Protocol: A Systematic Review of Multi-Sectoral Coordination during the COVID-19 Pandemic Practices, Challenges, and Recommendations for Future Preparedness

Introductionthe COVID-19 pandemic amplified the need for robust multi-sectoral coordination; yet the specific mechanisms, benefits, and challenges of such collaboration particularly in low-and middle-income countries (LMICs) remain poorly synthesised. ObjectiveTo identify the key elements, benefits, challenges, and improvement strategies of multi-sectoral coordination during COVID-19, with comparative insight between LMICs and high-income countries (HICs). Eligibility criteriaEmpirical studies (qualitative, quantitative, or mixed-methods) published in English between 1 January 2020 and 15 August 2024 that examine any coordination mechanism (e.g., task forces, public-private partnerships, inter-agency committees) related to COVID-19 response. Information sourcesPubMed, EBSCOhost, Emerald Insight, Google Scholar, and targeted grey-literature repositories will be searched; reference lists and citation chaining will supplement database queries. Risk-of-bias assessmentTwo reviewers will independently appraise qualitative studies with CASP and non-randomised quantitative studies with ROBINS-I; disagreements will be resolved by consensus or third-reviewer adjudication. Data synthesisOwing to the anticipated dominance of qualitative evidence, a CFIR-anchored framework synthesis will be conducted. Quantitative findings will be narratively summarised and, where outcomes are commensurate, explored for fixed-effect pooling. Subgroup analyses will contrast LMIC versus HIC contexts; sensitivity analyses will exclude studies at serious/critical risk of bias. Confidence in cumulative evidence will be graded with CERQual (qualitative) and GRADE (quantitative). Ethics and disseminationNo new human data will be collected; therefore additional REC approval is unnecessary. The overarching PhD project holds approvals from the University of KwaZulu-Natal (BREC/00007520/2024) and Kenyas NACOSTI (NACOSTI/P/24/37716). Results will be disseminated via open-access publication, conference presentation, and policy briefs to Nairobi County health stakeholders. Strengths and Limitations of This StudyO_LIComprehensive multi-database and gray-literature searching will minimise retrieval bias C_LIO_LITwo reviewers will independently screen, extract and appraise studies, enhancing methodological rigour. C_LIO_LIFramework synthesis mapped to the consolidated framework for implementation research (CFIR) domains provides a transparent, theory-driven structure for integrating heterogeneous qualitative evidence. C_LIO_LICASP and ROBINS-I instruments will standardise risk-of-bias assessment across qualitative and non-randomised quantitative studies. C_LIO_LILimitation: English-language restriction and the paucity of quantitative studies preclude meta-analysis and may introduce language bias. C_LI