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

Why do I lend my support to voices protesting world class renovation of Gandhi Ashram?

By Martin Macwan* One would not expect an activist working on Dalit rights to join such a protest. Dalits carry unhealed trauma that Gandhi caused to Dr BR Ambedkar and the Dalit cause of effective political representation by using violent means of his own definition in the event of the Poona Pact. This apart, Gandhi’s ideas in general, which changed often, on caste were orthodox. I have nothing to add to the subject after the sharpest critique offered by Dr Ambedkar.

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.

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".

Iswarchandra Vidyasagar was a 'frustrated' reformer who turned into a conservative

By Bhaskar Sur "If someone says the Manusamhita was written by all wise Manu and the principal scripture of the land and if he asks me to throw it away, I'll say it is nothing short of atrocious audacity." -- Iswarchandra Vidyasagar

Odisha bauxite mining project to 'devastate' life of 2,500 Adivasi, Dalit farmers: NAPM

Counterview Desk  While the public hearing on mining in Mali hills has been cancelled due to protests by Adivasi and Dalit farmers of the Mali Parbat Surakhya Samiti, Odisha, who have been protesting against the proposed bauxite mining project, India’s top civil rights network, National Alliance of People’s Movements (NAPM) has said it is “deeply concerned” at the decision of the Government of Odisha to push the project in a Schedule-V Adivasi-belt Koraput district against the interests of the people and environment.

Inaccurate gender-relevant data 'spoiling' government policy on Covid social impact

By Simi Mehta*  The impact of the Covid-19 pandemic has been different across vulnerable groups. They were hit by the pandemic at various stages, whether it was accessibility to medical treatment or financial support. The second wave witnessed human suffering at a level where one can never forget the traumatized faces of people due to the inaccessibility and unavailability of essential medical services such as hospitals beds and oxygen. The probability of the third wave has also been one of the major upcoming challenges.

2002 riots: Gujarat assembly 'misinformed' about dereliction of duty, says ex-DGP

By Rajiv Shah  Former Gujarat topcop RB Sreekumar, an IPS officer of the 1971 batch, has alleged that the Gujarat government gave “totally false information” on the floor of the State Assembly regarding the appeal he made to the Gujarat governor for the “initiation of departmental action against those responsible for culpable negligence in maintenance of public order and investigation of genocidal crimes” during the 2002 riots.

Flamboyant 'demagogues' adjust politics, personality in shadow of democracy

Modi, Erdogan, Bolsonaro By Ajit Singh The terms dictators and demagogues are used interchangeably in various contexts, but there is a difference. The former rule over a totalitarian states where governments are able to exercise complete influence over every aspect of citizens’ life, whereas the latter are a "wannabe dictators" but due to the system of checks and balances they are are not fully capable to create police states.

Celebrating birthday amidst image of 'coerced, submissive' India ruled by a strong leader

Pushkar Raj*  As the weeks long birthday festivity of the leadership was being rejoiced India wide, the Covid was still raging in several parts of India. The carnival was in line with the post-Covid decisions and actions of the leadership demonstrating a pursuit of personal power and glory instead of national interest in times of disease and death.

'Devastating impact': Rural workers suffer as Govt of India NREGA budget down by 34%

Counterview Desk  A civil rights group, the NREGA Sangharsh Morcha has sent a letter to the Prime Minister and the Minister of Rural Development and Panchayati Raj stating that 34 per cent decrease in the fiscal budget of the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGA) for year 2021-22 has added to woes on India’s rural population, already suffering from “devastating impact” of the Covid-19 pandemic.