Mapping the progress of achieving equity in Universal Health Coverage in Africa: A scoping review protocol

Background: Addressing health inequities is a global priority, especially with the resurgence of interest in universal health coverage (UHC). A fundamental step in addressing health inequities can be monitoring health inequalities. As health inequality is multidimensional, it is important to monitor inequality across different dimensions of equality as well as measure inequalities for coverage of all the services needed to attain UHC. However, in Africa, which has the lowest UHC service coverage index, there is limited information on the progress of countries in addressing health inequalities related to UHC. This scoping review seeks to map the evidence on the state of inequality in the progress towards UHC service coverage and its constituent components in Africa. Methods: We will conduct a scoping review following the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. We will consider any empirical research from any study design that assesses health equity in relation to service coverage in the context of UHC in Africa. We will search seven electronic databases from their inception onwards (e.g., MEDLINE, Embase, Cochrane Library), hand-search other relevant sources (e.g., Google Scholar, Hinari, WHO Library), and screen the reference lists of included or relevant studies. We will select eligible reports and extract data using standardized forms. We will further extract a core set of indicators which are disaggregated by different equity stratifiers. We will summarize data using a narrative approach involving thematic syntheses and descriptive statistics. We will report this review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews (PRISMA-ScR) checklist. Discussion: This work will also contribute to identifying knowledge gaps in the evidence of equity in the progress towards UHC, and propose innovative strategies that could help overcome current challenges. We will disseminate our findings to knowledge users through a publication in a peer-reviewed journal and organization of workshops.