Barriers and Facilitators to Harm Reduction Service Access Among Youth and Young Adults Who Use Substances in West Africa: A Scoping Review

This scoping review protocol maps the existing evidence on barriers and facilitators to harm reduction service access among youth and young adults aged 15 to 35 who use substances in West Africa. Substance use among young people remains a significant and growing public health concern across the region, yet harm reduction services such as needle and syringe programmes, opioid agonist therapy, and naloxone distribution remain severely limited, with adoption hindered by punitive drug policies, inadequate funding, stigma, and structural barriers. While reviews examining barriers and facilitators to harm reduction access exist in high income settings such as Canada and the United States, no scoping review has systematically examined this question in the West African context, where the legal, political, and resource environment differs substantially. Guided by the Population, Concept, Context (PCC) framework recommended by the Joanna Briggs Institute, this review aims to identify and map available evidence on barriers and facilitators to harm reduction service access in this population and region. The review will follow a systematic search of multiple databases and grey literature sources, with screening, data charting, and reporting conducted in accordance with JBI methodology and PRISMA-ScR guidelines. The expected outcome of this review is a comprehensive map of the current evidence base, including a descriptive summary of where research is concentrated and where gaps exist across countries and population subgroups, alongside a synthesis of documented barriers and facilitators organized across individual, interpersonal, community, and structural levels. These findings are intended to inform future primary research, the design of youth-friendly harm reduction programming, and drug policy reform efforts in West Africa.