Men
form one-third of a typical medical school’s population; Rest of the seats are
all occupied by women. The
pay gap in the healthcare sector is 25% higher than any other sector. Most
women agree to work at low wages because of the financial crises they face. Gender
inequality is leading to a shortage of healthcare workers in the sector. Women
in India face “extensive gender discrimination” in access to healthcare. Gender
inequality is leading to a shortage of healthcare workers in the sector because
obviously only one-third of the seats were taken by men.
Under
the National Health Mission, the government has launched several schemes. The
most important program launched by the government is Rashtriya Arogya
Nidhi which provides financial assistance to the patients that are below
poverty line and are suffering from life-threatening diseases. Rashtriya
Swasthya Bima Yojana is a government-run health insurance program for
the Indian poor. It aims to provide health insurance coverage to the
unrecognized sector workers belonging to the below poverty line. National
AIDS Control Organization was set up so that every person living with HIV
has access to quality care and is treated with dignity. Anganwadi
Workers and the ASHA workers are the grassroots level functionaries under the
umbrella ICDS Scheme and the National Health Mission respectively. Both
these functionaries being closely connected with the rural and urban poor
families, play a pivotal role in addressing their nutrition and health related
problems/issues.
How the Government has failed them ?
·
Do
not have regular salaries, partly because their work is supposed to be
voluntary and part-time.
·
Even
though the Code on Social Security, 2020 aims to include formal and
informal sectors under a social safety net, it excludes several categories of
workers, including ASHA and Anganwadi workers. The Code on Wages,
too, has left this constituency out of its coverage, depriving employees of a
fixed minimum wage.
·
“As
per Modi government’s definition, Anganwadi and ASHA workers are not ‘workers’
but only ‘volunteers’, who do not receive any ‘wage’ but only an ‘honorarium’!
So the principle of minimum wage would not apply to these scheme workers.”
Also a gender issue
· Limited space for
career progression is linked to low institutional recognition, demotivation,
and curtailed opportunities for growth. ASHAs face sexual harassment by other
health workers and community members, linked to their mobility and public
profile. ASHAs have worked
to further women’s interests, particularly in Chhattisgarh state where Mitanins
(the name for ASHAs there) have mobilized protests against alcoholism,
supported women’s collectives and taken action against gender based violence. ASHAs have begun
taking action to mobilize their peers to reduce gender based violence. ASHAs have
reported an increased sense of empowerment and personal growth, in part through
their belief in the social value of their work.
Gender as a social determinant of health
- The social
determinants of health (SDH) are the non-medical factors that influence health
outcomes. They are the conditions in which people are born, grow, work, live,
and age, and the wider set of forces and systems shaping the conditions of
daily life. These forces and systems include economic policies and systems,
development agendas, social norms, social policies and political systems. - The SDH have an important influence on health
inequities - the unfair and avoidable differences in health status seen within
and between countries. In countries at all levels of income, health and illness
follow a social gradient: the lower the socioeconomic position, the worse the
health. - The following list provides examples of the
social determinants of health, which can influence health equity in positive
and negative ways:
1.Income and social protection
2. Education
3.Unemployment and Job security
- Research shows that the social
determinants can be more important than health care or lifestyle choices in
influencing health. For example, numerous studies suggest that SDH account for
between 30-55% of health outcomes. In addition, estimates show that the
contribution of sectors outside health to population health outcomes exceeds
the contribution from the health sector. - Addressing SDH appropriately
is fundamental for improving health and reducing longstanding inequities in
health, which requires action by all sectors and civil . - Social determinants of health
are conditions in the environments in which people are born, live, learn, work,
play, worship, and age that affect a wide range of health, functioning, and
quality-of-life outcomes and risks. Conditions (e.g., social, economic, and
physical) in these various environments and settings (e.g., school, church,
workplace, and neighborhood) have been referred to as “place.” - In addition to the more
material attributes of “place, ” the patterns of social engagement and sense of
security and well-being are also affected by where people live. Resources that
enhance quality of life can have a significant influence on population health
outcomes. Examples of these resources include safe and affordable housing,
access to education, public safety, availability of healthy foods, local
emergency/health services and, environments free of life-threatening toxins.
freely and responsibly the number, spacing and timing of children. It is individual’s right to decide whether to reproduce and
have reproductive health. The Supreme Court of India and several state
high courts have recognized the importance of reproductive rights and have
observed that the denial of reproductive rights is violation of women's
fundamental and human rights.
and promoting reproductive rights. court through its various judgements from
time to time has promoted and protected the reproductive rights of women. for
instance, Puttaswamy judgment, Suchita Srivastava V. Chandigarh Administration, Navtej Singh Johar V. UOI.
environment where people sustain, i.e. they born, live, learn etc., which
affects the health, functioning and quality of life outcomes and risks. Health starts from our localities, our homes, schools,
communities where it is also examined by our access to social and economic
opportunities. So, social determinants of health are designed to identity
ways to create social and physical environment that promote good health.
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