Conference and Worshop Proceedings

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    Framing reproductive narratives
    (2026) Taqwim, SF; Xu, W; Kang, YH; Aweesha, H; Rashmi, R; Amani, PJ, et al.
    Childlessness is an increasingly visible phenomenon. Once predominantly associ ated with high-income settings, it now spans diverse cultural, economic, and political contexts, including the Global South. Among recent demographic shifts, childless ness has emerged as one of the most ideologically charged and widely debated topics in public discourse, particularly through media narratives. Although media are often overlooked in mainstream public health models, they play critical roles as structural and intermediary determinants of health - shaping issue framing, amplifying voices, and legitimizing solutions. Yet little is known about how childlessness is repre sented in global media, especially outside the Global North and in the post- pandemic era. This study analysed news media representations of childlessness from a public health perspective, drawing on 131 news articles from 101 outlets across 86 coun tries (2015–2025). Articles were identified through systematic keyword searches in English and 12 additional languages, screened for relevance, and analysed the matically using Braun and Clarke’s inductive method. Our approach was discourse- sensitive, drawing on a social constructionist lens and informed by framing theories and reproductive justice. Five themes were identified: The guinea pig of the state; Crazy rich selfish animal lovers; No baby, no cry; Bringing children into a broken world; and Winter regret and loneliness. These narratives operate across structural, intermediary, and individual levels, fulfilling four discursive functions: politicising, moralising, pathologising, and humanising. By examining how childlessness is prob lematized or legitimized, this study highlights the media’s role in shaping reproductive narratives, stigma, and health equity across diverse contexts
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    Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania
    (Frontiers Public Health, 2025-11-19) Shilugu,Lucas L.; Mushi, Lawrencia D.; Anasel, Mackfallen G.
    Tuberculosis (TB) remains the leading cause of morbidity and mortality among people living with HIV (PLHIV) in high-burden countries like Tanzania. Despite national and global guidelines recommending routine TB screening at every clinical encounter, missed and delayed TB case notifications persist, suggesting gaps in screening practices. This study evaluated the implementation fidelity of the TB screening algorithm and associated factors within routine HIV care in public health facilities in Geita, Tanzania. A facility-based cross-sectional study was conducted, involving the extraction of data from 423 client treatment records and observation of 423 screening sessions. Simple random and systematic sampling methods were employed to select the records and sessions, respectively. Descriptive and inferential analyses were performed using Excel and Stata. Modified Poisson regression with robust variance was used to estimate prevalence ratios (PRs) to determine factors associated with two binary outcomes: (1) consistent TB screening over 12-month period, and (2) correct utilization of the screening tool. TB screening was documented in 82.8% of clinical encounters. Overall, 70.7% of clients were screened at every encounter, and 75.4% screened at their most recent visit. Laboratory investigations were recorded in 94% of presumptive cases, with all confirmed TB cases initiated on treatment. Additionally, 80.6% of eligible clients were initiated on TB preventive therapy (TPT). The WHO Four-Symptom Screening (W4SS) was widely used (98.8%), and the tool was correctly administered in 62% of the sessions observed. Factors associated with inconsistent screening included age 40–49 years [Adjusted Prevalence Ratio (aPR) = 0.82; p = 0.046], age ≥50 years (aPR = 0.76; p = 0.025), suppressed viral load (aPR = 0.63; p < 0.001), monthly drug refill model (aPR = 0.55; p = 0.006), refill by treatment supporter (aPR = 0.09; p < 0.001), being traced back from a lost to follow up (aPR = 1.38; p = 0.019), and absence of prior TB (aPR = 0.81; p = 0.001). The correct use of the W4SS tool was less likely at PMTCT clinics (aPR = 0.55; p < 0.001). Although TB screening is widely integrated into HIV care, fidelity to the screening algorithm remains suboptimal in the initial stages of symptom screening. The completion of the algorithm cascade was well-implemented. Fidelity at earlier stages of the algorithm, such as the consistent and correct use of the W4SS, should be enhanced by strengthening provider capacity and routine monitoring to improve adherence to the protocol.