Mapping Of Southeast Asian headache Infrastructure and Care (MOSAIC): A Scoping Review

The Mapping of Southeast Asian Headache Infrastructure and Care (MOSAIC) is a scoping review designed to systematically map the current landscape of headache disorders and headache care across the Association of Southeast Asian Nations (ASEAN) countries. Headache disorders, including migraine, tension-type headache, and medication-overuse headache, represent a substantial public health burden through their effects on disability, quality of life, productivity, healthcare utilization, and socioeconomic well-being. However, evidence regarding headache care in Southeast Asia remains fragmented, with substantial variation in epidemiological data, healthcare infrastructure, clinical services, treatment availability, workforce capacity, education, research activity, and health policy. The primary purpose of this project is to characterize the extent and nature of available evidence on headache disorders and headache care across ASEAN countries and to identify important gaps in the existing evidence. The review will examine headache care as a continuum, from population and clinical burden through health system capacity, clinical care, treatment access, workforce and education, and research, leadership, collaboration, and policy. The review will address seven predefined domains: (1) population burden, (2) clinical and societal burden, (3) health system capacity, (4) clinical care, (5) treatment access, (6) workforce and education, and (7) research, leadership, collaboration, and policy. These domains will allow the review to move beyond epidemiological estimates and provide a broader assessment of the capacity of healthcare systems across the region to respond to the burden of headache disorders. The review will include evidence concerning individuals and populations affected by headache disorders, including migraine, tension-type headache, medication-overuse headache, and other relevant primary or secondary headache disorders. Evidence from primary care, secondary and tertiary care, specialist headache services, community settings, and population-based studies will be considered. Relevant national and regional guidelines, policy documents, healthcare reports, educational initiatives, and other grey literature will also be included when they provide information relevant to headache care in ASEAN countries. The geographical context will include Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam. The review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews and will be reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Searches will be conducted in MEDLINE (PubMed), Embase, and Scopus, supplemented by Google Scholar, manual searches of key headache journals, reference-list screening, citation tracking, and searches of relevant grey literature from organizations such as the World Health Organization, WHO South-East Asia Regional Office, ministries of health, and national headache societies. Two reviewers will independently screen identified sources and assess full texts against predefined eligibility criteria, with disagreements resolved through consensus or consultation with a third reviewer. Data will be charted using a standardized extraction form developed according to the review questions and predefined domains. Extracted information will include study and population characteristics, headache disorder characteristics, geographical setting, study design, and findings relevant to the seven domains of headache care. As the primary purpose of the review is to map the extent, nature, and distribution of available evidence, formal critical appraisal of individual sources will not be undertaken. The findings will be synthesized descriptively using tables, numerical summaries where appropriate, an evidence map, and narrative synthesis. The evidence map will illustrate the distribution of available evidence across ASEAN countries and the predefined domains, while comparative summaries will highlight similarities, differences, and areas where evidence is limited or absent. Expected Outcomes 1. This project is expected to provide a comprehensive regional overview of the current state of headache disorders and headache care across ASEAN countries. Specifically, it aims to: Map the epidemiological and clinical burden of headache disorders across ASEAN countries. 2. Characterize healthcare system capacity, including the organization of headache services, specialist workforce, primary care pathways, and referral systems. 3. Describe the current implementation of evidence-based headache diagnosis and management across healthcare settings. 4. Identify the availability, accessibility, affordability, and reimbursement of headache treatments, including established and newer therapeutic options. 5. Assess workforce capacity and educational opportunities related to headache diagnosis and management. 6. Map headache-related research, professional leadership, collaboration, guidelines, and policy initiatives across the region. 7. Identify major evidence gaps and unmet needs that may require further investigation. 8. Generate priorities for future research, education, regional collaboration, healthcare development, and policy initiatives aimed at strengthening headache care in Southeast Asia. Ultimately, MOSAIC is intended to provide an evidence-based regional framework that can help clinicians, researchers, professional societies, healthcare systems, and policymakers understand the current landscape of headache care in ASEAN and identify opportunities for improving access to appropriate diagnosis, treatment, education, research, and coordinated regional initiatives.