Global Health and Diplomacy — Winter 2013
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Afghan Women And The Unequal Burden Of Tuberculosis
Dr. Karam Shah

In most of the world more men are diagnosed with and suffer from tuberculosis than women. In Afghanistan however and neighbouring parts of Pakistan and Iran, the burden of tuberculosis is greater among women than men. Worldwide, tuberculosis is the third leading cause of death among women aged 15-44. Since the disease affects women mostly during their economic and reproductive years, their children and families also strongly feel the impacts of the disease. In Afghanistan, WHO figures show that more than 64% of reported tuberculosis cases are among women. This is a critical challenge given that women are an already marginalized and vulnerable group and that the country struggles with one of the highest tuberculosis incidence rates among the WHO Eastern Mediterranean Region Organization countries.

Understanding the determinants of tuberculosis among women and why they have a high burden of disease is essential to support evidence-based decision making in national tuberculosis policies and programs. To this effect, the Canadian International Development Agency (CIDA) is currently supporting an operational research project lead by the National Tuberculosis Control Programme which aims to clarify the factors associated with the greater burden of tuberculosis among women in Afghanistan. Results are expected in early 2013 and the National Tuberculosis Control Programme will design and implement programs based on the findings of the study in order to reduce the number of female patients.

Several initiatives have been implemented to increase case detection and reach women affected by tuberculosis: cooperation between the Stop TB Partnership Afghanistan and the Ministry of Women’s Affairs resulted in a houseto- house campaign to improve detection and referral of tuberculosis; over 300 members of women’s Shuras were trained in detecting the signs and symptoms of tuberculosis.

The Obstetrics and Gynecological Association of Afghanistan and the Stop TB Partnership Afghanistan have joined forces to provide services in four maternal health hospitals in Kabul; last but not least the National Tuberculosis Control Programme has launched a mass media campaign to reduce stigma against women suffering from tuberculosis.