Introduction: In sub-Saharan Africa, the predominant model of individualized, one-on-one antenatal care has not significantly improved perinatal outcomes. Although the benefits of group antenatal care have been demonstrated in developed countries, its feasibility, acceptability, and effectiveness in resource limited settings, particularly in sub-Saharan African countries, have yet to be fully investigated. However, pilot studies show promising evidence of its effectiveness in these areas. This systematic review and meta-analysis will, therefore, review and summarize available studies and provide comprehensive and robust evidence that tends to contribute to the ongoing efforts to implement group prenatal care models in low-resource settings. Methods and analysis: This systematic review protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines. A comprehensive literature search will be conducted across multiple electronic databases, including PubMed/MEDLINE, Web of Science, EMBASE, and CINHAL, to identify pertinent articles published from January 1, 2016, to June 30, 2024. Experimental studies (pre-post, quasi-experimental study, cluster randomized controlled trial), prospective cohort design, prospective comparative study, and qualitative and mixed method designs will be included in the review. Abstract and full-text screening will be conducted by three reviewers using Covidence, according to the eligibility criteria set. The Joanna Briggs Institute (JBI) Critical Appraisal Tools, specifically designed for JBI Systematic Reviews, will be utilized to assess the methodological quality of the included studies. Statistical heterogeneity will be assessed using the Higgins test. Meta-analysis will be performed using R version 3.6.1 software and STATA version 16; applying random effects models to determine the weights. Pre-specified subgroup analysis and sensitivity analysis will be conducted as necessary. The study results will be reported sequentially, beginning with the primary outcomes, followed by secondary outcomes, and important subgroup analyses. Ethics and dissemination: Ethical approval is not applicable as no original data will be collected. The findings of this review will be disseminated through publication and conference presentations. PROSPERO registration number CRD42024565501 .

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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