Mapping the implementation of neonatal care guidelines in sub-Saharan Africa: a protocol for a scoping review of rates, barriers, facilitators and strategies using Tanzania as a case study.

Abstract

Sub-Saharan Africa (SSA) bears the highest global burden of neonatal mortality, a problem continued by the widespread 'know-do gap', the failure to translate evidence-based guidelines into practice. Tanzania's 2019 national neonatal care guideline illustrates this challenge, as its impact remains unevaluated despite stagnant mortality rates. A systematic mapping of implementation evidence, including its rates, determinants and improvement strategies, is urgently needed to identify gaps and inform actionable policies across SSA. This scoping review will be conducted in accordance with the Joanna Briggs Institute methodology. We will systematically search six electronic databases (MEDLINE (PubMed), Embase, CINAHL (EBSCOhost), Web of Science, Cochrane Library and African Journals Online) and the grey literature from 1 January 2000 to 31 December 2025. Two reviewers will independently screen records using PCC criteria (Population: healthcare workers/systems; Concept: guideline implementation; Context: SSA/Tanzania). Data will be charted and analysed using descriptive statistics and deductive thematic analysis guided by the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change taxonomy. Ethical approval is not required as this synthesis uses published data. Findings will be disseminated through a peer-reviewed journal manuscript, conference presentations, integration into a PhD thesis and tailored outputs for policymakers (policy brief) and frontline workers (clinical implementation brief) in Tanzania. This protocol is registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/3FMBG).