DOI: 10.12688/f1000research.187618.1 ISSN: 2046-1402

Inequalities in Adolescent Sexual and Reproductive Health Outcomes and Service Utilisation in Sub-Saharan Africa: A Scoping Review Protocol

Billy Mawindo, Chimwemwe Ngoma, Zeleke Abebaw Mekonnen, Anthony B. Zwi
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Introduction Adolescents and young people in sub-Saharan Africa (SSA) face a disproportionate burden of poor sexual and reproductive health (SRH) outcomes, including high rates of unintended adolescent pregnancy, HIV and sexually transmitted infections (STIs), and unmet need for contraception. Access to and utilisation of SRH services remains inequitably distributed across the region, shaped by structural, sociocultural, health system, and institutional factors. Despite growing attention to adolescent SRH, no comprehensive synthesis has mapped how these multi-level determinants interact across both upstream SRH outcomes and service utilisation. Objective To map and synthesise evidence on the multi-level determinants of inequalities in upstream adolescent SRH outcomes (including family planning and contraceptive access, STI/HIV prevention and care, sexual health education, and adolescent pregnancy occurrence) and SRH service utilisation in sub-Saharan Africa. Methods This review will follow Joanna Briggs Institute (JBI) scoping review methodology and be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A systematic search will be conducted across PubMed, African Journals Online (AJOL), and Google Scholar, supplemented by Demographic and Health Surveys (DHS) publications and reference list searching, covering 2015–2026. Two independent reviewers will screen all records against pre-defined eligibility criteria, with a third reviewer resolving disagreements. Data will be extracted using a structured charting form and synthesised thematically across two parallel tracks: determinants of SRH outcomes and determinants of SRH service utilisation. Dissemination Findings will be submitted for publication in a peer-reviewed journal and disseminated at national and global forums. This protocol is registered on the Open Science Framework (OSF), available at OSF | Inequalities in Adolescent Sexual and Reproductive Health Outcomes and Service Utilisation in Sub-Saharan Africa: A Scoping Review Protocol

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