Table 1 Summary of measures and strategies identified in the included studies (n = 63)
Dimensions of social protection | Strategy or measure | Organizational and operational aspects | ||
|---|---|---|---|---|
Objective of strategies or measures | Conditionalities | Results and/or effects | ||
Proper nutrition and nourishment | - Increase adherence to TB treatment and DOT [20, 24, 29] - Reduce the severity of the disease and enhance the quality of life for people with TB [21] - Enhance TB treatment outcomes [20, 21, 25,26,27] and the nutritional status of people affected by TB [28, 30] - Alleviate the indirect costs of TB treatment [23] and the heightened vulnerability to food insecurity among families impacted by TB [24] | - Individuals with TB aged 18 years or older [21, 25, 29] or children aged 2 to 14 years [25] - Individuals with TB living below the poverty line [26], with low income, who have adhered to DOT [27] or conventional TB treatment [24] - Australian Aboriginal population [28] - Individuals with TB with some degree of malnutrition [23] - Individuals with TB who have a bank account [22] | Improved TB treatment outcomes and higher treatment completion rates [27, 29] | |
Monetary values for purchasing basic food baskets [20, 22, 25] Provision of food products [24] Weekly food baskets [28] | Increased rates of therapeutic treatment success and treatment follow-up losses [20] Significant weight and BMI gain among individuals with active TB [25] | |||
Enhancement of nutritional status and quality of life for individuals affected by TB [21] Decrease in treatment failure [26] | ||||
Nutritional counseling, vitamin supplementation (vitamin A and B6), and fortified/therapeutic foods [23] | Reduction in the lost to follow-up [23] | |||
Income | Specific Income Transfer Program for TB [31,32,33,34,35,36,37,38,39,40] | - Reduce the financial difficulties faced by people affected by TB and their family members [41, 53] - Achieve better success rates in TB treatment [32,33,34, 36, 38, 39, 53] and MDR-TB [40] - Increase adherence to TB treatment [31, 36, 51, 52] - Mitigate the direct and indirect catastrophic costs of TB treatment [31, 39, 52, 55] | - Individuals with drug-susceptible TB [31,32,33,34,35,36,37,38,39, 51, 52] - Individuals affected by antimicrobial-resistant TB [35, 39, 40, 53] - Family members of individuals with TB [54] and households with people with TB in situations of poverty [45, 55] - People affected by TB with a bank account [33] | Increase in the level of acceptance, motivation, and adherence to treatment [31] Improvement in treatment success for individuals with MDR-TB [40] |
Higher success rates in TB treatment and a lower rate of loss to follow-up in the group enrolled in the program, compared to the non-enrolled group [34] Better treatment progress in cases of individuals with MDR-TB [35] | ||||
Families of people affected by TB are less likely to incur catastrophic costs [37, 39] Success in TB treatment [38] | ||||
Sensitive Income Transfer Program for TB: | Better treatment outcomes in the group that was part of the BFP [41, 44, 50] In Brazilian municipalities with high BFP coverage, the TB incidence rate [46] and TB mortality rate [45] were significantly reduced compared to those with low and medium coverage Among the indigenous population, it was identified that the BFP had a protective effect against active TB [48] | |||
Better treatment outcomes among individuals with MDR-TB [51,52,53,54] Reduction in loss to follow-up [52] | ||||
Housing | Housing Provision Package [57] | Improving TB treatment outcomes among homeless individuals [57] | Homeless population with TB recruited through hospital outreach [57] | High treatment success rate [57] |
Health insurance | - Reduce the catastrophic costs incurred by people with MDR-TB [64] - Alleviate the financial burden among individuals affected by TB during treatment [58, 60, 62, 63] - Provide health protection against catastrophic diseases, such as TB [59] - Achieve equity in the utilization of health insurance schemes among both poor and non-poor people with TB [65] | - People with MDR-TB in the public and private sectors linked to the RNTCP [64, 65] - Individuals with TB and health insurance coverage [58] | Sharp decline in the severity of catastrophic costs during TB treatment [58, 60] Effective improvement in access to and utilization of inpatient and outpatient services for individuals with TB, as well as better adherence to medication across all income groups [62] and among low-income individuals [63] | |
Increased access of economically disadvantaged individuals with TB to public health services [65] Reduction in catastrophic costs [64] | ||||
Reimbursement of direct TB diagnostic costs [66] | Financial protection and enhanced detection of new TB cases [66] | |||
Expanded rights | Allocation of a larger proportion of the GNP to social protection programs [77] | - Increase treatment adherence [70, 74,75,76, 78, 80] and treatment success rates [75, 80] - Assist with the costs associated with disease treatment [72, 80] | - Minimum age of 15 years [67], or adults ≥ 18 years in initial assessment for TB [71] - New cases diagnosed with confirmed pulmonary TB based on clinical criteria [67], with DR-TB who received integrated support for a minimum of three months [73], or with MDR-TB [80] - Absence of a history of MDR-TB [67] - Receipt of at least one social benefit during TB treatment [67] - Situation of social and health vulnerability [70, 74], or at high risk of treatment loss to follow-up for TB [76] - Monitoring by municipal public primary health care services [67] | Reduction in TB incidence and mortality rates [77] |
Direct monetary benefits: BFP, retirement, sickness benefits, pension, and other financial aids [67, 69, 70, 79] | Higher proportion of cure among individuals receiving government and non-government benefits or only direct benefits [67] | |||
Indirect benefits: basic food baskets, free public transportation, discounted electricity tariff, housing programs, food acquisition programs, nutritional support, among others [67, 69, 70, 79] | ||||
Expanded set of rights: food, income, and transportation [76] | Higher treatment success rate in the beneficiary groups [76] Lower incidence of death and loss to follow-up [73] | |||