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Uncovering Malawi’s TB gender gap

Meclina Chirwa by Meclina Chirwa
November 19, 2025
in Health
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Harriet Kakhobwe, Public Relations Officer for Paradizo TB Patients Trust

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Raphael Gwetsani, a 41-year-old man from Kasengere Village, remembers the day he was diagnosed with TB like it was yesterday.

“I was coughing non-stop, I had lost weight, and I felt like I was going to die,” he recalls, his voice shaking with emotion. But it wasn’t until his wife, Maria, forced him to go to the hospital that he finally sought medical help. “I was scared, I didn’t want to go to the hospital. I thought it was a waste of time,” he admits.

But Maria wasn’t having it. “I told him, ‘You’re not going to die on me, you’re going to get treatment and get better’,” she says, her eyes filled with determination.

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And so, Raphael reluctantly agreed to go.

“I was diagnosed with TB in January this year,” Raphael explains. “I was put on treatment and I’m now fine. If it wasn’t for my wife, I could’ve died.”

Raphael’s story is not unique. According to Dr. Kuzani Mbendera, National TB and Leprosy Elimination Program Manager, men in Malawi are often reluctant to seek medical help, leading to a significant gender gap in TB treatment.

“We have a problem with men seeking medical care,” Dr. Mbendera says. “They often wait until it’s too late, and it’s affecting their health and the health of those around them.”

Harriet Kakhobwe, PRO for Paradizo TB Patients Trust, agrees.

“We work with communities to educate them about the importance of seeking medical attention. But it’s not just about education, it’s about changing mindsets. Men need to understand that seeking help is not a sign of weakness, it’s a sign of strength,” she said.

But what drives this reluctance to seek medical help?

Peter Shema Yelesani, a gender expert, believes it’s rooted in cultural beliefs and societal expectations.

“Many men believe that seeking help is a threat to their masculinity. They think that they need to be strong and tough, and that seeking medical help is a sign of vulnerability,” he said

Yelesani points out that healthcare facilities themselves can also be a barrier.

“Many facilities don’t have confidential rooms, making it difficult for men to openly discuss their symptoms,” he says. “And when men do seek help, they’re often met with judgmental attitudes from healthcare workers. It’s a turn-off, and they don’t come back.”

The statistics are stark. According to the World Health Organization, men are more likely to die from TB than women, with a male-to-female ratio of 1.7:1. In Malawi, the gap is even wider, with men accounting for 60% of TB cases.

So, what can be done?

Dr. Mbendera believes it’s about changing the narrative around masculinity.

“We need to redefine what it means to be a man. Seeking help is not a sign of weakness, it’s a sign of strength. We need to encourage men to prioritize their health and well-being.”

But it’s not just about the government, it’s about individuals. It’s about men supporting men, and encouraging each other to prioritize their health.

As Raphael puts it, “I’m not ashamed to say I’m a TB survivor. I’m proud of myself for seeking help, and I’m proud of my wife for pushing me to get it.”

 

 

 

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