Economic Implications of Artificial Intelligence in Surgical Systems Strengthening in Sub-Saharan Africa: A Scoping Review

Project title: Economic Implications of Artificial Intelligence in Surgical Systems Strengthening in Sub-Saharan Africa: A Scoping Review Description: This project contains the protocol for a scoping review examining the economic implications of artificial intelligence (AI) tools applied to surgical systems strengthening in sub-Saharan Africa (SSA). Despite accelerating global investment in AI for health, the evidence base for AI in surgical systems remains almost entirely concentrated in high-income and upper-middle-income country settings, with SSA critically underrepresented. Furthermore, while economic evaluations of AI in healthcare are beginning to emerge, none has specifically examined the cost-effectiveness, financial feasibility, or return on investment of AI tools within SSA surgical systems. This scoping review will map the available evidence on AI tools applied to surgical systems strengthening in SSA, synthesise the economic outcomes and implementation barriers reported in the literature, and generate a structured evidence gap agenda to inform future research and investment decisions in the region. The review will follow the methodological framework of Arksey and O'Malley as refined by Levac and colleagues, and will be reported in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). A comprehensive search will be conducted across PubMed, Scopus, Web of Science, and African Index Medicus, supplemented by Google Scholar and hand-searching of reference lists. Two independent reviewers will screen records and chart data using a standardised extraction form. Findings will be synthesised narratively and thematically across three domains: AI tool characteristics, economic outcomes, and implementation barriers and facilitators. This registration is submitted prior to commencement of the formal full database search. The protocol document is attached.