29th Jun, 2021
According to studies done and data collected by the World Health Organisation, in 2018 more than 3.2 million women fell ill with TB and it was one of the top six killers with the figure crossing the mark of 95000 deaths in 2018 alone. Did you know that India continues to account for more than 25% of deaths due to TB in the world? Approximately, 26% of all TB cases have been women in India of the age group 15-49 years, making it the third leading cause of death, for them. TB has been a threat to women’s emotional, mental, and physical health for decades, where gender disparity and gender-biased approaches and beliefs have undermined detection, treatment and post treatment care for women.
Eliminating TB has been the Indian government’s prime concern and the National Tuberculosis Elimination Program is slated to be fulfilled by the year 2025. However, one of the major roadblocks in the success of the TB program is the direct and indirect discrimination against women suffering from TB. Stigma and discrimination occur in many forms, with examples like parents of unmarried women hiding the condition of their daughters for the fear that no one will marry them. Married women fear being shunned if they disclose their TB status. Women at the workplace are often asked to leave their jobs for the fear of spreading infections. It is this stigma and discrimination that has become of the prime reasons for not seeking care, especially by women.
Another challenge is the lack of empathy amongst health providers for TB patients. TB patients continue to experience barriers in access to services and early diagnosis of TB is hindered by lack of trained health personnel. This coupled with the lack of support and compassion to patients can affect the patient’s recovery.
Gender disparity is made evident in all aspects of TB response, be it a risk of infection or time of diagnosis or access to quality treatment. For most women even the likelihood of treatment adherence becomes a challenge. The disparity does not end there. Studies conducted have bought forward more shocking facts about the patriarchal attitude prevalent in this discrimination.
In recent times, over 10% of young marriages ended in divorce with over 16% of women facing societal stigma and discrimination because of TB. 18% of women suffering from TB were rejected and shunned by their husbands and 25% of them reported severe discrimination at home. 40% of women stated they were considered ‘non-marriageable’. The discrimination towards women also becomes apparent as most male patients suffering from TB confirmed it was their wife’s duty to take care of them, but infected wives did not ‘deserve’ any such consideration. This divide is not limited to young couples but about 2% of older couple marriages ended in divorce in which women had TB. In many cases it is the males who discuss and consult with the healthcare provider outside the women’s presence.
TB for women does not affect the individual only; it creates orphans, leads to broken families, and puts a dent in the economic and social growth of the society. The way forward begins with making TB prevention and control programs to be more sensitive to the lack of right to information and participation and freedom of moment and privacy faced by women suffering from TB. Education is the first step to bridging the gaping divide. Interventions need to be carefully planned and made cost-effective to ensure that the decision-makers of the family do not see it as an additional financial burden.
The government of India has increased the budget of NTEP (gender component) by nearly 36%. India has already made great strides in fighting TB at grassroots levels by running special gender-specific programs to address the perils of TB in men, women, children, and transgender. The Ministry of Labour has also designed and put into motion the framework of creating a TB stigma-free workspace. Other measures that are proving effective include empowering women, girls, and their families to come out in open about TB and seek medical help with ease and enabling TB survivors to report any stigma to proper authorities. As we close out the month of June 2021, in line with TB Mukt Bharat and NTEP’s Jan Andolan, we must commit to ensuring redressal of stigma and discrimination, especially to protect women and young girls with TB, to ensure no one is left behind.