Revitalising Indigenous Games: A Systematic Review on Their Role in Health Promotion and Obesity Prevention Among Youth in South Africa

Physical inactivity and obesity among youth represent growing public health challenges in South Africa. Indigenous games, historically embedded in daily life and cultural practices offers a culturally relevant approach to promoting physical activity and preventing obesity. However, evidence on their integration into health promotion interventions remains fragmented. This study systematically reviewed the role of indigenous games in health promotion intervention strategies and obesity prevention programmes among youth in South Africa. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and guided by the Joanna Briggs Institute methodological framework. A comprehensive search of PubMed, Google Scholar, African Journals Online (AJOL), and Web of Science was undertaken to identify studies published between 2012 and 2025. A total of 25,986 studies were initially identified and after screening based on eligibility criteria. 25 studies were included in the final synthesis. Findings indicate that indigenous games are culturally meaningful forms of physical activity that enhance youth engagement, social cohesion, and participation in school and community settings. While most studies reported positive health promotion outcomes, direct evidence linking indigenous games to measurable obesity-related outcomes among youth was limited. Indigenous games show strong potential as culturally grounded health promotion strategies for South African youth. However, robust intervention studies measuring obesity-specific outcomes are required to strengthen their integration into formal health promotion and obesity prevention programmes.