Health system vulnerabilities during conflict: scoping review protocol

Protocol for a PRISMA-ScR and JBI-compliant scoping review mapping health-system vulnerabilities during armed conflict and fragile/conflict-affected settings (FCAS). The review adopts a Complex Adaptive Systems (CAS) lens to examine five recurrent vulnerability pathways (direct violence against health care, supply-chain/infrastructure collapse, workforce attrition, governance fragmentation, and transformed demand/access patterns). It synthesises global case evidence from major conflicts (Syria, Ukraine, Gaza, Sudan, Yemen, 2015–2026), documents attack patterns via WHO SSA and SHCC data, and provides focused analysis of India’s “inverted pyramid” structure with actionable recommendations for PHC/CHC strengthening and single-step point-of-care (POC) diagnostics. Expected outputs: full scoping review manuscript, evidence tables, and policy briefs for India’s MoHFW/NHM and global audiences. Full protocol document will be attached. Registration on OSF Registries for transparency and to prevent duplication. Completion timeline: March 2026.