One pair of feet: women, work and tuberculosis in Mumbai, Pg2

Key Highlights:

• Women in Mumbai face significant challenges in accessing tuberculosis (TB) treatment due to diagnostic delays, discrimination, and financial constraints.
• The India TB Report 2023 indicates women experience 2-3 months of diagnostic delays due to stigma, with 40% facing discrimination like job loss.
• A 2024 study showed that 30-61% of TB patients face catastrophic costs, exceeding 20% of their annual household income, even before treatment.
• The National Time Use Survey 2024 reveals women spend 305 minutes daily on unpaid domestic work, impacting their ability to seek timely treatment.

Detailed Insights:

• Diagnostic delays are common as TB symptoms are often normalized as workplace health issues or misdiagnosed by medical personnel.
• Incorrect treatment can lead to multidrug-resistant TB (MDR-TB), requiring more complex and expensive care.
• Out-of-pocket expenses, including transportation, lost wages, and nutrition, create a substantial financial burden for TB patients.
• Transportation barriers, as highlighted by the National Family Health Survey 5, disproportionately affect women's access to healthcare in Maharashtra.
• Social inequalities, such as caste and socioeconomic status, contribute to longer waiting times and unequal access to healthcare facilities.
• The Nikshay Poshan Yojana, providing ₹1,000 per month, offers limited relief for lost wages and expenses during TB treatment.
• Flexible DOTS clinic hours, like evening options, can improve treatment completion rates among working patients.

Key Concepts Involved:

• DOTS (Directly Observed Treatment Shortcourse): A TB control strategy where healthcare workers directly observe patients taking medication.
• MDR-TB (Multidrug-Resistant Tuberculosis): A form of TB that is resistant to at least two of the most powerful anti-TB drugs.
• Nikshay Poshan Yojana: A scheme providing financial assistance to TB patients for nutritional support during treatment.