Skip to main content

Access to maternal healthcare services eludes poor women in Vibrant Gujarat irrespective of caste group

Counterview Desk
A Swedish International Development Cooperation Agency (SIDA)-sponsored study has found strong discrimination against poorer sections of women -- irrespective of whether they belong to scheduled caste (SC), scheduled tribe (T) or general category -- in the delivery of maternal health care services in Gujarat.
Titled "Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data", and authored by scholars Deepak Saxena,Ruchi Vangani, Dileep V. Mavalankar and Sarah Thomsen, the study says, "Women who were poor among the ‘other’ caste category were 5.65 times less likely to use antenatal care (ANC) services than the non-poor in the same caste category. Poor women belonging to an ST were 5.32 times less likely to use ANC services than the non-poor advantaged groups. Similarly, women in the poor SC category were 5.1 times less likely to utilize ANC services than the non-poor ‘others’."
The scholars say, "There were no differences between the poor in the different caste groups. However, there was evidence of effects on ANC use due to caste status among the non-poor. Women belonging to an ST, but not poor, were 2.37 times less likely to use ANC services than the non-poor advantaged groups (‘other caste’)." Nor did they find any rural-urban divide in the non-delivery of health services to the poor mothers. They underline, "Being poor was also associated with less utilization of ANC services irrespective of the place of residence. Rural poor and urban poor were 5.22 and 5.19 times less likely to utilize the ANC services respectively in comparison to the urban non-poor."
The study comments, "Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth." It adds, "Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence."
The study further says, "Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste) has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic education and infrastructural development to begin to remove the structural causes of non-use of maternal health services."
In fact, the scholars say that a major reason for Gujarat's economic development is its geographical advantage. "Strategically located on the West Coast of India, Gujarat is also a gateway to the rich land-locked northern and central parts of the country. Because of its location on the coast, Gujarat also has access to all major port-based countries, including the United Kingdom, Australia, China, Japan, Korea, and the Gulf countries", they insist.
Coming to the maternal mortality rate (MMR), the study says, "The MMR in Gujarat is estimated to be 148 per 100,000 live births. This is favorable in relation to the India-wide rate of 200. Though Gujarat is an industrially developed state, the MMR of Gujarat is relatively high compared to the states of Tamil Nadu (97/100,000) and Kerala (MMR 8/100,000), whose per capita income is less than Gujarat."
It adds, "In addition, given the disparities in socio-economic measures within the state, and the above-stated importance of these variables in determining maternal health, it is likely that there are significant differences in maternal health outcomes between different population groups within the state. Furthermore, the interaction between structural determinants such as education, caste and income make it difficult for policymakers to identify where the greatest gaps remain in achieving MDG 5, and reducing health inequities, in Gujarat."
The scholars' findings suggest that "women who are urban, literate, wealthier, younger, ever-married at 18 or above use services more than their rural, illiterate, older, and ever-married younger counterparts. Over 80% of urban women are delivering in institutions. Similarly, over 80% of the non-poor attended at least three ANC visits (the recommended minimum in India) during their last pregnancy. Educational levels also show an apparent ‘dose-response’ relationship with use of all maternal health services studied here. That is, the more education one has, the more likely one is to use ANC, institutional delivery, and modern methods of contraception."
They add, "What is significant for policymakers to note here is that the high levels of use among the wealthy, urban, and educated women indicate what is possible to achieve in Gujarat. Furthermore, our study results show that there are fewer disparities in access to family planning services amongst the disadvantaged populations. This also begs the question ‘what are the family planning programs doing right that other maternal health programs are not?’ It also indicates that it should be possible to reach the poor and disadvantaged classes with other maternal health services."

Comments

TRENDING

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

Union budget 'mum' on relief to marginalised communities facing climate change impact

Counterview Desk  ActionAid, an international advocacy group which claims to work for a world without poverty, patriarchy and injustice, has wondered if the Union budget 2023-24, which is being acclaimed for providing succour to the middle classes, has anything to offer to the India's poor. In a statement, it said, while the budget may have "prioritised inclusive development", the financial outlay for ensuring it "does not show the zeal as hoped." Stating that the Finance Minister said Rs 35,000 crore revenue would have to be "forgone" due to a reduction in personal income taxes, "fiscal prudence is not enough to expand public employment, social security, welfare, education and health expenditures considerably." "The need of the hour is to raise revenues through the reduction of revenues forgone and innovative mechanisms such as wealth tax on super accumulation of wealth", it added. Text: The Union Budget 2023 has given significant

Savarkar 'criminally betrayed' Netaji and his INA by siding with the British rulers

By Shamsul Islam* RSS-BJP rulers of India have been trying to show off as great fans of Netaji. But Indians must know what role ideological parents of today's RSS/BJP played against Netaji and Indian National Army (INA). The Hindu Mahasabha and RSS which always had prominent lawyers on their rolls made no attempt to defend the INA accused at Red Fort trials.

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

How lead petitioner was rendered homeless when GM mustard matter came up in SC

By Rosamma Thomas*  On January 5, 2023, the Supreme Court stayed a December 20, 2022 direction of the Uttarakhand High Court to the Indian Railways and the district administration of Haldwani to use paramilitary forces to evict thousands of poor families occupying land that belonged to the railways.  Justice AS Oka remarked that it was not right to order the bringing in of paramilitary forces. The SC held that even those who had no rights, but were living there for years, needed to be rehabilitated. On December 21, 2022, just as she was getting ready to celebrate Christmas, researcher Aruna Rodrigues was abruptly evicted from her home in Mhow Cantonment, Madhya Pradesh – no eviction notice was served, and nearly 30 Indian Army soldiers bearing arms were part of the eviction process. What is noteworthy in this case is that the records establishing possession of the house date back to 1892 – the title deed with the name of Dr VP Cardoza, Rodrigues’ great grandfather, is dated November 14

Why no information with Assam state agency about female rhino poaching for a year?

By Nava Thakuria   According to official claims, incidents of poaching related to rhinoceros in various forest reserves of Assam in northeast India have decreased drastically. Brutal laws against the poachers, strengthening of ground staff inside the protected forest areas and increasing public awareness in the fringe localities of national parks and wildlife sanctuaries across the State are the reasons cited for positively impacting the mission to save the one-horned rhinos. Officials records suggest, only two rhinos were poached in Kaziranga National Park and Tiger Reserve since 1 January 2021 till date. The last incident took place probably in the last week of December 2021, as a decomposed carcass of a fully-grown (around 30 years old) female rhino was recovered inside the world-famous forest reserve next month. As the precious horn was missing, for which the gigantic animal was apparently hunted down, it could not be a natural death. Ironically, however, it was not confirmed when

Civil rights leaders allege corporate loot of resources, suppression of democratic rights

By Our Representative  Civil rights activists have alleged, quoting top intelligence officers as also multiple international forensic reports, that recent developments with regard to the Bhima Koregaon and the Citizenship Amendment Act-National Register of Citizens (CAA-NRC) cases suggest, there was "no connection between the Elgaar Parishad event and the Bhima Koregaon violence." Activists of the Campaign Against State Repression (CASR) told a media event at the HKS Surjeet Bhawan, New Delhi, that, despite this, several political prisoners continue to be behind bars on being accused under the anti-terror the draconian Unlawful Activities (Prevention) Act. Addressed by family members of the political prisoners, academics, as well as social activists, it was highlighted how cases were sought to be fabricated against progressive individuals, democratic activists and intellectuals, who spoke out against "corporate loot of Indian resources, suppression of basic democratic

Kerala natural rubber producers 'squeezed', attend to their plight: Govt of India told

By Rosamma Thomas   Babu Joseph, general secretary of the National Federation of Rubber Producers Societies (NFRPS) at a recent discussion at Mahatma Gandhi University, Kottayam, explained that it is high time the Union government paid greater heed to the troubles plaguing the rubber production sector in India – rubber is a strategic product, important for the military establishment and for industry, since natural rubber is still used in the manufacture of tyres for large vehicles and aeroplanes. Synthetic rubber is now quite widespread, but styrene, which is used in making synthetic rubber and plastics, and also butadiene, another major constituent of synthetic rubber, are both hazardous. Prolonged exposure to these even in recycled rubber can cause neurological damage. Kerala produces the bulk of India’s natural rubber. In 2019-20, Kerala’s share in the national production of rubber was over 74%. Over 20% of the gross cropped area in the state is under rubber cultivation, with total

Lack of welfare schemes, BSF curbs force West Bengal farmers to migrate far away

Counteview Desk  In a representation to the National Human Rights Commission chairperson, a senior West Bengal based activist has complained that villagers living near the border with Bangladesh are forced to migrate to as far away as Mumbai and Kerala because of lack of government sensitivity towards their welfare in original villages. Giving specific instances, Kirity Roy, secretary, Banglar Manabadhikar Suraksha Mancha (MASUM), said, if the Border Security Force (BSF) had not put any restriction on agricultural activities, and if villages had properly implemented welfare schemes, these people would never migrate to other States. Text: I want to attract your immediate attention to the inhumane condition of the migrated workers of Gobra village, Swarupnagar Block in North 24 Parganas district of West Bengal to seek your urgent intervention to protect the rights of these people. Gobra is a village situated near the Indo-Bangladesh Border where the border fencing is about 500 meters i

Bangladesh 'rights violations': US softens stance, fears increased clout of China, India

By Tilottama Rani Charulata*  In December 2021, in addition to the Rapid Action Battalion (RAB), the United States imposed sanctions on seven former and current officers of the force, alleging serious human rights violations. Benazir Ahmed and former RAB-7 commander Miftah Uddin Ahmed were banned from entering the US. RAB as an institution was also canceled the support it was getting from the US and its allies. At the same time, those under the ban have been notified of confiscation of assets held abroad. The anti-crime and anti-terrorism unit of the Bangladesh Police, RAB is the elite force consisting of members of the Bangladesh Army, Bangladesh Police, Bangladesh Navy, Bangladesh Air Force, Border Guard Bangladesh, Bangladesh Civil Service and Bangladesh Ansar, and has been criticized by rights groups for its use of extrajudicial killings and is accused of forced disappearances. The government of Bangladesh has been insisting about lifting the ban on RAB, but the US had till recen