The health consequences of the current urbanisation and industrialisation in Africa are being aggravated by the climate crisis. Meanwhile, the population of sub-Saharan Africa (SSA) is likely to double between 2022 and 2050, accounting for more than half of the global population growth.1 Furthermore, about 57% of the global population is expected to be living in urban areas by this time.1 This rapid urbanisation in SSA will lead to a myriad of challenges that will significantly impact the health of people living in the subregion.2 3 The rapid expansion of cities in the region and the increase in industrialisation are leading to remarkable changes in landscape, a situation that threatens the existence of natural elements vital for human health.4–6 Increasing climate change events, including heat waves, are also likely to exacerbate the health consequences for the urban dwellers.7 As a result of this, the importance of urban green spaces and their potential positive impacts on population health is receiving substantial interest.8 9

Urban greening is an improvement or increase of green spaces in cities.10 Urban green spaces contribute to sustainable biodiversity conservation by providing a livable area for plants and animals, including human beings.11 Green spaces, including parks, gardens and other natural areas located in urban environments, are popular worldwide for their complex but positive impacts on the physical, mental and social health of the population.12–15 The different socioeconomic conditions across SSA and the varying patterns of urban planning contribute to the intricate interplay of factors that impact access and utilisation of these green spaces by the population.16 17 The rationale for the usage of urban green spaces varies with people using such spaces for diverse purposes, such as exercise and physical activity,18 relaxation and stress reduction,19 experiencing nature20 and seeking a serene environment for restorative effects.21

Urban green space is typically considered a strategic public health intervention,22 with benefits, such as improved physical activity levels,18 23 improved health outcomes,14 22 food production,24 25 climate change mitigation,26 27 better air quality,28 29 conservation of natural habitats30 31 and opportunities for recreation and education.32 33 However, it is unclear whether these benefits that have been discovered and well documented in other parts of the world34–36 are being realised to a large degree in SSA, at a time when climate change is driving the occurrence of frequent heatwaves.37

As one of the most diverse regions in terms of cultures, ecosystems and urban settings,38 SSA provides a unique setting to investigate the link between urban greenness and population health outcomes. In SSA, where the burden of communicable and non-communicable diseases is already high,39 40 and the devastations of heat waves are increasing,41 understanding the potential of green spaces as catalysts for good health outcomes is critical.40 42 In SSA, the significance of green spaces is emphasised in the context of ecological threats, health issues and social problems.17 43 As temperatures rise beyond the normal ranges and heat waves become a frequent occurrence due to climate change, the region has also become vulnerable to heat-related illnesses and complications, such as heat oedema, heat cramps, heat syncope, heat tetany, heat rash, heat exhaustion and heat stroke.44 Moreover, rapid urban development and industrialisation have increased pollution levels, threatening the health of the people and reducing the quality of living environments.45 46 Also, urban expansion and mechanised agriculture have led to a sharp increase in deforestation, resulting in environmental degradation, loss of habitats and biodiversity erosion.47 These factors, through air pollution, poor nutrition and increased stress, predispose the population in SSA to non-communicable diseases, such as chronic respiratory disease, stroke and cardiovascular diseases,48 49 as well as communicable diseases, such as malaria, diarrhoea, dengue fever, Lassa fever, pneumonia and measles.50

Urban green-space dynamics and their impacts on population health in SSA are still understudied. This necessitates an in-depth review of the existing literature to provide evidence-based insights. This will provide guidance for policy decisions, urban planning initiatives and other public health interventions to improve the quality of life for SSA populations amidst rapid urbanisation, industrialisation and increasing heat waves. This scoping review aims to synthesise the available literature and identify knowledge gaps on the availability and utilisation of urban green spaces in SSA. The review also identifies factors affecting the utilisation of urban green spaces in SSA and assesses the impact of urban greenness on the health of the SSA population.

This scoping review will adhere to the updated JBI framework for conducting scoping reviews.51 The framework recommends identifying and stating research questions, identifying studies pertinent to the topic, selecting these studies, collecting and charting of data and the summary and synthesis of collected data.51 This scoping review is registered with the Open Science Framework registry (osf.io/nfh68). The authors confirm that no such study had been registered at the time they registered this study.

The approach will further build on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Extension for Scoping Reviews (PRISMA-ScR).52 The review will be guided by the following three research questions: (1) what is the level of availability and utilisation of urban green spaces in SSA? (2) what factors affect the utilisation of urban green spaces in SSA? (3) what are the health impacts of utilisation of the available urban green spaces among the population in SSA? We have consulted an Associate Professor in urban planning in finalising the research questions.

A systematic search will be carried out in five major databases, namely PubMed, JSTOR, SCOPUS (via Elsevier), MEDLINE (via PubMed) and Green FILE (via EBSCO). These databases are selected based on their broad scope in reporting relationships between environmental factors and health. A search will be carried out using medical subject headings and controlled vocabularies in PubMed. These search terms will then be modified and used in the other databases (refer to online supplemental file 1 for details). Further searches will be done in Google and Google Scholar to elicit grey literature, including preprints, theses and dissertations, conference proceedings, policy documents and government reports. Furthermore, the reference lists of the eligible full-text records will be searched for additional relevant articles. The search has already begun and is expected to end on 10 October 2024, covering the period up to 2024. There is no low-level time filter applied because it is believed that evidence on the impact of green spaces on health has been available for a long time. We are consulting a chartered librarian at the Sam Jonah Library at the University of Cape Coast throughout the search process. The search strategy, inclusion and exclusion criteria are presented in table 1.

This scoping review will include all articles that studied the interaction between urban green spaces and population health within the SSA region. The eligibility criteria will include the following: (1) original studies reporting primary data; (2) grey literature from preprints, theses and dissertations, conference proceedings, policy documents and government reports; (3) studies that explored the relationship between urban greening or urban green spaces and population health; (4) studies conducted in SSA; (5) full-text reports published in the English language; (6) records found online. Studies will be excluded if they do not focus on urban greening and health of the population in SSA.

Titles and abstracts screening will be done by three authors independently to select relevant records for full-text assessment. This will be done after duplicate records have been merged using the Mendeley software. The full-text records obtained will be compared against the eligibility criteria to ensure that the relevant records are chosen for the scoping review. Additionally, the reference lists of the selected full-text records will be searched to obtain further records relevant to the eligibility criteria. Disagreement in the screening processes would be resolved by EWA, who is a subject matter expert and supervising author. The process of searching and screening is shown in figure 1.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. This figure illustrates the stages of study selection, beginning from the identification of records through to the inclusion of studies in the review. The identification stage involves records being sourced from the database searches, with the screening stage involving the removal of duplicates as well as screening the records for title and abstract relevancy. Subsequently, full-text articles are assessed for eligibility, with articles not meeting the inclusion criteria excluded. Finally, studies that meet the eligibility criteria are included in the final review.

Three coauthors (EOA, PS and HKA) will perform the data extraction independently, while two other authors (JA and AEB) will review the extracted data. The charting and extraction of the data will be based on the name of author(s), year of publication, publishing journals or outlets, study design, study location, countries of first, corresponding and last authors, data sources, population, sampling method, sample size, definition of green spaces, health outcomes and challenges associated with using available green spaces. A predesigned data extraction form will be used to facilitate the data charting. This seeks to comprehensively extract data covering the availability, access and utilisation of urban green spaces, the factors affecting the utilisation of green spaces in SSA and the impact of urban green spaces on population health. To ensure data accuracy and completeness, we will continuously consult an urban planning professional and a health geographer in extracting the relevant data for this scoping review.

The synthesis and analysis of the data for this scoping review will be done using a structured method to sort, group and analyse the extracted data. A narrative synthesis and a thematic analysis will be performed according to the research questions.

Narrative synthesis will be done by identifying, evaluating, describing and discussing the differences among the various selected studies based on the location, population, socioeconomic status, definition of green spaces, specific health impacts, and general and specific health outcomes. This method will help contextualise the findings within the broader literature, helping to assess and synthesise both qualitative and quantitative evidence.53–55

Thematic analysis will be used to code the data and organise it into recurring themes, patterns and trends in the literature.56 57 This will cover the availability of urban green spaces, the utilisation of urban green spaces, the factors that influence the utilisation of urban green spaces and the impact of these factors on the health of the urban population in SSA.

The synthesis and analysis procedure will facilitate a comprehensive representation of evidence on the impact of urban greening on population health in urban SSA. Finally, based on the findings of the review, recommendations will be made for future research, policy development and evidence-based green-space interventions.

There will be no patient or public involvement in the design, conduct, reporting or dissemination of this study.

The rapid population growth and urbanisation trends pose substantial problems for people living in SSA.2 3 Urbanisation and industrialisation threaten to deplete the natural elements essential for population health.4–6 Aggravating these challenges are the increasing heat waves with their attendant public health consequences.7 44 Amid these challenges, the concept of urban greening becomes an important adaptation strategy to prevent or reduce the impacts of these challenges on population health and enhance the quality of life for urban dwellers in SSA.8 9 However, there is currently no comprehensive body of evidence clearly outlining the degree to which urban green spaces influence the health of populations across SSA within the context of a rapidly changing climate, necessitating this scoping review.

This scoping review will follow a systematic approach in data collection, assessment of available evidence and summarise findings that will shed more light on the role of urban greening in SSA, with respect to its effect on population health. The review will be done based on the JBI framework, with the reporting of the findings guided by the PRISMA-ScR to ensure a thorough and rigorous assessment of the current level of knowledge on the topic. The research questions directing this scoping review probe into the vital aspects of urban greening and its effects on the health of the urban population in SSA. These vital aspects include the availability, access and uptake of urban green spaces, determinants of their utilisation and the health effects generated by the use of these spaces.

Through a thorough search strategy utilising the relevant databases and grey literature sources, this review seeks to comprehensively answer these pertinent questions. The inclusion criteria of this study have been designed to ensure that all studies on the topic are identified. The focus on peer-reviewed original studies and grey literature sources provides an all-inclusive evidence on the topic in current literature. The data will be charted and extracted based on a criteria that will ensure that the data extracted answers the research questions relevant to this review. Synthesis and analysis will be done thematically to summarise and report varying findings across the studies identified. The findings of this scoping review hold promise for serving as a basis for formulating evidence-based green-space-related policies and interventions to promote the health of the urban population in SSA.