Tuberculosis Care Access Among Internally Displaced Persons in India and Nigeria: A Review of Structural Barriers and Context-Specific Interventions.

This review examined the structural barriers limiting access to tuberculosis (TB) care in internally displaced persons and context-specific strategies to address the public health threat. Low- and middle-income countries contribute more than 95% of the global burden of tuberculosis, with Nigeria and India being the highest TB-burdened countries in Africa and Asia, respectively. Despite this burden, internally displaced persons remain underrepresented in TB research. Both countries share similarities in demographic, economic, and sociopolitical backgrounds that raise the risk of TB spread among vulnerable populations, including IDPs. Communal conflict, disasters, and insecurity promote internal population displacement, but India's share of global IDPs is mainly due to climate events and natural disasters. In both countries, sociocultural, economic, and healthcare governance concerns remain significant barriers to TB care access among IDPs. Although the health of all people is a fundamental human rights issue, selective recognition of those rights to the detriment of the marginalized group perpetuates health inequities. Unlike Nigeria, India lacks an actionable framework for protecting the health of internally displaced persons. The review identified that TB control and access to TB care efforts require intersectoral collaboration to help fast-track movement toward TB elimination. It further underscores the relevance of primary healthcare infrastructure tailored to local contexts. It concludes by recommending prioritizing policy reforms that promote equity in TB care, with an expansion of TB interventions to address the threat among internally displaced persons.