It is odd but hardly surprising that gender inequality and discrimination against women and girls are major contributors to the health risks faced by those in the poorer sections of society. It is generally accepted knowledge now that women and girls often face greater barriers than men and boys in terms of access to basic sanitation and health services. The socially validated restrictions on mobility, lack of decision making power, lower literacy rates, and discriminatory attitudes of policy makers and healthcare officials have marginalised the needs of women in the past. Furthermore, a general lack of training among healthcare providers, along with a shocking level of unpreparedness of the systems built to cater to the specific health needs and challenges of women and girls, make for some of the barriers to a successful struggle for basic healthcare services.
As such, women face greater risks of unintended pregnancies, sexually transmitted diseases along with cervical cancer, malnutrition, lower vision, respiratory infections, and elder abuse- all commonplace yet ignored. Women and girls also face unacceptably high levels of violence rooted in gender inequality and are at a grave risk of harmful practices such as child, early and forced marriage. WHO figures show that about 1 in 3 women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.
Women of Rajasthan, specifically, while usually partaking in agricultural practices and contributing a major share of the family’s economy in terms of food grains, milk, fuel, fiber, timber and so on, face a similar struggle. The average sex ratio of the region is low, along with the literacy status of the women. The participation of women in tertiary sectors such as medical, teaching, administrative and other official services is also lower than the male population. Hinting at a disbalance of power even in light of equitable contribution to the economy, further research highlights that the excess workload in reality, when coupled with inadequate nutrition, leads to severe malnutrition among women. Women of this majorly rural state are busy in various household activities and consequently almost 42 % of them fall under the grip of moderate to severe malnutrition. This malnutrition also leads to complications during pregnancy. NFHS (1998-99) found that severe anaemia in India is the highest in Rajasthan at (69.4 %).
This could perhaps be the reason that the maternal mortality rate in Rajasthan is 318, the infant mortality rate is 55 and the child sex ratio is an abysmal 883 girls against 1,000 boys. Women in India face a number of issues on a regular basis. All states have their own struggles to confront. However, the condition of women in Rajasthan is especially pitiable in comparison to other states. Infamous for child marriages, here, women still collect water from uncovered wells and cook food on firewood. Besides, the desert state also has the lowest female literacy rate- way below the national average of 65.46, at 53.33. The women are not well employed either. The reproductive span of women here is second highest in the country. When taken together, these facts highlight a level of inequality in all systems that is rooted in gender. Especially for healthcare, there is a dire need of immediate rectification lest more women and unborn children fall victim to this social dogma that is yet to be highlighted and brought down.
Fortunately, off late, several initiatives have been rolled out to increase accessibility of healthcare services in rural Rajasthan. One such initiative is exemplified by the National Rural Health Mission of the Government of India, which has been working towards increasing the level of “communitization” – to facilitate healthcare services in the rural regions of Rajasthan. “Aanganwadi” centres and Accredited Social Health Activists (ASHAs) have been providing services such as awareness campaigns, and access to prenatal health care services in an effort to improve the situation of women across states in India. “Sahyoginis” – additional women health workers – have been recruited in the state of Rajasthan to support the Asha and Anaganwadi workers.
The efficiency of such large-scale efforts however, remains to be gauged while the scale of the same doesn’t seem to match that of the issues at hand. In depth studies to validate models that best resonate with the people and a magnification of said efforts seem to be the logical next steps. Hopefully, we as a people can continue to do our bit for the upliftment of an ignored social class.
Written by Ena Kaushal
Dhara Shakti Foundation 