Women and tuberculosis care in India: a scoping review

IntroductionAs per the "India TB Report 2023", men are more affected by TB compared to women. However, gender differences and inequalities play crucial roles in how people of different genders access and receive TB-related services in the public and private sectors.ObjectiveThe main objective of this scoping review was to understand how women's gender is positioned in the TB care cascade in India, map research, and identify opportunities for further research in this area.MethodsThe guidelines of Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) were followed to report this scoping review. Three databases, PubMed, DOAJ, and Scopus, were searched to gather articles published between 2004 and 2024 in English, with studies primarily conducted in India. Fourteen articles were included in this review.ResultsOf the 14 studies, which included two decades of studies (2004-2014 & 2015-2024), the ratio stands at 1:2.5. Four studies each are of retrospective, mixed methods in nature with one systematic review. Eight studies used TB cases as study participants, and five studies were from the southern part of India. Earlier studies focused on factors for differential care, gender roles, and norms concerning women, and recent ones focused on notification, clinical presentation, and treatment outcomes.ConclusionThis scoping review clearly shows that while the variables that impacted women in the past, particularly gender roles and norms, seem to be waning over time, they cannot be ignored in the present. The focus that the government of India is placing on gender equity serves as a reminder that the problems are still relevant for the TB elimination efforts among women.