A Systematic Review of Implementation Fidelity and Patient Satisfaction with the South African Triage Scale in District Emergency Units, Maputo Province

The South African Triage Scale (SATS) is a standardised tool for prioritising care in resource-limited emergency settings. Its implementation in district emergency units is a key component of health systems strengthening. In Maputo Province, understanding how faithfully SATS is applied and its relationship with patient perceptions remains a salient issue for service improvement. This systematic review aimed to synthesise existing evidence on the implementation fidelity of SATS in district emergency units within Maputo Province and to explore its reported association with patient satisfaction. A systematic literature review was conducted according to established guidelines. Multiple electronic databases were searched for relevant peer-reviewed and grey literature. Studies were screened against pre-defined inclusion criteria, and data from included studies were extracted and synthesised thematically. No primary empirical studies meeting the inclusion criteria were identified. Consequently, no direct empirical results on implementation fidelity or patient satisfaction with SATS in this specific setting can be reported. The findings underscore a significant evidence gap concerning the operational use and patient-centred outcomes of SATS in Maputo Province's district emergency units. A paucity of published research specifically evaluates the implementation fidelity of SATS and its correlation with patient satisfaction in the district emergency units of Maputo Province. This absence of evidence constrains the ability to assess the tool's operational effectiveness and its impact on patient experience in this context. Primary, context-specific research is required to evaluate the implementation process and outcomes of SATS in these settings. Future studies should employ robust methodologies to measure fidelity and incorporate patient-reported satisfaction metrics. Investment in local operational research capacity is also recommended. South African Triage Scale, implementation fidelity, patient satisfaction, emergency care, district health services, Mozambique, systematic review. This review identifies and delineates a critical gap in the literature, providing a necessary foundation and directing focus for future primary research on triage implementation and patient experience in district-level emergency care in Mozambique.