Models of post-operative and longitudinal care for cardiac surgery patients in sub-Saharan Africa: a scoping review

This scoping review maps how longitudinal care is delivered to patients following cardiac surgery in sub-Saharan Africa. It examines models of post-discharge follow-up, including decentralised and district-level care, nurse-led and pharmacist-led anticoagulation services, point-of-care and remote INR monitoring, task-shifting arrangements, peer-support interventions, and the funding and referral structures that sustain them. The review follows the Arksey and O'Malley framework with Levac et al. refinements and is reported according to PRISMA-ScR. Databases searched include PubMed, Scopus, Web of Science, Cochrane Library, African Journals Online, and African Index Medicus, from inception to present. Screening is conducted independently by two reviewers with a third adjudicating disagreements, and Cohen's kappa is reported for inter-reviewer agreement at both title/abstract and full-text stages. Data are charted descriptively across care-model type, provider cadre, geographic setting, and reported outcomes (retention, anticoagulation control, mortality, barriers and enablers). The review does not assess surgical outcomes or operative mortality, distinguishing it from existing reviews of cardiac surgical outcomes in Africa. Expected outcomes include a synthesis of the distinct models of post-operative care delivery documented across the region, identification of gaps in the evidence base, and recommendations to inform the design and evaluation of sustainable follow-up services for cardiac surgery patients in resource-limited settings.