National Framework for A Gender-Responsive Approach to TB in India

National Framework for a Gender-Responsive Approach to TB in India

Goal:

 To adopt and implement a gender-responsive approach to TB in India.

Objective:

To aim for equitable, rights-based TB services for women, men and transgender persons by adopting a gender-specific programmatic approach at all levels 

To mobilise, empower and engage women, men and transgender persons in the TB response at the health system and community levels

The overall guiding principles:

Non-discrimination, Informed choice, Informed consent, Confidentiality, Respect for all, Access for all, Working in partnership, Promoting rights of individuals and groups, Fostering accountability and Empowering communities. 

Basic steps for gender responsive programming: 

Assess provider knowledge on gender responsive programming and existing gender-sensitive practices.

Build capacity of providers on the gender perspective and providing comprehensive person-centric care. 

Conduct baseline assessment of facilities, infrastructure and linkages in the context of gender-responsive programming. 

Promote active involvement of people affected by TB of all genders in all aspects of the design, planning and delivery of programmes. The participation of people affected by TB and survivors must be supported through capacity building and mentoring. Accordingly, all the activities outlined under the NSP heads - Detect, Treat, Prevent and Build - incorporates components of community engagement. 

The framework deals with interventions under the heads of Detect, Treat, Prevent and Build as outlined in the National Strategic Plan.

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Detect: 

Train providers (public and private) on gender-sensitive provision of care

Integrate screening for TB into maternal health services

Gender-sensitive Active case Finding

Improve gender and age disaggregated notification for public and private sector.

Strengthen referral and feedback mechanisms between program and community

Treat:

Adopt comprehensive patient-centric care

Ensure respectful behaviour and confidentially of identity

Provide non-judgmental, safe space for all, especially women and transgender persons

Enlist support of programme/private sector intervention for people with TB in the private sector

Engage communities in community monitoring, peer psychosocial support and mitigation of stigma

Prevent:

Institute air-borne infection control in health facilities, especially in MCH and ART clinics

Prioritise screening for LTBI and management among transgender persons, women and children

Enlist support for women for contact screening and chemoprophylaxis

Screen care givers for TB and educate them on cough hygiene

Support cough hygiene drives by TB champions and community groups

Build:

Strengthen linkages between program, private sector and communities

Work towards gender equitable planning and budgeting

Assess and aim for gender parity in the workforce

Ensure representation of women, men and transgender persons in all forums

Promote participation of women’s collectives in community response to TB

The programmatic approach ensures gender mainstreaming in all matters concerned with running the programme including the causes and consequences of TB, risks and vulnerabilities, access to healthcare and treatment outcomes.