Factors influencing access to safely managed sanitation in sub-Saharan Africa: a systematic review protocol

Abstract

Introduction Several interventions have been implemented to improve access for all to safely managed sanitation in sub-Saharan Africa (SSA) since the beginning of the Sustainable Development Goals in September 2015. However, consolidated evidence on how such interventions worked or not worked remains limited. The proposed systematic review aims to synthesis evidence on how, why and under which circumstances the implementation of such sanitation interventions in SSA succeeded or failed so as to draw lessons for any future similar interventions. Methodology A systematic review protocol was designed and registered in PROSPERO – registration number CRD42023468109. Literature searches will be conducted in multiple electronic databases (from 2015 to 2023), including PubMed, Embase, CINAHL, Scopus, African Journal Online and Google scholar. Gray literature from ProQuest and Theses Global (PQTD) will also be searched. Other databases to be searched will be from IRIS- (WHO Digital Publications), United Nation Children Emergency Fund (UNICEF) and World Bank. Keyword searches will be used to identify articles. Peer-reviewed full text articles written in English and documenting how, why and in which contexts sanitation interventions improve access to safely managed sanitation will be considered eligible for inclusion. Two reviewers will independently screen eligible titles, abstracts and full articles with the third reviewer to help resolve any disputes. Assessment risk of bias in included studies will be appraised using the appropriate Critical Appraisal Skills Programme (CASP) checklist for systematic review and disputes will be resolved through discussion and consensus. The narrative and thematic synthesis of findings will be conducted. Discussion Understanding how and why certain sanitation interventions contribute to safely managed sanitation in SSA could guide program implementers on how to design interventions that contribute to the attainment of Sustainable Development Goal number 6.2 of universal access for all to adequate and equitable sanitation. The review will further compliment the limited studies that focus only on sanitation in SSA.