Governance of the Health Workforce Under Decentralisation in Sub-saharan Africa: a Scoping Review Protocol
Year: 2026
Type: preprint
Abstract: Many sub-Saharan African (SSA) countries have decentralised their health systems, transferring responsibility for managing the health workforce, in whole or in part, to subnational governments. Evidence from the region suggests that human resources for health (HRH) functions are often transferred faster than the structures, financing and capacity needed to perform them, with consequences for the distribution, motivation and retention of health workers and for industrial relations. Existing reviews of decentralisation are not specific to HRH governance in SSA. The objective of this scoping review is to map the evidence on how HRH governance and management functions are organised, implemented and experienced under decentralised health systems in SSA. The review will follow the JBI methodology for scoping reviews and will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Africa-Wide Information (EBSCO) and Google Scholar will be searched, together with grey literature from the World Health Organization, the World Bank and other key HRH organisations, for publications from 1 January 2015. After a pilot on 50 records, two reviewers will independently screen titles and abstracts, and then full texts, in Covidence. Data will be charted using a piloted form, with one reviewer charting each source and a second verifying it. Findings will be summarised descriptively, mapped in an evidence matrix of HRH functions by form of decentralisation, and analysed thematically.
Source: OSF Preprints (OSF Preprints)
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7223264774