Mental health of people living in Afghanistan: protocol for a systematic review.

introductionAfghanistan has experienced decades of war, political instability, displacement, poverty and structural upheaval, all of which are likely to have contributed to the population's deteriorating mental health. Individual studies and reports describe depression, anxiety, trauma-related distress and a severe lack of access to care, especially among women. However, the evidence remains fragmented. There has been no recent synthesis of evidence on mental health conditions, determinants, coping strategies, services and interventions among people living in Afghanistan. This protocol describes a systematic review of the literature on the mental health of this population. METHODS AND ANALYSIS: This systematic review protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. The review will be conducted and reported in accordance with PRISMA 2020. MEDLINE, Embase, APA PsycINFO, Web of Science and WHO Global Index Medicus will be searched using subject headings and keywords related to Afghanistan and mental health, with searches updated before final analysis. Relevant grey literature will also be included. Eligible study designs include quantitative, qualitative and mixed-methods studies reporting mental health outcomes, determinants, coping strategies, access to mental healthcare or mental health interventions among people living in Afghanistan. No language restrictions will be applied. Title and abstract screening and full-text review will be conducted independently by two reviewers, with disagreements resolved through discussion or, if necessary, adjudicated by a third reviewer. Data will be extracted using a piloted structured template. Given the expected heterogeneity in study designs and outcome measures, quantitative findings will be reported as frequencies and qualitative data will be analysed using thematic approaches to support the synthesis. Where appropriate, findings will be grouped by population subgroup and study setting. Study quality will be appraised using the Mixed Methods Appraisal Tool. ETHICS AND DISSEMINATION: Ethical approval is not required for this study as it will involve the analysis of previously published literature and publicly available reports. The findings will be disseminated through peer-reviewed publication and conference presentations and may inform clinicians, researchers, humanitarian agencies and policymakers. PROSPERO REGISTRATION NUMBER: CRD420261403755.