Evidence map›Paper›PMID 40910864›Full record

ArticleGlobal health action2025

A discourse analysis of social inequities, gender, and stigma in tuberculosis policies of seven countries from Africa, Asia, Europe and South America.

Mariana Valdivino, Alethe de Vaulgrenant, Klasien Horstman, Yuliya Chorna, Ruby Stein, Jeremiah Chikovore, Amrita Daftary, Nora Engel

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Article in Global health action, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Mariana ValdivinoDepartment of Health, Ethics & Society, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Alethe de VaulgrenantDepartment of Health, Ethics & Society, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Klasien HorstmanDepartment of Health, Ethics & Society, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Yuliya ChornaSchool of Global Health and Dahdaleh Institute of Global Health Research, York University, Toronto, Canada.
Ruby SteinDepartment of Health, Ethics & Society, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Jeremiah ChikovorePublic Health, Societies and Belonging Division, Human Sciences Research Council, Durban, South Africa.ORCID 0000-0002-4910-6952
Amrita DaftarySchool of Global Health and Dahdaleh Institute of Global Health Research, York University, Toronto, Canada.ORCID 0000-0003-2275-3540
Nora EngelAthena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0002-1823-3908

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInterventions tackling the social aspects of tuberculosis (TB) are widely suggested, yet we miss insights into how policies incorporate these. The language and framing of policies to address TB can lend important insights into how these social drivers are perceived, problematized, and responded to.

objectiveTo understand how discourses in current TB policies frame social dimensions of TB, especially concepts of social inequity, gender, and stigma.

methodsWe conducted a comparative critical discourse analysis of twenty-one publicly available TB-related policies from Belarus, Brazil, Indonesia, Mozambique, Netherlands, Portugal, and Romania, countries with diverse epidemiological, geographical and sociopolitical contexts. Documents were sourced from public websites from May - September 2024. The Bacchi approach was used to analyze policy framings of social inequities, gender, and stigma.

resultWhile policies from Brazil and Indonesia showed greater attention to social inequities, gender, and stigma, and were more explicitly reflective of an equity-oriented and people-centered approach, overall, a dominant biomedical perspective was observed that individualizes responsibility for cure. This tends to disregard issues of social inequity, obscures gender relationships and the multiple dimensions of stigma. At the same time, allocation of individual as well as structural responsibility for TB risk and outcomes co-existed.

conclusionsExplicit and implicit discourses about TB within health-related policies can influence the nature of attention given to the social dimensions of TB and can shape corresponding responses to the disease. We recommend a participative policy process that includes a broader set of actors to ensure documents are responsive to social realities.

Indexed as

Health PolicySocial StigmaTuberculosisAfricaAsiaEuropeFemaleHumansMaleSex FactorsSouth Americadiscourse analysispolicy analysisqualitative methodssocial drivers of diseaseTB policy

Identifiers

PMID40910864
PMCPMC12416019

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.