Gender, health-seeking, and tuberculosis: Negotiating responsibility in urban Peru

Tuberculosis (TB) remains a persistent public health concern in Peru, particularly in densely populated urban districts marked by poverty, informal labor, and overcrowded housing. Drawing on 25 semi-structured interviews with adult residents insured under the public health system (Seguro Integral de Salud) in San Juan de Lurigancho, Lima, this article examines how gender norms shape everyday understandings of TB, health-seeking practices, and moral responsibilities for care. Rather than focusing on individuals currently undergoing treatment, the study explores how TB is understood through the experiences of relatives, neighbors, coworkers, and illness trajectories within participants’ social networks. Findings show that masculinities and femininities organize distinct moral economies of risk and care. Men’s narratives emphasize endurance, work obligations, and the minimization of symptoms, often delaying engagement with health services, while women’s accounts foreground caregiving responsibilities and the coordination of care within households. These gendered practices intersect with structural constraints, making self-medication and delayed consultation pragmatic responses to precarious everyday conditions rather than signs of neglect. By situating TB within everyday life and gendered moral expectations, this study contributes to debates on health, gender, and urban inequality. It argues for gender-sensitive public health strategies that engage with local moral worlds beyond purely informational models.