Process mapping in clinical healthcare settings in low-income and lower-middle-income countries: a scoping review

Objectives To examine the use of process mapping (PM) in clinical healthcare settings in low- and lower-middle-income countries (LLMICs). Methods A scoping review was conducted. Full-text empirical studies published from 2014 to 2024 were identified from MEDLINE, Embase, Web of Science, and CINAHL databases. Results Twenty-six articles were included. Deductive and inductive content analysis was performed. Applications have included process- and quality-improvement initiatives (n = 12), health system process analysis and assessment (n = 7), health systems tools design, implementation and evaluation (n = 4), and costing (n = 3). Observations, workshops and interviews were applied, with 65% using a single method (n = 17). PM was predominantly researcher-led (n = 17), with local healthcare workers participating in the majority of studies (n = 21); none involved patients. Gaps in reporting and documentation of PM activities were identified (n = 16). Conclusion PM demonstrated significant potential as a versatile and adaptable method for improving clinical processes. Future PM studies should adhere to reporting guidelines, promote locally led PM activities and incorporate diverse perspectives, particularly those of patients.