Organizing the tuberculosis care pathway to achieve comprehensiveness of care in health systems: a scoping review

Abstract Objective To identify strategies aimed at promoting comprehensiveness of care for people with tuberculosis (TB) in order to organize health systems through the TB Care Pathway. Method A scoping review aligned with the JBI Manual for Evidence Synthesis methodology and PRISMA-ScR recommendations, based on the research question: “How does the TB Care Pathway contribute to promoting comprehensiveness of care within the health care network?” The search strategy targeted studies mentioning any element of comprehensiveness of care. Primary studies and gray literature were included, with no restrictions regarding time period or methodological perspective. Duplicate or inaccessible studies, as well as those in languages that could not be translated, were excluded. Searches were conducted in five databases (Scopus, Web of Science, MEDLINE, LILACS, and Embase) and four gray literature sources (Google Scholar, WorldCat, CAPES, and BDTD) in June 2025. Two independent reviewers screened titles and abstracts in a blinded manner. Data extraction was performed after reading the publications in full, divided among four reviewers working independently, resulting in a narrative synthesis. Donabedian’s analytical framework and the construction of a logic model were used as the analytical design. Results A total of 2,119 publications were identified, 20 of which were included. The strategies identified in the studies were grouped inductively by a reviewer based on thematic proximity, resulting in seven variations: three categorized under the analytical dimension and four under the care delivery dimension. These were synthesized using the “Structure, Process, and Outcome” triad, with a Logic Model serving as the representation framework. Conclusion Based on expected long-term results, the complementary relationship between the analytical and care-delivery dimensions enabled the development of a Conceptual Model, a simplified graphic representation outlining the proposed organization of care for people with TB. As constructs of interest within the field of public health, the two proposed models describe the current state of knowledge regarding care organization and provide a foundation for modeling the TB care pathway, as well as for strengthening health care networks and improving the health system’s response to TB. The protocol for this review was registered in the Open Science Framework ( https://doi.org/10.17605/OSF.IO/S85HV ).