To examine trends and factors associated with isoniazid preventive therapy (IPT) initiation among people living with HIV (PLHIV) aged ≥15 years who initiated antiretroviral therapy (ART) in mainland Tanzania between 2015 and 2020.

A retrospective observational study using routinely collected data. Multilevel logistic regression analysis was used to identify factors associated with IPT initiation.

HIV care and treatment clinics across mainland Tanzania.

The study included PLHIV aged ≥15 years who initiated ART between 2015 and 2020.

The primary outcome was IPT initiation among eligible PLHIV. Secondary outcomes included trends in IPT initiation from 2015 to 2020 and factors associated with IPT initiation.

Among 124 846 PLHIV (mean age 35.8±11.40 years), cumulative IPT initiation was 59.8% (10.50% at first visit; 21.70% within 3 months). Initiation trend increased from 52.70% in 2015 to 68.30% in 2020 (2.05, p

Although IPT initiation among PLHIV in mainland Tanzania improved between 2015 and 2020, coverage remained suboptimal. Strengthened efforts are needed to ensure all PLHIV initiating ART are appropriately screened for tuberculosis (TB), initiated on IPT if eligible and promptly treated if diagnosed with active TB.

Premature birth is the leading cause of neonatal morbidity and mortality. Understanding perceptions, beliefs and attitudes towards preterm births, and how these factors influence care provision at health facilities and at home is crucial for improving preterm newborns’ health outcomes.

We conducted an exploratory qualitative study at Batu and Meki communities in the East Shewa Zone of Oromia Region, Ethiopia. We conducted in-depth interviews (n=81) and focus group discussions (n=8) using semistructured guides. The study participants included women who had preterm births, family members, community members, healthcare workers and expert stakeholders. We audio-recorded, transcribed the interviews and coded the transcripts. We employed the socioecological model to present perceptions, beliefs and attitudes towards preterm birth at individual, interpersonal, organisational and societal levels.

Giving birth to a preterm newborn is often associated with fear, stress, unhappiness, concern and worry. At the individual level, preterm newborns’ mothers often feel guilt and self-blame. Families tend to keep preterm birth a secret due to perceptions of ‘incompleteness’. At the interpersonal level, preterm newborns are often stigmatised and families are disappointed by mothers who give birth prematurely. However, some believe that preterm newborns are accepted within the community. At the organisational level, healthcare providers find the causes of preterm birth unpredictable, they do not consider preterm births prevalent, and consider some of them as abortion. There is also a common belief that preterm infants have a low survival rate, leading to the deprioritisation of their care. At the societal level, some believe preterm births are caused by divine will as punishment for sins committed by the mother, while others think they occur naturally. Preterm newborn’s death is often not acknowledged as true loss and families are discouraged from grieving.

Our study found that the beliefs, perceptions and attitudes surrounding preterm birth, held by families, communities, healthcare providers and society at large, influence the care that preterm newborn–mother dyads receive both at home and within health facilities. Addressing these requires a multifaceted approach targeted at deeply ingrained attitudes and perceptions.