Gender, Social Inequity, and Stigma in Tuberculosis Policies of Belarus and Romania

Original research by Alethe Peting de Vaulgrenant-de Cugnac

Introduction: Tuberculosis (TB) is an airborne bacterial disease, disproportionately affecting socially disadvantaged people. Despite global action, propagation of TB persists, suggesting the need to move beyond its medicalization by considering gender, social inequities and stigma, which would encompass the neglected attributes of Lalonde’s Health Field Concept. Additionally, the framing of TB nationally can provide insight into the problematization and the potential pitfalls of policy. 

Theoretical Framework: The Bacci (2009) “What’s the Problem Represented To Be” (WPR) approach is used in this study enable the extraction of the framing gender, social inequities, and stigma within the national policy texts of Belarus and Romania in a systematic way. 

Methodology: This study is a qualitative, discourse analysis of TB in Belarus and Romania. Data collection was done through government websites between May and June 2022. Policies chosen were from the last 10 years, and were analysed using WPR approach. 

Results: Eight policies were analysed, three for Belarus, and five for Romania. Compelling differences were found in addressing gender. Social inequities and stigma were also identified to a great extent, with limited measures being found in both Romania and Belarus. Additionally, individualization of responsibility was profound in the policy analysis. 

Discussion: Despite overall similar policy texts, Belarus and Romania have distinct epidemiological TB landscapes and approaches to TB control. These differences are striking, and enforce the necessity of holistic intervention in the two contexts as important relationships between TB are society are absent. Correspondingly, a model is put forth to illustrate the necessity of addressing gender, social inequities, and stigma within the national discourse is imperative for the eradication of TB. 

This project contributed to Mariana’s Master in Global Health degree at Maastricht University, The Netherlands. Mariana plans to continue working in social sciences research and is contemplating a PhD.