A Governance-Informed Framework for Sports Injury Surveillance and Tiered Rehabilitation Care in Low- and Middle-Income Countries

This project develops a governance-informed conceptual framework for integrating sports injury surveillance and tiered rehabilitation care in low- and middle-income countries (LMICs), through a scoping review and framework synthesis. Purpose. Sports injury prevention depends on a foundational sequence: a system must first measure injury occurrence and burden (surveillance), then act on that knowledge through accessible, appropriately tiered rehabilitation. In high-resource settings both are largely assumed; in many LMICs they are fragmented or absent. Critically, the literatures on injury surveillance and on tiered rehabilitation delivery remain siloed, despite both being, at root, questions of health-system governance. This project addresses that gap by mapping both literatures together through a governance lens and synthesising them into a single conceptual model. Approach. The study is a scoping review conducted per the Arksey & O'Malley framework as advanced by Levac et al., and reported following the PRISMA-ScR standard. A structured search across major databases (MEDLINE, Embase, Scopus, Web of Science, CINAHL, SPORTDiscus) and relevant grey literature will be screened in duplicate against predefined eligibility criteria (PCC). Extracted data will be charted descriptively and, critically, analysed against the ten health-system governance principles of Siddiqi et al. (2009) — a framework developed specifically for developing countries — adapted to the sports-injury context. Expected outcomes. The primary output is a novel, named conceptual framework — the Governance-Informed Sports Rehabilitation Infrastructure (GISRI) model — describing how a nation can build, from limited resources, an interlocking system in which local injury data informs national rehabilitation capacity, and specialist expertise reaches athletes through tiered referral. The model will be accompanied by an implementation maturity ladder, rendering it an operational blueprint rather than a diagram alone. Findings are intended to inform sports federations and health ministries across Africa, the Arab region, and comparable settings, and to be submitted to a peer-reviewed journal. This registration establishes the study protocol and its intellectual origin prior to commencement. It is registered as an open-ended registration; any subsequent methodological refinements will be documented transparently as dated updates.