In many parts of rural and urban India, where women’s health often takes a back seat to family responsibilities, a silent struggle unfolds. A persistent cough is brushed aside as “just a cold,” not out of ignorance, but out of fear—fear of stigma, judgment, or becoming a burden. For countless women, tuberculosis (TB) is not only a medical challenge but a social one. While TB can strike anyone, societal pressures and gender norms make women more likely to hide their symptoms, delay diagnosis, and risk their lives. Understanding this hidden burden is the first step toward changing it—through awareness, empathy, and action.
The hidden gender burden of TB
TB remains a major public health challenge in India. According to the WHO Global Tuberculosis Report 2023, India accounts for 27% of global TB cases, and women represent about 35% of notified cases1. Yet, many go undetected. The NFHS-5 (2019–21) reveals that only 58% of women seek timely medical advice for persistent coughs, compared to higher rates among men2. This points to a clear gender gap in health-seeking behaviour.
The double burden: Stigma and social role
Why do women hide their TB symptoms? The reasons are woven into the fabric of daily life. This delay stems from deep-rooted cultural norms where women prioritise family over self-care, fearing stigma or economic fallout. Stigma plays a villainous role—TB is often linked to poverty or ‘weakness,’ leading to social isolation or marriage prospects dimming for young women. In a study by the Indian Council of Medical Research (ICMR), 40% of female TB patients reported facing discrimination, including job loss or family rejection.3 Economic dependence exacerbates this; many women, especially in rural areas, worry that admitting illness could burden their households financially. The India TB Report 2023 from the Ministry of Health and Family Welfare (MoHFW) notes that women experience longer diagnostic delays—up to 2-3 months—due to these fears, increasing transmission risks within families.4
Family over self-care
TB symptoms in women
Women hiding TB symptoms
Tuberculosis stigma in India
TB awareness for women
Gender and TB care
For many women, particularly in patriarchal societies, their health is often secondary to the needs of the family. A persistent cough or fever might be dismissed as a minor ailment, or worse, ignored entirely to avoid becoming a burden on the household. The journey to a clinic can be a logistical and financial challenge, requiring permission from a spouse or in-laws, time away from domestic duties, and money for travel and consultation.
Beyond these practical challenges lies a deeper, more insidious problem: social stigma. A TB diagnosis can carry immense social weight for a woman. It can be seen as a source of shame, leading to isolation from the community. Critically, it can threaten a young woman’s marriage prospects, or, in the worst cases, lead to marital instability or divorce for a married woman. The fear of being ostracized, losing her social standing, and facing an uncertain future is often enough to make a woman hide her symptoms and suffer in silence.
Data speaks
- 35% of global TB cases are in women, with a large share in India¹.
- Only 64% of Indian women (vs. 70% of men) have been visited by a health worker for any health advice².
- Women’s treatment initiation rates are lower than men’s in several Indian states³.
This is not just about numbers—it reflects systemic barriers preventing women from seeking timely care.
Key steps to a TB-free future for women
- Empowerment through Information: We need to raise awareness not just about TB symptoms, but about the right to seek care without fear or shame.
- Decentralized healthcare: Bringing screening and diagnostic services closer to homes, with a focus on women-friendly timings and female healthcare workers.
- Community-led solutions: Engaging community leaders and support groups to dismantle the social stigma associated with a TB diagnosis.
- Financial support: Providing financial assistance for transport and medication to remove the economic barriers that prevent women from seeking and completing treatment.
- Proactive screening: Instead of waiting for symptoms to be reported, campaigns must actively screen for TB in vulnerable communities.
Bridging the gap
Why Women Hide TB Symptoms in India – And How We Can Change It
The Hidden Gender Burden of TB
stigma: The Invisible Barrier to Care
Family Over Self-Care
What the Data Tells Us
Key Steps to a TB-Free Future for Women
Bridging the Gap: From Silence to Support
Eradicating TB among women requires more than medical treatment—it calls for a shift in social attitudes. By fostering supportive environments, engaging communities, and tailoring healthcare services to women’s realities, we can make early detection the norm, not the exception.
Mobile diagnostic vans, flexible clinic hours, and empathetic, trained health workers can transform access to care. And at the heart of it all, education and awareness can dismantle the myths that keep women silent.
TB is curable. Silence is not. The sooner we make it safe for women to speak about their health, the closer we move to a TB-free India.
This is an educational initiative supported by Mylan Pharmaceuticals Private Limited (a Viatris company).
References:
1. World Health Organization. (2023). Global Tuberculosis Report 2023. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023
2. International Institute for Population Sciences (IIPS) and Ministry of Health and Family Welfare (MoHFW). (2021). National Family Health Survey (NFHS-5), 2019-21: India. https://rchiips.org/nfhs/NFHS-5_FCTS/India.pdf
3. Indian Council of Medical Research (ICMR). (2022). Study on TB Stigma and Gender Disparities in India. https://www.icmr.nic.in/sites/default/files/reports/TB_Stigma_Gender_2022.pdf 4. Ministry of Health and Family Welfare (MoHFW). (2023). India TB Report 2023. https://tbcindia.gov.in/WriteReadData/IndiaTBReport2023/IndiaTBReport2023_FullReport.pdf