{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:23:22Z","timestamp":1787318602195,"version":"build-2736575974"},"reference-count":46,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["302604\/Z\/23\/Z"],"award-info":[{"award-number":["302604\/Z\/23\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns5:p>Background Incarceration has vast and unequal impacts on public health beyond prison walls. Research from the United States documents these collateral consequences, including elevated mental illness and morbidity for the children and partners of incarcerated individuals, alongside community-level effects such as increased rates of teenage pregnancy and multidrug-resistant tuberculosis. In Latin America, however, these broader health impacts remain critically understudied. A significant barrier is the absence of data collection efforts or theoretical frameworks for mapping how Latin America\u2019s prisons affect the health of families and surrounding communities. Objective This scoping review synthesises existing evidence on the collateral health consequences of incarceration in Latin America by conducting a comprehensive search in 2025 that included English, Spanish and Portuguese language peer-reviewed studies. Results From 17 included documents, prisons emerge as epicentres for tuberculosis transmission to visiting families and surrounding communities. The evidence reveals significant mental and physical health burdens on families. Women with incarcerated partners experience depression and anxiety whilst managing economic strain and expanded caregiving responsibilities, often neglecting their own health. Children of incarcerated parents show marked emotional distress, and incarcerated mothers alongside their young children face severely inadequate healthcare access within detention spaces. Conclusions Despite collecting demographic data, most studies overlook how these burdens fall unequally across racialised populations. Future research must centre ethnoracial disparities and situated knowledge.<\/ns5:p>","DOI":"10.12688\/wellcomeopenres.26021.1","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T16:29:06Z","timestamp":1774628946000},"page":"193","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Prison Walls:\u00a0A Scoping Review of Incarceration\u2019s Public Health Impacts in Latin America"],"prefix":"10.12688","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-236X","authenticated-orcid":false,"given":"Daniela","family":"Larrain","sequence":"first","affiliation":[{"name":"Anthropology London WC1H 0BW University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M.","family":"Parker","sequence":"additional","affiliation":[{"name":"Anthropology London WC1H 0BW University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"63-70","DOI":"10.5588\/ijtld.15.0056","article-title":"Tuberculosis in prisoners and their contacts in Chile: Estimating incidence and latent infection.","volume":"20","author":"X Aguilera","year":"2016","journal-title":"The International Journal of Tuberculosis and Lung Disease: The Official Journal of the International Union against Tuberculosis and Lung Disease."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"170-184","DOI":"10.1080\/17441692.2015.1091023","article-title":"Connectivity, prison environment and mental health among first-time male inmates in Mexico City.","volume":"12","author":"A Albertie","year":"2017","journal-title":"Glob. 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Sa\u00fade Colet."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"100374","DOI":"10.1016\/j.jcte.2024.100374","article-title":"Burden of diabetes in correctional facilities: A global systematic review and meta-analysis.","volume":"39","author":"M Shabil","year":"2025","journal-title":"J. Clin. Transl. Endocrinol."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e2847","DOI":"10.1590\/1518-8345.1569.2847","article-title":"Repercussions of imprisonment for conjugal violence: Discourses of men.","volume":"24","author":"A Sousa","year":"2016","journal-title":"Rev Latino-Am Enfermagem."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"S181-S184","DOI":"10.2105\/AJPH.98.Supplement_1.S181","article-title":"Incarceration as Forced Migration: Effects on Selected Community Health Outcomes.","volume":"98","author":"J Thomas","year":"2008","journal-title":"Am. J. 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Rev."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1464-1474","DOI":"10.1016\/S0140-6736(17)30259-3","article-title":"Mass incarceration, public health, and widening inequality in the USA.","volume":"389","author":"C Wildeman","year":"2017","journal-title":"Lancet."},{"key":"ref46","article-title":"South America.","year":"2020"}],"updated-by":[{"DOI":"10.12688\/wellcomeopenres.26021.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000}}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:24:34Z","timestamp":1787315074000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":46,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.26021.1","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.28646.r156186","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.28646.r155612","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.28646.r152170","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.28646.r155612","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.28646.r156186","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.28646.r152170","asserted-by":"object"}],"is-version-of":[{"id-type":"doi","id":"10.12688\/wellcomeopenres.26021.2","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.28646.r152170, Heather Wurtz, University of Southern California, Los Angeles, California, 16 Apr 2026, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1#referee-response-152170","order":0,"name":"referee-response-152170","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Daniela Larrain<\/b>; \n<i>Posted: 08 Jul 2026<\/i>; \n<i>Thank you for your thoughtful and substantive engagement with our manuscript. We greatly appreciate your comments and suggestions. Below, we address each of your comments in turn.<\/i> \n<b>Methods<\/b>  \n<b>When describing the final corpus of studies included in the scoping review, it might be helpful to include the overall breakdown of qual, quant, and mixed methods studies (rather than just the breakdown within each population).<\/b>  We agree that an overall methodological breakdown would improve clarity. We have added a sentence to the Methods section (p. 5) immediately following the description of the final corpus and its geographic distribution, that summarizes the overall balance of qualitative and quantitative designs across all 17 included studies, as well as the breakdown within each of the three analytical groupings. No mixed-methods studies were identified in the final corpus. &nbsp;  \n<b>How is Latin America defined? There is not one universal system of categorization, so it might be a good idea to include a citation for how you are defining it (e.g., WHO, World Bank).<\/b>  \n<i>We agree that an explicit definition of Latin America is needed. We have added a sentence to the Methods section defining Latin America operationally as the 20 Spanish- and Portuguese-speaking countries of the Americas, plus Puerto Rico given its Spanish-speaking population. Haiti was included in our original search terms but on reflection, following the reviewer\u2019s request for clarification, Haiti has been removed from the definition and search string, as it yielded no results and its inclusion&nbsp;<b>did not align with<\/b>&nbsp;the linguistic criterion underpinning our regional definition. <\/i>  \n<b>Results<\/b>  \n<b>The sentence is missing \u201cto\u201d following \u201crelative\u201d: \u201c\u2026experience poor health outcomes relative their counterparts without incarcerated relatives.\u201d<\/b>  We thank the reviewer for catching this typographical error. The missing preposition has been corrected (p. 6) &nbsp;  \n<b>In the next paragraph, I would not recommend beginning a paragraph with \u201cthis study.\u201d Perhaps replace \u201cthis\u201d with a more specific referent.<\/b>  We have restructured the opening sentence to lead with the study design and sample (p. 6). &nbsp;  \n<b>In the following paragraph, beginning \u201csupporting the link\u2026\u201d - this sentence is hard to follow. I would reverse the order of the sentence, beginning with \u201ca cross-sectional survey\u2026\u201d<\/b>  We have restructured the opening sentence to lead with the study design and sample (p. 6). &nbsp;  \n<b>Regarding the following statement \u201cHowever, the study\u2019s small sample size and lack of a comparison group for either pre-incarceration behaviours or for women whose partners are not incarcerated makes it difficult to determine whether these sexual risks behaviours are produced by the prison environment.\u201d This sentence reads as though the small sample size and lack of comparison group were limitations to this study. But this is not the case because comparison, generalizability, causal inference, etc. are not objectives of qualitative research. I would suggest removing this sentence and instead focusing on what this study contributes to our understanding of family-level impacts of incarceration. <\/b>  We have removed the sentence and focused on what the study contributes. &nbsp;  \n<b>Regarding the same paragraph, why are these insights \u201cpreliminary\u201d? Weren\u2019t they based on findings from this qualitative study? Would it make more sense to say something about how these insights point to hypotheses that could be further tested in future studies?<\/b>  We have replaced the word \u2018preliminary\u2019 with language that accurately represents the standing of qualitative findings while acknowledging their potential to generate future hypotheses (p. 7). &nbsp;  \n<b>Throughout the results, there is frequent mention of the limitations of studies due to the lack of a control group. This is highlighted in the discussion, which seems fitting. I\u2019m not sure it\u2019s as helpful to emphasize this in the results section (especially for qualitative studies); I would suggest focusing on what the featured studies contribute to the current landscape of knowledge and then - as you do - highlighting gaps and limitations in the discussion.<\/b>  We have removed all sentences in the Results section that critique studies for lacking a comparison group or limiting causal inference, and save that discussion exclusively for the Discussion section. &nbsp; \n<b>Discussion<\/b>  \n<b>In the paragraph about ethnoracial diversity, could you expand a tad on the implications of expanding knowledge of ethnoracial data for public health research and practice? How could a better understanding of ethnoracial diversity inform interventions for improving health equity and outcomes?<\/b>  \n<i>We have added more detail about the implications of expanding knowledge of ethnoracial data for public health research and practice: \u201cWe therefore suggest that future research systematically collect and analyse ethnoracial data\u2014ideally grounded in Latin American epistemologies and local understandings of ethnoracial diversity\u2014and pursue intersectional analyses that examine how race, gender, and class interact to shape the health consequences of incarceration across the region. Such data should be read in dialogue with the existing qualitative evidence on lived experiences, while further community-rooted qualitative work is needed to deepen understanding of how these burdens unfold within distinct social and cultural contexts. Only then can practitioners and policymakers design situated interventions that address structural inequities rather than applying uniform responses to a heterogeneous population; without this evidence base, interventions risk perpetuating cycles of neglect among the communities already disproportionately affected by both incarceration and poor health outcomes\u201d (p. 15).<\/i> &nbsp;  \n<b>Regarding the following statement: \u201cAs well as researchers, government and policy play a critical role.\u201d A critical role in what?<\/b>  We have clarified the referent to make explicit what governments and policymakers are being called upon to do (p. 15) &nbsp;  \n<b>Latin America is an incredibly diverse region in terms of culture, politics, geography, etc. I understand that the literature is limited and that grouping all Latin American countries together makes sense for the purpose of this review. But, I think somewhere this needs to be acknowledged, as well as the importance of contextualizing studies (and recommendations for interventions or policy change) within distinct historical, political, and social climates.<\/b>  We agree that acknowledging Latin America\u2019s heterogeneity is important. We have expanded the Limitations paragraph to recognize that grouping all Latin American countries under a single regional framework was operationally necessary but inevitably obscures the region\u2019s profound cultural, political, geographical, and historical diversity. We also note that future research should attend to how race, ethnicity, and colonial legacies shape who bears the burdens of incarceration across distinct national contexts (p. 15).","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1#referee-comment-6647","order":1,"name":"referee-comment-6647","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.28646.r155612, Priscila de Morais Sato, Federal University of Bahia, Bahia, 04 Jun 2026, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1#referee-response-155612","order":2,"name":"referee-response-155612","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Daniela Larrain<\/b>; \n<i>Posted: 08 Jul 2026<\/i>; Thank you for your thoughtful and substantive engagement with our manuscript. We greatly appreciate your comments and suggestions. Below, we address each of your comments in turn. &nbsp;  \n<b>Gender does not appear to be explicitly discussed in the manuscript's discussion section.&nbsp;<\/b>  We agree that an explicit discussion of gender is necessary. We have added a dedicated paragraph to the Discussion (p. 13-14) that addresses the disproportionate burden for women, situates this within broader debates on incarceration, caregiving, and structural vulnerability, and reflects on the absence of studies examining male partners and fathers. &nbsp;  \n<b>Further clarification regarding the timeline described in the methods section.&nbsp;<\/b>  We agree that clarification about our timeline is necessary.&nbsp;We have added this clarification to the Method section (p. 4). The three-month search period (September\u2013December 2025) reflects the sequential nature of our two-stage process rather than iterative database updates. The initial database search across PubMed, Scopus, Web of Science, and EBSCOhost was conducted in September 2025, yielding 1,532 records. The subsequent months were dedicated to duplicate removal, title and abstract screening of 842 records, and the full-text review of 498 studies. The application of Stage 2 thematic criteria \u2014 refining the corpus to studies addressing family and community health impacts \u2014 required close reading and iterative discussion between reviewers to resolve inclusion decisions, particularly for studies at the boundary of our inclusion criteria. All database searches were conducted at the same time point in September 2025; no iterative updates to the search were performed, and study inclusion was therefore not affected by publication timing differences across databases. &nbsp;  \n<b>Discussion of methodological rigor. The manuscript states that several qualitative studies were limited by their \u201clack of control groups and concrete health measures, which restricts causal inference.\u201d The current wording may unintentionally suggest that qualitative studies are inherently less rigorous because they do not employ quantitative designs or control groups. Clarify the criteria used to assess methodological rigor across different study designs.<u> <\/u>Qualitative studies are often designed to provide depth, contextual understanding, and insight into lived experiences rather than causal estimation, and therefore should ideally be evaluated according to criteria appropriate to qualitative methodologies. Reframing this discussion could help avoid applying quantitative standards to qualitative work and would strengthen the methodological balance of the review.<\/b>  &nbsp; We agree with this observation. We have revised the opening paragraph of the Discussion to explicitly recognize the qualitative literature\u2019s distinct contribution, offering rich, contextually grounded insights into lived experiences that would be difficult to capture through experimental designs alone. We have also removed sentences from the Results section that could have led readers to conclude that qualitative studies were being evaluated within a hierarchy of evidence privileging quantitative designs.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1#referee-comment-6648","order":3,"name":"referee-comment-6648","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.28646.r156186, Nicholas Iacobelli, University of Washington, Seattle, Washington, 13 Jun 2026, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1#referee-response-156186","order":4,"name":"referee-response-156186","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Daniela Larrain<\/b>; \n<i>Posted: 08 Jul 2026<\/i>; Thank you for your thoughtful and substantive engagement with our manuscript. We greatly appreciate your comments and suggestions. Below, we address each of your comments in turn. \n<b>Introduction. <\/b>  \n<b>&nbsp;<\/b>\n<b>The sentence that outlines lower life expectancy, higher rates of teenage pregnancy, and higher rates of multidrug resistant tuberculosis (MDR-TB) is a little confusing in this context. It seems to flow from commentary about data in the US and is cited with other studies about the US. However, there is little evidence of higher rates of community level MDR-TB in the US associated with incarceration due to lower burden of disease especially of MDR strains (though rates of TB among incarcerated people are still higher than the general public), longer incarceration times, and improved testing and treatment. The reference for this claim is from the country of Georgia, so I would recommend rephrasing these sentences to be clearer and more specific. <\/b>  We have removed the citation of Gygli et al. (2021), which referred to Georgia rather than the United States, to avoid misattributing MDR-TB community spillover to a US context where evidence for this association is limited. Following the reviewer\u2019s suggestion, we have incorporated Holaday et al. (2026) and Uggen et al. (2023) to replace this reference, adding community-level STI transmission as a documented consequence of incarceration in the US context. &nbsp;  \n<b>Although outside the scope of this review, it would be helpful to provide some context about what the drivers of this surge in incarceration rates are in Latin America and if it is heterogeneously experienced across Latin American nations.<\/b>  We agree that contextualizing the drivers of Latin America\u2019s prison surge would be helpful. While a full discussion of these drivers falls outside the scope of this review, we have added a brief reference in the Introduction (p. 3) to the punitive drug policies and penal populism that have primarily fuelled this growth (Parker &amp; Weegels, 2023), without expanding into a country-by-country analysis. In the Discussion, we have added a brief discussion of how incarceration\u2019s health impacts on families may differ across countries with different incarceration rates (p. 14). &nbsp;  \n<b>The methodology for the review is sound, with appropriate search terms and language inclusion for the compiling of relevant studies. It is notable as the authors point out that most of the studies were from Brazil and were qualitative. Although the authors mention the breakdown of qualitative and quantitative studies in the text, it would also be helpful to represent this in the chart in Figure 1.<\/b>  Figure 1 follows the PRISMA-ScR flow diagram format, which is publicly registered in our PRISMA-ScR checklist (Larra&iacute;n &amp; Parker, 2026; https:\/\/doi.org\/10.5281\/zenodo.18564752), and we have therefore kept it in its original form. However, we have addressed this point by adding an explicit breakdown of qualitative and quantitative studies (both overall and within each of the three analytical groupings) in the Methods section of the manuscript. &nbsp;  \n<b>The authors frequently discuss lack of control or comparison group for qualitative studies, which I do not think is a particularly relevant metric. A more meaningful parameter for qualitative studies would be to assess either how the authors of those studies frame the connection between the health\/social effects described and incarceration or how the participants themselves framed it in their narratives as presented. The mix of qualitative and quantitative studies, though, does reinforce the strength of some of these findings and allow for more causal relationships to be inferred.<\/b>  We agree with this observation, which was also raised by Reviewers 1 and 2. We have revised the Discussion to explicitly recognize the distinct contribution of qualitative research in capturing lived experiences that quantitative designs cannot access, and have clarified that both approaches are complementary, with qualitative studies illuminating experiential dimensions and quantitative studies providing epidemiological grounding where possible. We have also removed sentences from the Results that could have been misread as evaluating qualitative studies against quantitative standards. We appreciate the suggestion to assess how authors and participants frame the incarceration-health connection. We consider that the review already attends to this through its use of direct participant quotations and its focus on how authors situate their findings within the broader context of incarceration\u2019s health effects, rather than applying formal appraisal criteria to the qualitative evidence. &nbsp;  \n<b>Regarding Barbosa et al., 2018: Although the authors state they do not appraise the quality of evidence, I would recommend that they be more explicit about this study\u2019s limitations with respect to the theme of the review. <\/b>  We agree that greater explicitness about this study\u2019s limitations in relation to the review\u2019s aims would strengthen the synthesis. We note that Barbosa et al. (2018) does reference the lifetime prevalence of depression among women in Brazil (18.4%; Bromet et al., 2011), which allows for a contextual comparison even in the absence of a formal control group. We have added a sentence to the Results section making this comparison explicit (p. 6), noting that the 42.2% prevalence of depression observed in the sample considerably exceeds this population baseline, while acknowledging that the absence of a formal comparison group limits causal attribution. &nbsp;  \n<b>Rearding ethnoracial diversity: I suggest that the authors give a bit more information about what focusing on this demographic characteristic might reveal as opposed to others. They state that there are acknowledged ethnoracial health disparities and that investigating these in the context of incarceration\u2019s effects would be informative, though presumably the same is true for other demographic variables (e.g., gender, class). <\/b>  We appreciate this observation. We agree that gender is an equally important dimension, and we have substantially expanded the gender analysis in the revised Discussion. In the health literature included in this review, gender appears primarily as a descriptive demographic variable\u2014outcomes are reported for women, but the structural dynamics of how gender shapes exposure, vulnerability, and health consequences are largely unexamined. By contrast, the Latin American social science literature has extensively theorized these gendered dynamics, particularly around reproductive labor and caregiving, and we now draw on this work to contextualize the health findings. We also agree that class is relevant. Our emphasis on ethnoracial diversity is not meant to suggest it is more important than other axes of inequality, but rather to highlight a specific gap in the included studies: several collected ethnoracial data without analyzing it, even as regional evidence points to significant disparities. We therefore suggest that future research pursue intersectional analyses that examine how race, ethnicity, gender, and class interact to shape incarceration\u2019s health impacts, rather than treating any single dimension in isolation. &nbsp;  \n<b>The beginning paragraph on page 11 discusses the epidemiological fact of population-level health threats and the challenge of demonstrating causality amongst other social and structural vulnerabilities that generate confounders. I found this section of the paragraph confusing both in content and phrasing. <\/b>  We agree. In the revised Discussion, we have reframed the opening paragraph to reject causality as the gold standard of evidence. We now foreground qualitative research for what it uniquely offers: grounded, contextual insight into the lived realities of incarceration \u2014something quantitative methods cannot access. Both approaches are complementary, not hierarchical. The revision no longer forces the evidence through a causal lens, but instead asks what each study genuinely contributes to understanding incarceration's community-level health effects. &nbsp;  \n<b>Address what social and political drivers have resulted in the representation of mostly qualitative, mostly Brazilian, mostly maternal-child, mostly TB related studies.<\/b>  In the revised Discussion, we now explicitly pose the question the reviewer raises: why does the evidence base skew so heavily toward Brazilian, qualitative, maternal-child, and TB-focused studies? We do not pretend to have a definitive answer, but we briefly note several plausible drivers: differential research capacity across countries, the alignment of TB and maternal-child health with global funding priorities, and the feasibility of qualitative methods in settings where quantitative data are scarce. Rather than resolving the question, we offer it as a critical lens through which to interpret the gaps in the literature","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-193\/v1#referee-comment-6649","order":5,"name":"referee-comment-6649","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Wellcome Trust [grant number 302604\/Z\/23\/Z] awarded to Caroline Parker. We confirm that the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":6,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}