Study shows untouchability and caste bias determine access to health care in rural areas
A study on the access to health care services in Gujarat has found that children in rural areas who belong to backward castes are being left out of vaccination drives when compared to children of upper castes.
The study conducted in 2011 by Navsarjan, a non-profit, focused on the coverage of polio vaccine campaign in 68 remote villages covering 2,027 children belonging to backward and upper caste communities.
It was found that 15 per cent children under the age of five from the backward communities were not vaccinated or vaccinated just once as compared to only five per cent non-vaccinated children among the upper castes.
Immunisation dates withheld selectively
“Health workers must give polio drops to the children at their homes but they usually sit at the panchayat house and all parents take their children there. Many a time, dalit, nomadic and tribal villages are not informed of the immunisation dates. Also, many such families are migrants, so they miss the polio doses,” says Sushma Vania who works for the research and documentation unit of Navsarjan.
The Pulse Polio campaign is run in the country by the Union health ministry, under which all the states have to carry out routine immunisation in every district. The government boasts about its robust polio campaign; only one polio case was reported last year. For a child to be fully immunised against polio, multiple doses of the vaccine have to be given till the child is five years old.
The high coverage shown in official records is not reflected in the area covered by the study. The survey by Navsarjan shows dismal coverage of selected communities in Gujarat. “It is a myth that polio campaign is reaching everyone,” says Mark West, justice information specialist working with the USAID on the programme on rights and justice. West also worked with Navsarjan on this project.
Expectant mothers, too, left out
The survey also touched upon at maternal health care; 834 mothers of backward communities were asked questions.
The women were asked if the village health care worker visited them during pregnancy and the number of times they were visited. The number of women who said “never” was twice as high among women of backward communities.
“The villages of the communities that were questioned were selected on the basis of whether they are equidistant from the health centre and to the main road. This means that if the village health worker is going to a non-dalit village, she can just as easily visit the dalit village as well,” explains West.
The survey showed that the homes of upper castes were visited more frequently by the health workers, which shows that untouchability and caste bias exists even today, adds West. He presented the preliminary findings of the study in New Delhi recently at a conference on public health and law. The findings of this survey are due to be published by this month.
Navsarjan had earlier carried out a survey in 2010 called ‘Understanding Untouchability’, in which they surveyed 1,500 villages. A section of this survey was on health. Under this, 64 per cent women reported caste bias in midwives and 10.4 per cent women faced such bias at a health centre.
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