Gender-transformative health promotion interventions for linking and retaining tuberculosis diagnosed adult men in care in sub-Saharan Africa: A scoping review protocol

Background Tuberculosis (TB) remains one of the leading causes of morbidity and mortality globally, with men disproportionately affected. In sub-Saharan Africa (SSA), gender disparities in TB care engagement persist, as adult men are less likely to link to care, initiate treatment, or remain engaged in care. Social and structural determinants particularly gender norms and masculinities, play a critical role in shaping men's health-seeking behaviours. Despite global commitments to gender equity in health, TB programs often remain gender-blind or neutral, with limited implementation of gender-transformative health promotion interventions. Purpose of the scoping This scoping review aims to map existing evidence on gender-transformative and health promotion interventions designed to strengthen linkage to and retention in care adult men diagnosed with TB in SSA. Subsequently, the central research question guiding this review is: What evidence exists on gender-transformative and health promotion interventions aimed at strengthening the linkage to and retention in care of adult men diagnosed with TB in sub-Saharan Africa? Methods The review will follow Arksey and O’Malley’s five-stage scoping review framework. A systematic search will be conducted across multiple databases, including PubMed, Web of Science, MEDLINE, PsychINFO, and grey literature sources. Studies published between 2015 and 2024 in English, focusing on adult men (≥18 years) diagnosed with TB in SSA, will be included. Data will be charted and analyzed using a narrative synthesis approach. Quality appraisal will be performed using the Mixed Methods Appraisal Tool (MMAT) 2018. Discussion The review will provide an overview of existing gender-transformative and health promotion interventions targeting men diagnosed with TB in SSA. It will summarize the core components, delivery mechanisms, and implementation settings of these interventions, and identify opportunities for future research, policy development, and practice improvement. This review will contribute to the evidence base for designing inclusive and gender-responsive TB programs in SSA. It aims to inform the co-development of a context-specific intervention framework to improve linkage to and retention of men diagnosed with TB in care, thereby supporting the goals of the End TB Strategy. Registration: Open Science Framework. https://doi.org/10.17605/OSF.IO/RNF2T Keywords: Tuberculosis, gender-transformative interventions, men’s health, linkage to care, retention in care, health promotion, sub-Saharan Africa, scoping review.