Gender Disparity in Dialysis Utilization under Pradhan Mantri National Dialysis Program in India

Dear Editor,

The Pradhan Mantri National Dialysis Programme (PMNDP) was launched by the Ministry of Health and Family Welfare, Government of India, under the National Health Mission,¹ and has substantially improved the accessibility of dialysis services across the country. As of January 2026, it has reached 759 districts with 1,889 dialysis centers. Overall, 262,444 patients have benefited, and more than 14.4 million dialysis sessions have been delivered.² Political will, effective administrative coordination, and public-private partnerships have been key to the programme’s success. A closer look at the beneficiary data reveals a gender disparity in dialysis service utilization. Of the 262,444 patients currently benefiting under PMNDP, around 69% (181,089) are males.² This gender disparity persists despite the program’s broad eligibility criteria. Socio-cultural, structural, economic, and health-system factors contribute to this disparity.³

Delayed diagnosis and referral are the key contributors. Chronic kidney disease (CKD) is often diagnosed later in women because of reduced healthcare-seeking behavior, under-recognition of symptoms, and limited access to routine screening.^4,5 Secondly, the prevailing cultural norms deprioritize women’s health needs compared to those of male earning members.⁶ The economic dependence and high indirect costs limit access to chronic care for women.⁶ In rural and suburban regions, women often bear caregiving responsibilities. This limits their ability to attend thrice-weekly dialysis sessions.⁶ Finally, women have lower access to vascular access creation and follow-up care.⁴

Targeted gender-responsive interventions are required to improve equity in dialysis access. Table 1 presents potential policy solutions to eliminate gender disparities in dialysis care. It’s time to translate India’s universal dialysis access policy into equitable benefits for both men and women.