Privatization "introduces" deep holes in pockets of Gujarat's poorer sections: Healthcare to pregnent women
Coming down heavily on Government of India initiative, Janani Shishu Suraksha Yojana (JSSY), meant to ensure “free” and “cashless” services to pregnant women for deliveries in public health facilities, antenatal care, and to infants up to a year, a top advocacy group has found that, in Gujarat, “more than half the women (51.4%) incurred out-of-pocket expenditure for antenatal care, and 48% for deliveries.”
Calling this as the result of the ugly face of privatization intruding into the health sector in Gujarat's rural areas, propagated as a model for toher states to follow, the advocacy group, Jan Swasthya Abhiyan (JSA) said its survey of 500 pregnant women in Gujarat in the first half of 2015 suggests, most pregnant women are forced to go to private sector, “where JSSY is not operational.”
Giving the example of Anand district in Cenral Gujarat, which is economically developed, where the public health system is functioning relatively better, the JSA says, here, “the unregulated private sector has managed to capture much of health services.”
“In Anand district's Pansora Primary Health Centre (PHC), 80% of the women incurred out-of-pocket expenditure even for antenatal care, which is supposed to be provided by the public health system. Even in public facilities, up to 53.4% women (in Rasnol PHC) incurred the expenditure of up to Rs 6000”, JSA says.
“By contrast”, JSA says, “The backward tribal Panchmahals and Dahod, supposedly high priority districts, the government health system is weak, lacking resources and staff. The impoverished and already vulnerable women are pushed to the private sector. Around 75% of those who went to the private sector incurred expenditures for delivery up to Rs. 5,000”.
JSA's revelations came ahead of a crucial public hearing by the National Human Rights Commission (NHRC), to last for about six months starting in November, to be undertaken in different parts of India, on right to health and how it should be implemented in India. The hearing will be held in association with JSA.
JSA also revealed that as of March 2014, 136 blood banks were functioning in Gujarat, of which just 30 were managed by the state government at 12 medical college hospitals, nine district hospitals, two special hospitals, one taluka hospital, four municipal hospitals, one military hospitals, and one at a private medical college. As many as 82 blood banks were managed by charitable trusts, and 24 by private bodies.
“Eight districts did not have a government blood bank”, JSA said, adding, “In Narmada, a tribal district, there was no blood bank, either government or charitable/private.”
Releasing these facts at a press conference in Ahmedabad, JSA said, that while Gujarat may have reduced maternal mortality rate (MMR), an earlier survey report by it suggests there is little positive impact of the state's health programme on women who face “multiple vulnerabilities – young, SC/ST, low education, wage labourers, migrants.”
The report, in association with CommonHealth, another advocacy group, titled “Social Autopsies of Maternal Death in Selected Areas of Gujarat”, says that “41% of the maternal deaths occurred in very young women, below the age of 25 years – seven were between 16 and 20 years, more than half, i.e. 27 of the 46 deaths were of SC and ST women.”
The report says, “This is a higher proportion than the state’s SC-ST population of around 22 % (2011 Census). Almost half of the women who died – 46 % - were illiterate in comparison to 37% female illiteracy in Gujarat.”
It continues, “Most of the women who died had multiple occupations /responsibilities – in addition to domestic work”. Based on a survey of 45 women who suffered death, the report says, “25 of them were involved in either agricultural work or/and wage labour. Nine of the women who died migrated for longer than 2-3 months without safety of home and other basic amenities or any social security.”
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