A Systematic Review of Multi-Sectoral Coordination During the COVID-19 Pandemic—Practices, Challenges, and Recommendations for Future Preparedness: A Review Protocol
Authors: Okello Javan Solomon , Ginindza Themba , Nyerere Julius 
Published: February 2025

INTRODUCTION: The COVID-19 pandemic underscored the vital importance of multi-sectoral coordination in managing complex public health crises. Effective collaboration among stakeholders—including governments, health systems, private enterprises, civil society, and academia—has been pivotal in mitigating the pandemic’s impacts. However, significant gaps persist in understanding the mechanisms, benefits, and challenges of multi-sectoral coordination, particularly in low- and middle-income countries (LMICs) such as Kenya. This systematic review seeks to address these knowledge gaps, providing actionable insights to strengthen future pandemic preparedness.

METHODS AND ANALYSIS: This systematic review will synthesize evidence on multi-sectoral coordination during the COVID-19 pandemic, focusing on key elements, benefits, challenges, and strategies for improvement. Studies meeting predefined inclusion criteria—such as those addressing coordination mechanisms and published in English between 2020 and 2024—will be sourced from electronic databases (PubMed, EBSCO Host, Emerald Insight, and Google Scholar) and reputable gray literature. A narrative synthesis will be conducted for qualitative data, and, where feasible, meta-analysis will aggregate quantitative findings. Subgroup and sensitivity analyses will compare coordination outcomes between LMICs and high-income countries (HICs). Risk of bias will be assessed using CASP and ROBINS-I tools, and confidence in evidence will be evaluated using GRADE and CERQual frameworks.

ETHICS AND DISSEMINATION: As this review does not involve primary data collection, additional ethics approval is not required. However, the study has received ethical clearance from the University of KwaZulu-Natal and Kenya’s National Commission for Science, Technology & Innovation (NACOSTI). The protocol will be disseminated through open-access publications in peer-reviewed journals, presentations at international and regional conferences, and institutional platforms to engage policymakers, researchers, and public health practitioners.

STRENGTHS AND LIMITATIONS OF THIS STUDY

STRENGTHS:
• Adherence to PRISMA-P guidelines ensures methodological rigor and transparency in the review process.
• Comprehensive search strategy incorporates both peer-reviewed and gray literature, capturing diverse perspectives on multi-sectoral coordination during the COVID-19 pandemic.
• Use of standardized tools, such as CASP and ROBINS-I, enhances the reliability of risk of bias assessments across qualitative and non-randomized quantitative studies.
• Focus on LMICs, particularly Nairobi County, addresses a critical research gap and provides context-specific insights for global health research.
• Emphasis on actionable recommendations aims to engage policymakers, practitioners, and researchers in improving multi-sectoral coordination frameworks.

LIMITATIONS:
• Exclusion of non-English studies may omit relevant data from non-English-speaking regions, limiting the comprehensiveness of findings.
• Reliance on publicly available sources and databases may exclude unpublished or inaccessible studies, particularly from LMICs.
• Heterogeneity of study designs and methodologies may complicate data synthesis and limit the feasibility of quantitative meta-analysis.
• The study timeframe, constrained to research published between 2020 and 2024, may exclude emerging findings from newer studies.
• Variability in the quality of gray literature introduces potential bias, requiring careful evaluation and transparent reporting.