The intersection of gender and health in tuberculosis (TB) highlights systemic inequalities that exacerbate women's vulnerability to disease and economic hardship. Women account for 36% of TB cases in India, yet they face significant barriers in accessing treatment and support. This article explores how deprivation, discrimination, and debt shape the experiences of women affected by TB, ultimately impacting their health outcomes and economic stability. The challenges faced by women with TB are multifaceted, involving not only health-related issues but also social and economic factors that hinder their recovery and well-being. Addressing these systemic inequalities is crucial for improving TB outcomes among women and ensuring equitable healthcare access.

Institutional and Legal Framework

• National TB Elimination Program (NTEP): Aims to eliminate TB by 2025, yet lacks gender-sensitive strategies that consider the unique challenges faced by women.
• Right to Health: Article 21 of the Constitution ensures the right to health, but implementation is uneven, particularly for marginalized groups.
• National Health Mission (NHM): Focuses on maternal and child health, often neglecting TB's gender dimensions, which can lead to inadequate care for women.
• WHO’s End TB Strategy: Calls for gender-sensitive approaches, but local adaptations are insufficient, resulting in continued disparities in treatment access.

Key Challenges

• Stigma and Discrimination: About 80% of women with TB face stigma, limiting their healthcare access and discouraging them from seeking help (The Hindu, 2023).
• Economic Burden: The average treatment cost of INR 20,000 creates a significant financial strain, particularly for women who may already be economically disadvantaged (Economic Survey 2021-22).
• Treatment Completion Rates: Only 40% of women complete treatment compared to 60% of men, highlighting a critical gap in healthcare delivery (WHO Global TB Report 2022).
• Lack of Data: Insufficient gender-disaggregated data impedes targeted interventions and effective policy-making, making it difficult to address the specific needs of women.

Critical Evaluation

The existing frameworks for TB management in India are inadequate in addressing the specific needs of women. The lack of gender-sensitive policies leads to unequal health outcomes and perpetuates economic disparities. Key issues include:

• Absence of gender-disaggregated data hinders effective policy-making, making it challenging to design interventions that specifically target women's needs.
• Insufficient awareness and training for healthcare providers on gender issues in TB can result in biased treatment and care practices.
• Economic policies do not consider the financial burden of TB on women, often leaving them without necessary support during treatment.

Structured Assessment

1. Policy Design: Current policies lack gender sensitivity and fail to address the unique challenges faced by women, resulting in inadequate healthcare access.
2. Governance Capacity: Limited coordination between health departments and gender-focused initiatives undermines effective implementation of TB programs.
3. Structural Factors: Societal norms and stigma surrounding TB disproportionately affect women, limiting their access to care and support systems.