Conceptualising patient pathways for neglected tropical diseases in sub-Saharan Africa: A systematic scoping review protocol

Neglected Tropical Diseases (NTDs) disproportionately impact the poorest and most marginalized populations, with 90% of the global NTD disease burden in sub-Saharan Africa. Providing care for NTDs requires ongoing engagement with the care continuum, yet there is a paucity of research on NTD patient pathways. Patient pathways are a framework to conceptualize how a person may seek and receive care for a specific health condition through the health system. Within patient pathways, referrals may be used to facilitate continuity of care between diagnosis and treatment. In low-resource, NTD-endemic settings in SSA, patient pathways for management of chronic infectious diseases may be fragmented, requiring continued engagement with overburdened, under-resourced, and insufficiently integrated primary care clinics as the first point of contact with the health system. As the global health agenda continues to emphasize Universal Health Coverage and systems-based solutions for global health inequity, it is important to understand how NTD care fits into the health system and develop health systems-informed, patient-centred perspectives of NTD care continuity. This systematic scoping review will synthesise evidence on patient pathways for managing NTDs in SSA to derive NTD patient pathways. By understanding the factors that facilitate NTD care continuity, this review will expand on prior research on barriers and enablers to NTD health-seeking and expose potential obstacles along the care continuum during NTD research and management in SSA to ultimately enable further research on NTDs.