Table 3:

Key themes preventing comprehensive TB care generated from impacted families among a predominantly rural, low wealth population in a TB endemic region of Tanzania with suggested recommendations at the local, institutional and national levels

Themes	Summary	Recommendations for further study
Socioemotional impacts of TB	Challenges: • Psychosocial effects of TB on sick children, caregivers, siblings	• In addition to attending to physical symptoms of TB, address burden of psychological distress due to socioeconomic deprivation, stigma, isolation, trauma of being ill, etc. • Anti-stigma campaign to normalize TB • Raising awareness of mental health and TB-related stigma
Broadened scope of financial impacts	Challenges: • Transportation fare • Meals costs • Lodging expenses • Lost wages • Lost productivity	• Promote creation of communal village emergency funds for families affected by childhood TB • Expansion of social welfare programs and hospital assistance programs to include children and families affected by drug-sensitive TB • Facilitate TB-specific direct cash transfers for vulnerable families to improve clinical outcomes and alleviate chronic poverty • Provision of affordable health insurance, with free insurance for children with chronic disease
Barriers to pediatric TB treatment	Challenges: • Effort required to obtain diagnosisAccess to nutritional diversity	• Develop village-level emergency action plans and educate community on early identification of signs and symptoms of TB to prevent child mortality • Build capacity of community health workers (CHWs) to serve as proxies and disseminate health education / provide accompaniment • Enable CHWs to assist with active case finding, assist with in-home TB screening • Social welfare programs to assist with nutritional support and transportation