Socio-cultural and Knowledge-Based Barriers to Tuberculosis Diagnosis for Women in Bhopal, India

BACKGROUND: In India, only one woman is diagnosed with tuberculosis (TB) for every 2.4 men. Previous studies have indicated gender disparities in care-seeking behavior and TB diagnosis; however, little is known about the specific barriers women face. OBJECTIVES: This study aimed to characterize socio-cultural and knowledge-based barriers that affected TB diagnosis for women in Bhopal, India. MATERIALS AND METHODS: In-depth interviews were conducted with 13 affected women and 6 health-care workers. The Bhopal Diagnostic Microscopy Laboratory Register (n = 121) and the Bhopal district report (n = 261) were examined for diagnostic and care-seeking trends. RESULTS: Women, especially younger women, faced socio-cultural barriers and stigma, causing many to hide their symptoms. Older women had little awareness about TB. Women often sought treatment from private practitioners, resulting in delayed diagnosis. CONCLUSIONS: Understanding these diagnostic and help-seeking behaviors barriers for women is critical for development of a gender-sensitive TB control program.