusion of grey literature strengthens the review by reducing publication bias and enhancing the comprehensiveness of findings.
▪ Article selection for this scoping review is limited to English; thus, relevant data in non-English articles might be missed.
▪ This review is limited to articles reporting evidence on NCDs in South Africa.
Author contributions
Conceptualization: OMO
Methodology: OMO and CSR
Writing – original draft preparation: OMO
Writing – manuscript critical review and editing: OMO and CSR.
All authors have read and agreed to the published version of the manuscript.
Reporting guidelines
The PRISMA P checklist for this study is available on Figshare:
https://doi.org/10.25406/wsu.29930486.v1 (Ogbodu, Olubunmi; Rusike, Constance 2025).
Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).
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how to cite this article
Ogbodu OM and Sewani-Rusike C. A Scoping Review Protocol to explore the growing burden of non-communicable diseases in South Africa and their implications for public health [version 1; peer review: awaiting peer review]. F1000Research 2025, 14:945 (https://doi.org/10.12688/f1000research.169734.1)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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