We will use a scoping review approach to map out existing evidence on males’ health-seeking behavior and access to and uptake of health care services in Africa. This will enable us to identify aspects for tailored intervention to improve males’ health-seeking behavior. In conducting this review, we will apply the methodological approach and review process of the Joanna Briggs Institute (JBI) [18]. The JBI framework enables an extensive and less-biased synthesis of studies by using comprehensive and transparent methods [19]. The JBI framework synthesizes existing knowledge rather than creating new knowledge [20]. This yields decisions that reflect on the feasibility, appropriateness, meaningfulness, and effectiveness of health behavior [19,20] The Preferred Reporting Items for Systematic reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) guidelines [21,22] will be adhered to in reporting this scoping review. The PRISMA-ScR guidelines are congruent with the JBI approach for scoping reviews, which emphasizes the importance of methodological precision for scoping reviews. We believe that the PRISMA-ScR will improve the reporting of our scoping review [22]. According to the 5 main steps [18], we discuss our review process in the following sections.

The scoping review questions will be formulated according to the population, concept, and context (PCC) approach recommended by the JBI. The PCC framework is suitable when developing objectives and eligibility criteria for scoping reviews [23]. In our study, the PCC inclusion criteria will be useful to guide how the data should be extracted. There is no need for outcomes or interventions of interest to be identified for a scoping review [24] (Table 1).

Based on the PCC framework mentioned above, the research questions we will explore are outlined below:

We will systematically search PubMed, African Journals Online, Web of Science, Scopus, and Google Scholar. The search will include papers with publication years from 2010 to 2023 to better reflect more recent information and current health-seeking behavior among males across the African continent. In addition, government reports available on the websites of departments and ministries of health and associations will be reviewed with a focus on males’ access to health care services, knowledge, perceptions, and attitudes regarding health care services, as well as barriers and facilitators to uptake of health services by males. This will help us to identify reports related to males’ health-seeking behavior in Africa.

The search strategy will include titles, abstracts, and combinations of keywords, as presented in Multimedia Appendix 1 and Multimedia Appendix 2.

After collection of study data from the aforementioned bibliographic databases, 3 reviewers will conduct the review; 2 will perform data selection and database searching and the third will perform quality checking and resolve inclusion and exclusion disagreements between the 2 primary reviewers. The 2 primary reviewers will independently use the inclusion and exclusion criteria to search the titles and abstracts, and they will document reasons for inclusion and exclusion as outlined below. Any discrepancies will be discussed and resolved between these 2 reviewers, but if no conclusion can be reached, the third reviewer will be included in the discussion. Furthermore, the reviewers will independently source full-text versions of articles found to be eligible during the title and abstract screening phase. They will exclude articles without full-text versions available after a conclusive discussion regarding the excluded articles is reached. The searched articles will include male-related studies and include qualitative, quantitative, and mixed methods interventions for males’ health, knowledge, attitudes, and perceptions regarding health services for males, as well as access and challenges to use of health care services. Overall, this scoping review will include material that fulfill the criteria outlined in Tables 1 and 2. The exclusion criteria entail studies not conducted in Africa; not including males’ health care service access and uptake or health-seeking behavior; and those conducted prior to 2010.

Data from the identified eligible studies will be collected and charted. Reviewers will record key themes from each eligible article. The themes will include author, journal, publication status, study duration, year, and demographic information (age, ethnicity, marital/relationship status, employment, residential location [rural or urban], income, and education level), geographical information (country and region in which the study was done), research methodology, and findings included in the synthesis (study design, health-seeking behavior, access, uptake, intervention, main results and outcome, limitations, and other important discoveries; Textbox 1). Microsoft Excel, EndNote, and Rayyan will be used in obtaining the data, saving the search, cleaning the data, screening the data, and charting the data for this scoping review.

A qualitative and quantitative approach will be used to report and summarize the scoping review. The number and type of eligible studies will be reported numerically, and methods, results, health care services, program, and health-seeking behavior information will be described in a narrative form. Tables and charts will be used to map out the screening process and results. Discussion will be guided by developed themes and study objectives and will include definitions of keywords. The risk of bias will not be assessed, as the scoping review is meant to provide an overview of existing literature about health-seeking behavior of African males and not critically analyze or appraise the selected articles; the limitations of the studies will be noted. Secondary analyses will be performed looking at health-seeking behavior and challenges, knowledge, and stigma regarding access to and uptake of health care services among boys and the transgender population. Analyses will also compare males’ health-seeking behavior and service access and use across different regions.

We expect to substantiate that the burden of disease in males compared to females is high for a plethora of reasons, such as availability of context-specific health care services for males, access by males to health care, and the socioeconomic position of households. Moreover, available evidence has shown that male health-seeking behavior is often delayed, and the uptake of health care services is poor due to barriers such as cultural beliefs, perceptions of masculinity, stigma, gaps in health knowledge, and social and economic factors [25,26]. Based on the limited number of published articles on males’ access to and uptake of health care services, especially in Africa, and observations on trends in the proportions by sex of outpatients (ie, there are more females than males) seeking care in primary health care centers [27-30], there is a need for male health care to be taken into consideration. Facilitators like community-based interventions, male-targeted programs, and peer support have been shown to improve male engagement with health care [26]. To our knowledge, this scoping review is the first on this topic, and it will identify key themes and gaps regarding the barriers to and facilitators of African males’ health care access and uptake. The scoping review will summarize and discuss our findings, including challenges and facilitators of health care service access and uptake and health-seeking behavior among African males. The results may form the basis for future qualitative research on exploring the health-seeking behavior of African males, quantitative research on barriers to and facilitators of access to and uptake of health care services, implementation research on intervention programs to influence African males to access and use health care services voluntarily, or systematic reviews of programs for working African males to access health care and support systems and increase their health care–seeking behavior. The results may also help policy makers to develop programs and interventions specifically tailored for the needs of males through males’ input. The literature synthesis will support the development of evidence-based practices that will address challenges related to males’ access to health care services, enhance their health care knowledge, and promote intervention programs to improve uptake, which may result in a decreased burden of disease and mortality rate among males. We expect our main findings to provide insights into what geography-specific health services are available across the African region, as well as provide the latest evidence on the extent of access and uptake, including contributing factors. The results of this scoping review will be disseminated through scientific conference proceedings and presentations, stakeholder meetings, and by publication in a peer-reviewed journal. During the dissemination of findings, stakeholders will be invited to discuss gaps and challenges affecting males’ health-seeking behavior and the uptake of health care services to develop context-specific strategies that can be implemented to address the identified gaps and challenges. The dissemination report will also include recommendations for future research, review limitations, and discuss the risk of bias.

Through this scoping review, we intend to provide a range of information about the health-seeking behavior of males, including their access to and use of health services. However, as we will limit our search to include only published works written in English and implemented in Africa, we are likely to inadvertently exclude relevant programs, thereby skewing the comprehensiveness of the review. Constraints related to the publication type, language, and geographic region will restrict the diversity of the included sources, limiting its applicability across various contexts. Our search strategy did not use the built-in search functionalities of the relevant electronic databases, such as Medical Subject Headings terms for PubMed. Our search strategy might have increased the risk of missing literature. To mitigate this, we constructed a wide range of search terms to ensure a wider reach.