Table 2:

Quotes illustrating themes related to the diagnostic process and reaching a diagnosis (steps II and III in patient pathway)

Theme	Quote
II-A. Diagnostic procedures depend on patients’ economic means	“Normally in all private centers, we have more access to blood, ultrasound, and radiological tests, because the person who goes to a [private] clinic usually has the economic means to afford to afford it. So, we reach a diagnosis more easily because we ask for everything that is needed, they do all the tests, and the diagnosis is made quickly.” (Interview 17, Private provider who had diagnosed TB in past year)
	“The cost of the consultation is low and they make the most money with the laboratory. For example, with [facility name], I know of many patients I have seen with TB that have gone through [facility name] and they all come with spirometry and many expensive tests as well. And they did not do a smear because it was very cheap.” (Interview 1, Key informant from NGO)
II-B. Impact of insurance type on diagnosis	“If I were in a clinic that had everything, and the patient had an EPS [private insurance] that covers everything, I would order everything, from a sputum BK [smear microscopy] to a tomography scan. But we are talking about the poorest portion of the population, we have to think carefully about what we order for them because sometimes the patient does not have the means to pay for everything. [...] I take a good medical history and a physical exam, and if they have respiratory symptoms of a contagious disease such as tuberculosis, I order them to get a serial sputum BK - usually, because those are the cheapest, the sputum BK and a chest x-ray.” (Interview 10, Private provider who had diagnosed TB in past year)
II-C. Thorough consultation for a better diagnosis	“Ideally, they [healthcare providers] take their time to take a good medical history for the patient. If they achieve this, it’s already 80% - the diagnosis is 80% in the medical history. [...] They have to dig for things, and then they will find out what the problem is.” (Interview 2, Private provider who had diagnosed TB in past year)
II-D. Lack of TB training in the private sector	“Here, in this establishment, I have not received any training, neither for diagnosis nor for management of TB. I have been practicing here in the country since [date] 2020. [...] Until now, I have not had any training here, at least not with respect to TB.” (Interview 5, Private provider who had not diagnosed TB in past year)
III-A. Role of private sector in early TB detection	“Well, in our case as a country, as I mentioned, one of the main advantages that could be considered for their case is early detection. That is, the ability to detect or at least identify probable cases for quick referrals. I mean, in that they could contribute a lot.” (Interview 22, Key informant from Ministry of Health)
III-B. Duplication of diagnostic tests	“There may be requests for sputum smear tests to private laboratories, but we do not know if they are truly capable ofproviding that type of test. [...] It has always been considered that if diagnoses are made in the private sector, they must be validated because if they are not evaluated by the [National Health Institute] that gives a certain guarantee, we will not have the confidence in knowing that those diagnoses are truly what they are.” (Interview 22, Key informant from Ministry of Health)