Methodology and scope of peer-reviewed evaluations of TB programmes in high-incidence settings: a scoping review

TB disease control programmes routinely report on basic performance indicators, such as case detection or treatment success. Structures, processes, and quality of care are also important. We assessed published TB programme evaluations with respect to these basic and wider system factors.We conducted a scoping review of English peer-reviewed literature. We included articles if they presented TB programme evaluations in high-TB-incidence settings. We extracted data across domains and indicators to describe scope and methodology across the TB programme wider system.The search yielded 885 articles, of which 57 were included. The majority (73.7%) did not use a systematic approach to indicator selection and 71.9% had unclear indicator definitions. Reports tended to be narrow in scope and focused on quality of care (89.5%), infrastructure and supplies (70.2%), human resources (70.2%), and outcomes/cascade of care (59.6%). Access to care (42.1%), engagement with community and patients (31.6%), knowledge and information (29.8%), leadership and governance (26.3%), and finances (26.3%) were infrequently evaluated.TB programme evaluations vary in methodology and reporting, and are limited in scope. A more strategic and systematic combined approach to operational research, external evaluation, and internal diagnostic control systems would be beneficial for TB programmes..