ABSTRACT Introduction: In sub-Saharan Africa, most people pay for healthcare directly out-of-pocket (OOP). This makes it harder for countries in the region to achieve Universal Health Coverage (UHC), as many people cannot afford care, resulting in poor health, and some people being pushed deeper into poverty due to the high cost of care. To reduce this burden and move closer to UHC, many African countries have introduced health insurance to raise funds for healthcare and reduce direct OOP spending. To make the health insurance more effective, it is important to understand how willing people are to pay for health insurance, how much can be raised relative to GDP, and what factors influence their willingness to pay (WTP). This information can help shape health financing policies in the region. Methods and Analysis: A systematic search will be conducted using PubMed, Google Scholar, Science Direct, relevant references from selected studies and grey literature that would be identified from the databases searched. The search will cover all available studies that focus on WTP for health insurance in sub-Saharan Africa from inception to 31st May 2025. Key outcomes will include the percentage of people willing to pay, amount to be raised relative to GDP per capita, and the factors that frequently influence WTP. Each study will be carefully reviewed using the STROBE (strengthening the reporting of observational studies in Epidemiology) tool for quality, and the results will be combined and analysed using quantitative methods. Ethics and Dissemination: Since this is a systematic review that does not involve recruiting or studying people directly, ethics approval is not required. The findings will be disseminated through conferences, symposia, and published in a peer-reviewed journal. They will also be shared with policymakers and the general public interested in health financing. PROSPERO registration number: CRD420251027763

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

It is a systematic review that does not involve recruiting or studying people directly.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present work are contained in the manuscript