The role of decentralized health systems in operationalizing data sovereignty of citizens and jurisdictions across governance levels: A scoping review protocol

The purpose of this scoping review is to systematically map and synthesize global evidence on how decentralized health systems operationalize data sovereignty for citizens, communities, and jurisdictions across multiple levels of governance. The review focuses on understanding how governance structures such as devolution, regionalization, federal and subnational arrangements, and community-led decision making shape the control, sharing, and stewardship of health data within decentralized health systems. The review aims to examine the mechanisms, models, and governance processes that influence data control and data sharing across health system levels, identify barriers and facilitators affecting implementation, and highlight evidence gaps that require further research. Particular attention is given to equity, participation, accountability, and contextual factors relevant to underserved, Indigenous, and low-resource settings. Expected outcomes include a comprehensive mapping of decentralization models and data sovereignty mechanisms, identification of enabling and constraining conditions affecting equitable data governance, and synthesis of lessons to inform policy development, future research, and the design of decentralized health systems that support accountable, participatory, and contextually grounded data governance.