Despite significant global advancements, the past decade has seen stagnation in Maternal, Neonatal and Child Health (MNCH) service coverage and a concerning high under-five and maternal mortality rates, which have been worsened by COVID-19 pandemic-related disruptions, particularly in sub-Saharan Africa. This scoping review protocol will support the comprehensive mapping, evaluation and assessment of the application, impact, effectiveness and adaptability of health-resilient frameworks in maintaining these services during pandemics, while also identifying gaps in the literature and areas for further research.
Following the Joanna Briggs Institute guidelines, a literature search across databases such as PubMed, Scopus and African Journals Online for studies published from the inception of the databases to 2024 will be conducted. Covidence will facilitate the iterative screening process by two independent reviewers. Data extraction will employ the Population, Intervention, Comparison, Outcomes and Healthcare Contexts framework to categorise information. The thematic synthesis will integrate the findings to comprehensively evaluate the framework’s application, impact, effectiveness and adaptability in the context of routine immunisation and MNCH services.
This is part of a broader study approved by the evaluation committee of the Faculty of Health Sciences at the University of the Free State, and ethical clearance was granted by the university’s Human Research Ethics Committee with registration number UFS-HSD2025/0102/2705. The findings will be shared with relevant stakeholders through publications in peer-reviewed journals and presentations at meetings, conferences, seminars and professional forums.
Sepsis is a major cause of death both globally and in the United States. Early identification and treatment of sepsis are crucial for improving patient outcomes. International guidelines recommend hospital sepsis screening programmes, which are commonly implemented in the electronic health record (EHR) as an interruptive sepsis screening alert based on systemic inflammatory response syndrome (SIRS) criteria. Despite widespread use, it is unknown whether these sepsis screening and alert tools improve the delivery of high-quality sepsis care.
The Sepsis Electronic Prompting for Timely Intervention and Care (SEPTIC) master protocol will study two distinct populations in separate trials: emergency department (ED) patients (SEPTIC-ED) and inpatients (SEPTIC-IP). The SEPTIC trials are pragmatic, multicentre, blinded, randomised controlled trials, with equal allocation to compare four SIRS-based sepsis screening alert groups: no alerts (control), nurse alerts only, prescribing clinician alerts only, or nurse and prescribing clinician alerts. Randomisation will be at the patient level. SEPTIC will be performed at eight acute-care hospitals in the greater New York City area and enrol patients at least 18 years old. The primary outcome is the percentage of patients with completion of a modified Surviving Sepsis Campaign (SSC) hour-1 bundle within 3 hours of the first SIRS alert. Secondary outcomes include time from first alert to completion of a modified SSC hour-1 bundle, time from first alert to individual bundle component order and completion, intensive care unit (ICU) transfer, hospital discharge disposition, inpatient mortality at 90 days, positive blood cultures (bacteraemia), adverse antibiotic events, sepsis diagnoses and septic shock diagnoses.
Ethics approval was obtained from the Columbia University Institutional Review Board (IRB) serving as a single IRB. Results will be disseminated in peer-reviewed journal(s), scientific meeting(s) and via social media.
ClinicalTrials.gov: NCT06117605 and