Mapping Stigma and Cultural Beliefs Shaping Dementia Care in Sub-Saharan Africa: A Scoping Review

Abstract

Background: Dementia is an escalating public health concern in Sub-Saharan Africa (SSA), where over 60% of the global dementia burden is projected by 2050. Despite this, SSA remains underrepresented in dementia research, especially regarding stigma and cultural beliefs that shape the lives of people living with dementia and their caregivers. This scoping review systematically maps existing evidence on dementia-related stigma and cultural beliefs in SSA. Methods: The review followed the Arksey and O’Malley framework as refined by the Joanna Briggs Institute and adhered to PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, CINAHL, PsycINFO, Web of Science, and African Journals Online (AJOL) was conducted for studies published between 2000 and 2025. Eligibility was guided by the Population-Concept-Context (PCC) framework, focusing on studies addressing dementia stigma and cultural beliefs in SSA. Data were charted using a template informed by the Integrated Framework for Normative Influence on Stigma (IFNIS) and synthesised thematically. Results: Twenty-four studies from nine SSA countries were included. Most were qualitative, with few quantitative or intervention studies. Stigma was largely rooted in cultural beliefs linking dementia to witchcraft, curses, or ancestral punishment, leading to social exclusion, neglect, dispossession, and violence, especially targeting older women. Public stigma was reflected in negative stereotypes, discriminatory language, rejection, and avoidance. Structural stigma encompassed untrained health professionals, absent policies, and fragmented care pathways. Caregivers experienced courtesy stigma, isolation, and accusations of abuse. Direct perspectives from people living with dementia were limited. Evidence on stigma-reduction interventions was scarce. Conclusions: Dementia stigma in SSA is a complex cultural, social, and structural phenomenon. There is urgent need for stigma-informed policy, culturally sensitive education, caregiver support, health system strengthening, and robust intervention research.