CONCLUSION
There is significant room for improvement of anticoagulation control in countries across SSA. Increasing numbers of patients will need anticoagulation in the future because of the epidemiological transition in the region. Despite the many challenges faced by patients, health care providers, and health systems in these resource-limited settings, several opportunities for improvement exist. Decentralisation of anticoagulation care, together with expanded access to medicines and monitoring, and enhanced support to practitioners and patients, are pivotal in achieving better control. Dose initiation and dose adjustment protocols that have been developed taking locally relevant factors into account can also contribute to better anticoagulation control. With the cost of DOACs still prohibitive, locally-developed “warfarin care bundles” which address multiple anticoagulation challenges in combination, particularly when they leverage off systems that are already functional in SSA, currently appear to be the most appropriate strategy to improve anticoagulation control in this setting.