Palliative and supportive care for people living with COPD in sub-Saharan Africa: a scoping review and evidence-gap map protocol

This project will conduct a scoping review and evidence-gap map of palliative and supportive care for adults living with chronic obstructive pulmonary disease (COPD) in sub-Saharan Africa. Its purpose is to determine what evidence exists, where that evidence was generated, which models and components of care have been described or evaluated, and where important gaps remain for clinical practice, service design, policy, and future research. COPD palliative care is a particularly important but undercharacterized topic in the region. Earlier COPD research in sub-Saharan Africa was sparse and unevenly distributed; one review found only nine eligible studies from four countries. The directly relevant evidence identified during preliminary scoping includes a recent South African qualitative study of patients, caregivers, and healthcare professionals. It reported needs related to communication and health literacy, multidimensional symptom and social burden, unreliable medicines, rapid access during exacerbations, and continuity between hospital, primary care, and home. Broader regional end-of-life literature has also largely focused on HIV/AIDS and South Africa, leaving the COPD-specific evidence base uncertain. The review will follow JBI scoping-review methodology and be reported according to PRISMA-ScR. This design is appropriate because it can incorporate qualitative, quantitative, mixed-methods, implementation, policy, guideline, and grey-literature evidence, and is intended to characterize the extent, range, and nature of heterogeneous evidence rather than pool a single intervention effect. Searches will cover major biomedical, nursing, psychology, global-health, regional African, and grey-literature sources from inception to the final search date. Two reviewers will independently screen records using prespecified Population–Concept–Context eligibility criteria: adults with COPD; palliative or supportive-care needs, models, interventions, or pathways; and any sub-Saharan African setting. For each included report, the team will chart geography, setting, population, study design, care model, care components, outcomes or reported needs, and barriers and facilitators. The analysis will not use meta-analysis or statistical hypothesis testing. Instead, it will produce descriptive tables, a framework-based synthesis, and evidence-gap maps showing the distribution of evidence by country, setting, stakeholder group, care component, and maturity of evidence. These outputs will distinguish no eligible evidence identified from descriptive evidence and from implemented or evaluated service evidence; they will not treat publication counts as proof of service availability or effectiveness. Expected outputs are: (1) a transparent PRISMA-ScR flow diagram; (2) a searchable or tabular inventory of included evidence; (3) country-by-care-component and setting-by-care-component evidence maps; (4) a synthesis of care needs, service models, and implementation barriers/facilitators; and (5) a prioritized research and service-development agenda. The project is expected to identify both available COPD-specific evidence and the regional blind spots that prevent evidence-informed palliative-care integration for this population.