The impact of community-based participatory health systems interventions on prevention of mother-to-child transmission of HIV (PMTCT) in sub-Saharan Africa: a systematic review and meta-analysis protocol.

BACKGROUND

Despite global efforts to prevent mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), important gaps remain, particularly in low-resource countries. Community-based health systems strengthening (HSS) interventions are emerging as a strategy towards effective prevention of mother-to-child transmission (PMTCT) of HIV services. However, the nexus between interventions and impact indicators remains unclear. This systematic review aims to assess all available evidence on the impact of community-driven HSS interventions on PMTCT.

METHODS AND ANALYSIS: We will develop a search of studies published between 2015 and 2025 from databases such as PubMed/Medline, Scopus, Web of Science, Google Scholar and African Journals. We will use a combination of search terms such as 'participatory action research', 'health systems strengthening', 'PMTCT of HIV', 'childhood HIV', 'MTCT of HIV' and 'under-five mortality'. Studies aimed at community-based participatory health system intervention on PMTCT of HIV published in English will be used. Experimental, quasi-experimental and observational (including cohort and case-control) studies will be included. Data will be analysed using narrative and meta-analysis approaches. The risk of bias will be assessed using Cochrane Handbook guidelines. The primary outcome measure will cover PMTCT of HIV and secondary outcome measures are HIV prevalence and under-five mortality. Finally, the quality of evidence will be assessed using Grades of Recommendation, Assessment, Development and Evaluation technique.

ETHICS AND DISSEMINATION: As no original data will be collected, ethical approval is not applicable for this study. The results will be disseminated through peer-reviewed publication and presentations at health summits and conferences. The review would inform context-sensitive HIV policies and interventions in developing countries, particularly for women and children.

PROSPERO REGISTRATION NUMBER: CRD420251131511.