Building a Gender-Responsive Tuberculosis Program in India

In 2021, India became one of the first tuberculosis (TB) high-burden countries in the world to adopt a national framework for a gender-responsive approach to TB. This infectious disease remains a priority global public health challenge today. The gender dimensions of TB are numerous and impact vulnerability to the disease, access to and the experience of TB services, and treatment outcomes. This chapter reflects on the development and adoption of the first-of-its-kind framework, describing key steps in the six-year journey to date: from the first national assessment on TB and gender, which resulted in a collaborative policy development process led by the national TB program, to the efforts that followed to harness the considerable gender expertise in India to develop, test, and rollout participatory training curricula on TB and gender for all TB program decision-makers. The chapter adopts an analytical approach, grounded in both public health and gender theory, presenting what is known about TB and gender in India; mapping gender differences using the TB care cascade approach; describing in detail recent efforts in India to adopt gender-responsive approaches to TB at the health system and community levels; and identifying challenges and opportunities that lie ahead.