The impact of social protection interventions on treatment and socioeconomic outcomes of tuberculosis-affected people and households in low income, high burden settings: A systematic review and meta-analysis

Tuberculosis (TB) is the leading cause of death due to infectious disease worldwide. Social protection interventions can benefit TB-affected households. We conducted a systematic review and meta-analysis to quantify the effectiveness of social protection on TB treatment and socioeconomic outcomes. We identified articles published from January 2012 to December 2025 by searching PubMed (includes MEDLINE), Embase, and Web of Science. We included studies that described at least one social protection intervention and reported on either TB treatment or socioeconomic outcomes for people with TB or TB-affected households. Random-effects meta-analysis was used for our primary outcome of interest, TB treatment success (treatment completion or cure). We performed a meta-regression to evaluate the association of study characteristics with odds of TB treatment success. Risk of bias was assessed using the Newcastle Ottawa Scale and the Cochrane Risk of Bias tool. This review was registered prospectively in the PROSPERO database (registration number CRD42022382181). Our search generated 55,975 articles. Of the 55 which were eligible for inclusion, 41 reported TB treatment outcomes, 8 reported on socioeconomic outcomes, and two studies reported both TB treatment and socioeconomic outcomes. Random-effects meta-analysis of 26 articles found that people with TB who received social protection interventions during treatment had 2.15 times the odds of TB treatment success (95% CI 1.76, 2.64, I2 94.5%). Subgroup analysis indicated that whether a social protection intervention was TB sensitive or TB specific was a significant source of heterogeneity, although both increased the odds of TB treatment success. Both TB sensitive and TB specific social protection interventions significantly improve odds of TB treatment success. Outcomes and definitions used in our study have the potential to guide further research and implementation of social protection for TB-affected populations.