Governance and Organizational Determinants of Routine Health Information Use Across Health-System Levels in Sub-Saharan Africa: A Scoping Review Protocol

This project is a scoping review protocol examining governance and organizational determinants that influence the use of routine health information across health-system levels in sub-Saharan Africa. The review is motivated by the persistent gap between the availability of routine health information and its effective use for management, planning, supervision, resource allocation, service improvement, surveillance response, and policy. Although previous reviews have examined technical, behavioural, organizational, community-level, district-level, and digital-health determinants of routine data use, this review addresses a narrower governance-focused question: how organizational arrangements, decision authority, accountability, resources, leadership, supervision, coordination, financing, organizational culture, and data governance shape whether routine information progresses from review and interpretation to decision-making, implementation, and follow-up. The review will cover a prospectively defined 48-country sub-Saharan African scope and will examine evidence across five health-system levels: community, health facility, district/local, intermediate subnational, and national. It will include routine health information from RHIS/HMIS/DHIS2 systems, community health information systems, routine surveillance and IDSR, electronic medical or health records used for managerial purposes, routine service statistics, and other recurring programmatic information streams. The review will follow Joanna Briggs Institute guidance for scoping reviews and will be reported according to PRISMA-ScR, with search reporting informed by PRISMA-S. Searches will include MEDLINE/PubMed, Embase, Scopus, Web of Science Core Collection, CINAHL, Global Health, WHO Global Index Medicus, African Journals Online, grey-literature repositories, and backward and forward citation searching. Governance and organizational determinants will be synthesized using a hybrid analytical framework combining PRISM with governance and decision-space concepts. Findings will be mapped by health-system level, data-to-action stage, determinant domain, determinant-origin level, effect-experienced level, evidence directness, and methodological quality. Expected outputs include a country-level evidence map, a 48-country coverage matrix, determinant-by-health-system-level matrices, a data-to-action pathway, an evidence-directness display, methodological-appraisal summaries, and evidence-gap mapping. The review is intended to identify where governance and organizational barriers or enabling mechanisms arise, which level has the authority or resources to respond, and where important evidence gaps remain. At the time of registration, formal multi-database searching, deduplication, study screening, data charting, critical appraisal, and synthesis have not begun. The registration is intended to prospectively document the review methods before formal review execution.