Climate resilience and sustainable Anaesthesia practice in African health systems: A systematic review protocol

Objective: To systematically identify, appraise, and synthesize evidence on (i) climate change impacts on anaesthesia services in sub-Saharan Africa, (ii) the environmental footprint of perioperative practice, and (iii) the effectiveness of resilience and sustainability interventions in African health systems.
Methods: This protocol follows PRISMA-P 2015. MEDLINE, Embase, Global Health, and African Index Medicus will be searched from inception to March 2025. Two independent reviewers will screen, extract data, and assess bias using ROBINS-I, RoB 2.0, and AGREE II. Synthesis will follow SWiM, with GRADE certainty assessment.
Anticipated Results: We anticipate identifying a limited but growing body of evidence on climate-anaesthesia interactions in Africa, with substantial heterogeneity precluding meta-analysis. The review will map available evidence, identify adaptation strategies, and highlight critical research gaps.
Conclusion: This systematic review will provide the first comprehensive mapping of Africa-specific evidence on climate change, anaesthesia, and health system resilience, informing locally relevant sustainability guidelines and national adaptation plans.