TITLE: Scoping review protocol on the use of telephone in the implementation of citizen participation in the processes of developing health system strengthening reforms/policies in Sub-Saharan Africa (participation in decision-making)
AUTHORS: Wendkouni Adelphe Sabine OUEDRAOGO, Sandrine Biau-Lalanne, Emmanuel Bonnet, Valery Ridde

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Rationale
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							Accountability and empowerment of populations are two notions that are increasingly important in sustainable development policies implemented in sub-Saharan Africa. Faced with the strong social inequalities in health, the idea that the implementation of health democracy through citizen participation in the making of health reforms constitutes a sustainable way of strengthening health systems[1] has gained ground in recent years. Indeed, in the field of health, issues of citizen participation were developed early in the corpus of the Alma Ata declaration on primary health care of 1978 and the Ottawa Charter for Health Promotion of 1986.Citizen participation in health be " a condition for the effective exercise of democratic citizenship by everyone and in this case citizenship sanitaire "[2]. Campagné and al define it as " a political process of putting the power of actors in the field of public health under pressure from a perspective of democracy and social justice "[3]. Citizen participation can be a means, here we speak of participation-action[4]or an end in itself[5] here we speak of participation-empowerment[6]. Although citizen participation, as a means or an end, can contribute to reducing social inequalities in health, the question of mobilising people around the issue can be complex. In order to overcome this complexity of mobilising citizens in the implementation of their " capacitation " and empowerment in health matters, increasing use of information and communication technologies has been experimented with and is now seen as a reliable way of implementing citizen e-participation, particularly in sub-Saharan Africa. Information and communication technologies (ICTs), especially telephony in general, are strongly rooted in these countries and are strongly supported by the population[7].
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Review objectiveThe objective of this scoping review is to explore the scientific literature relating to the use of the fixed and mobile telephone for the implementation of citizen participation in the decision-making processes of reforms / policies to strengthen health systems[1] in sub-Saharan Africa.
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Search strategy
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Data selectionWe will focus our data search on scientific articles, exploratory and systematic reviews, books, and research reports on citizen participation in decision-making in health systems strengthening reform/policy development processes in sub-Saharan Africa. We will collect data on five electronic databases: Web of Science, Medline, PubMed, 1findr and Scopus. These bibliographic databases have been selected based on their areas of specialisation and their inclusion of studies focusing on public health/health law issues (i.e. specialised and generalist databases) and their accessibility and ease of use.The research equations considering each database's specific requirements  will be replayed every day and we will export (until mid-August) the data to Zotero. The keywords that will be used to construct the search equations are as follows:  ABCDEFG1Concept  ICT    Telephone    Citizen
  participation    Health
  Policy Making    Health
  system    Sub-Saharan
  Africa  2Keywords  NICT  Information and communication technology  New Technology                             MeSH Terms: information technologies    Mobile phone     Cellular phone     Fixed-line telephone                            Community participation     Social participation     Citizen engagement     e-participation                    MeSH terms: community participation     Health Regulation     Health legislation  Making                          MeSH Terms:   Health care reform    Health care system     Health facility     Health services                       MeSH terms: health care delivery       Angola OR Benin OR Botswana OR "Burkina
  Faso"&nbsp; OR Burundi&nbsp; OR "Cabo Verde"&nbsp; OR Cameroon OR "Central African
  Republic"&nbsp; OR Chad&nbsp; OR Comoros&nbsp;
  OR "democratic republic of the Congo"&nbsp; OR "ivory coast"&nbsp; OR "Equatorial Guinea"&nbsp; OR Eritrea&nbsp;
  OR Swaziland&nbsp; OR Ethiopia OR
  Gabon&nbsp; OR Gambia&nbsp; OR Ghana&nbsp;
  OR Guinea&nbsp; OR
  "Guinea-Bissau"&nbsp; OR
  Kenya&nbsp; OR Lesotho&nbsp; OR Liberia&nbsp;
  OR Madagascar&nbsp; OR Malawi&nbsp; OR Mali&nbsp;
  OR Mauritania&nbsp; OR Mauritius&nbsp; OR Mozambique&nbsp; OR Namibia&nbsp;
  OR Niger&nbsp; OR Nigeria&nbsp; OR Rwanda&nbsp;
  OR "Sao Tome"&nbsp; OR Senegal&nbsp; OR Seychelles&nbsp; OR "Sierra Leone"&nbsp; OR Somalia&nbsp;
  OR "South Africa"&nbsp; OR
  Sudan&nbsp; OR Tanzania&nbsp; OR Togo&nbsp;
  OR Uganda&nbsp; OR Zambia&nbsp; OR Zimbabwe
ABCDEFG1Concept  ICT    Telephone    Citizen
  participation    Health
  Policy Making    Health
  system    Sub-Saharan
  Africa  2Keywords  NICT  Information and communication technology  New Technology                             MeSH Terms: information technologies    Mobile phone     Cellular phone     Fixed-line telephone                            Community participation     Social participation     Citizen engagement     e-participation                    MeSH terms: community participation     Health Regulation     Health legislation  Making                          MeSH Terms:   Health care reform    Health care system     Health facility     Health services                       MeSH terms: health care delivery       Angola OR Benin OR Botswana OR "Burkina
  Faso"&nbsp; OR Burundi&nbsp; OR "Cabo Verde"&nbsp; OR Cameroon OR "Central African
  Republic"&nbsp; OR Chad&nbsp; OR Comoros&nbsp;
  OR "democratic republic of the Congo"&nbsp; OR "ivory coast"&nbsp; OR "Equatorial Guinea"&nbsp; OR Eritrea&nbsp;
  OR Swaziland&nbsp; OR Ethiopia OR
  Gabon&nbsp; OR Gambia&nbsp; OR Ghana&nbsp;
  OR Guinea&nbsp; OR
  "Guinea-Bissau"&nbsp; OR
  Kenya&nbsp; OR Lesotho&nbsp; OR Liberia&nbsp;
  OR Madagascar&nbsp; OR Malawi&nbsp; OR Mali&nbsp;
  OR Mauritania&nbsp; OR Mauritius&nbsp; OR Mozambique&nbsp; OR Namibia&nbsp;
  OR Niger&nbsp; OR Nigeria&nbsp; OR Rwanda&nbsp;
  OR "Sao Tome"&nbsp; OR Senegal&nbsp; OR Seychelles&nbsp; OR "Sierra Leone"&nbsp; OR Somalia&nbsp;
  OR "South Africa"&nbsp; OR
  Sudan&nbsp; OR Tanzania&nbsp; OR Togo&nbsp;
  OR Uganda&nbsp; OR Zambia&nbsp; OR Zimbabwe
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Inclusion and exclusion criteriaThe documents collected will be included if:-They are dealing with the use of telephony for the implementation of citizen participation in the decision-making process of health reform/health systems strengthening-They are focused on sub-Saharan Africa-They are in French or English-They are accessible and available in full PDF versionDocuments will be excluded if:-They are relating to the use of m-health/health for improving health coverage-They do not involve the use of telephony for the implementation of citizen participation in the decision-making process of health reform/system strengthening-They are not in English or French-They are not accessible or available in full PDF version
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Main results- Scope of scientific analyses on the use of fixed or mobile telephone in the implementation of citizen participation in the processes of developing reforms/policies for strengthening health systems in sub-Saharan Africa: number of studies and their distribution according to sub-Saharan sub-regional areas (South, Central, East, West Africa)- The type of citizen participation implemented by the selected documents: citizen participation as a means (participation-action) or as an end (participation-empowerment)- The consideration in the scientific literature of the contribution of citizen participation to the empowerment and the accountability of health system users and health service providers in the decision-making processes of health system reform/strengthening in sub-Saharan Africa.
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Data ExtractionData collected on Web of Science, PubMed, 1findr, Medline and Scopus and exported to Zotero will be imported into the Covidence systematic review application. The Covidence tool will automatically remove duplicates before two reviewers independently select the imported data on title and summary. Once the title and summary selection of included studies has been made, the reviewers will still independently make a selection after full reading. Irrelevant documents will be excluded.Data extraction will be done on the final documents included in the exploratory review. The MMAT grid will be used to describe the methodology of the included studies.The extracted data will include :- Characteristics of the study: title, author(s), year of publication, country of publication- The area covered by the study: West, Central, East or Southern Africa- Type of study: qualitative, quantitative, randomised trials, non-randomised trials, mixed studies- The main results of the study according to the type of citizen participation implemented (means or end in itself)- The theoretical and conceptual approaches used- Methodological limitations according to the authors- Operational recommendations
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Risk of Bias in the evaluationThe quality of the selected studies will be described using the Mixed Methods Appraisal Tool (MMAT).
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Strategy for data synthesisThe synthesis of the extracted data will be done under the guidance of the PRISMA ScR method. The criteria for data synthesis will be based on the number of studies that reported results relevant to the scoping review subject, i.e. the use of fixed or mobile telephone in the implementation of citizen participation in the processes of developing health system strengthening reforms/policies in sub-Saharan Africa. The results will be presented in a descriptive manner and will also be the subject of a thematic analysis.
?. [Bibliographie]
[1]Robert E, Rajan D, Koch K, et al.Policy dialogue as a collaborative tool for multistakeholder health governance: a scoping study. BMJ Global Health 2020;4:e002161.[2] Romero-Portier C. Les approches participatives. Mémoire de fin de cycle, EHESP 2019.[3] Campagné, et al. Enjeu démocratique de la participation en promotion de la santé. In E. Breton, F. Jabot, J. Pommier § W. Serlaw (Eds), la promotion de la santé. Comprendre pour agir dans le monde francophone (pp.331-362). 2017, Rennes : Presses de l’EHESP[4]According to the utilitarian view, here citizen participation constituting a simple tool in order to achieve results or ends distinct from a participation objective.[5]Participation-empowerment implies a sharing of power and control of decision-making power.[6]Scheen B. Promotion de la santé et démarches participatives : Décryptage et points d’attention. Woluwe-Saint-Lambert : RESO, 2018[7]"The number of smartphone connections in the sub-Saharan region reached 302 million in 2018. It will reach nearly 700 million by 2025, with an adoption rate of 66%" Tchemedie. « Selon la GSMA, il y aura près de 700 millions de connexions 3G en Afrique subsaharienne d’ici 2025 », Aout 2019.[8]Carman KL, Dardess P, Maurer M, et al.Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Affairs 2013;32:223–231.[9]Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med 2018;169:467. doi:10.7326/M18-0850[10]Pluye P. Mixed kinds of evidence: synthesis designs and critical appraisal for systematic mixed studies reviews including qualitative, quantitative and mixed methods studies. Evid Based Med 2015;20:79–79. doi:10.1136/ebmed-2014-110158[11]Traverson L, Mathevet I, Paes A, et al.Lessons learned from the resilience of public health systems, hospitals and their personnel to the COVID-19 pandemic: a scoping review protocol. Published Online First: 22 July 2020. doi:10.17504/protocols.io.birtkd6n