The distribution of work-related musculoskeletal disorders among nurses in sub-Saharan Africa: a scoping review protocol
Authors: Kgakge Kagiso , Hlongwa Mbuzeleni , Ginindza Themba 
Published: August 2021

Abstract
Background
Although measures have been put in place, musculoskeletal injuries are noticeable high among the nursing fraternity with low back pain (LBP) being the most prevalent. It is evident that healthcare professionals are in constant exposure to occupational hazards such as musculoskeletal injuries as they discharge their professional duties. Not only does LBP affect the health of the nurses, it also creates a huge burden on the health systems with consequent poor performance at the workplace as well as economic burden. Therefore, the main objective of this study is to map evidence on the prevalence, incidence, mortality, risk factors, and economic costs of musculoskeletal disorders (MSD) in sub-Saharan Africa (SSA). This is a scoping review because we want to map the evidence of MSD among nurses in SSA and to identify the scope of body literature in which the findings will be used for planning the intervention study thereafter.

Methods and analysis
Scoping review will be done to explore, describe, and map literature on the prevalence, incidence, mortality, risk factors, and economic costs related to MSD among nurses in SSA. The search will be done using databases such as PubMed, EBSCOHOST, Scopus, Web of Science, Science direct, Sabinet, WorldCat Local (iCatalogue), MEDLINE, CINAHL, Google Scholar, nursing academic editions, and World Health Organization (WHO) library databases. The search will look for primary studies within peer-reviewed articles as well as gray literature. In addition, the researcher will search for articles using keywords from the included studies as well as the list of references for related studies. The screening will be guided by Arksey and O’Malley’s framework which has five steps to be followed: (I) identifying the research question, (II) identifying relevant studies, (III) study selection, (IV) charting the data, and (V) collating, summarizing, and reporting the results, and the scoping review will be reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. A thematic content analysis will be used to give the narrative account of the review; using NVivo version 11 software, two independent reviewers will follow the three stages outlined by the thematic synthesis theory: (a) coding the findings of the included studies line-by-line, (b) organizing these free codes into related areas to construct descriptive themes, and (c) developing analytical themes. The outcome of coding will be verified and discussed with a third reviewer. The process of cross-checking the outcomes of coding of each included article will be discussed thoroughly.

Discussion
At the end, this study anticipates to uncover the relevant literature in SSA in regard to the prevalence, incidence, mortality, risk factors, and economic costs related to MSD among nurses; furthermore, findings from this study will help in identifying research gaps; informing policy, priority in funding, and planning; and guiding future research.