ABSTRACT
Background: Gender is a social determinant of health. In view of the substantial burden of tuberculosis (TB), it is important to look into the gender issues related to utilization of services. Aims: To find out gender differences in health care seeking behaviour of tuberculosis patients. Methods: A cross sectional study, using integrated mixed method, was conducted in Chandigarh (India). Systematic random sample was used to interview 109 TB patients (54 men and 55 women) from eight randomly selected health institutions. Results: More women (40%) resorted to home remedies or medicines without prescription at the onset of symptoms compared to men (13%). More men (87%) consulted qualified medical practitioners compared to the women (60%). Consultations from private doctors were more common among men. Mean delay in diagnosis was more in men (60 days) than women (33 days). Main reasons for delay, in men and women respectively, were late referral by doctor (37% vs 26%), long distance to health institution (29% vs 28% ), prolonged use of self-medication (30% vs 26%), and financial constraints (7% vs 17%). More women (20.8%) reported missing a prescribed dose of treatment as compared to men (11.1%). However, 10% men were on re-treatment compared to none of the women. Conclusions: Delay in diagnosis was more in men than women. More delay occurred due to delayed referral by doctors among men and due to financial constraints among women. Hence, gender differences in health care seeking behaviour should be kept in mind while selecting programme strategies.