The situation of Women Healthcare in Jammu & Kashmir

Abstract: Women’s Healthcare in India has always been a minor concern. In public/private hospitals, the ratio of doctor-patient numbers needs to be increased, as does the hospital staff and the number of hospitals. Hospitals in the cities lack the required staff structure. In rural areas, community healthcare centers, dispensaries, and hospitals are not easily accessible, they lack the proper infrastructure, or are unavailable. Women and Children become the most marginalized population in accessing healthcare facilities. Women’s reproductive health in India has suffered to date, with many women not even being aware of the problems that they are facing. An expansion of healthcare infrastructure facilities in the rural areas of J&K is required with awareness and sensitization workshops on the importance of women’s healthcare. This study used secondary sources of key research studies, articles, journals to discuss the challenges and importance of women’s healthcare in Jammu & Kashmir. 

Introduction

National Context: The status of women’s health in India is often interlinked with their status in society. “They usually have limited autonomy, as they are ruled by their fathers first, then their husbands, and lastly their sons. (The World Bank, 1996; Chatterjee, 1990; Desai, 1994; Horowitz and Kishwar, 1985; Chatterjee, 1990).” A woman’s bad health affects her, but it affects her whole family. Over the years, healthcare in India has improved remarkably.

Nonetheless, women’s healthcare is still in question. Women have been the victim of discrimination against varied developmental adaptations. Many retrogressive practices have declined with time, but they have not been wholly rooted out; women are still trapped in a patriarchal society where their development of healthcare for the community is still not a priority or a topic of concern. “India has fallen 28 places to rank 140th among 156 nations, becoming the third-worst performer in South Asia,” according to the World Economic Forum’s global gender gap report for 2021. The health and survival subindex statistics show discrimination against women. With 93.7% of this gap closed to date, India ranks among the bottom five countries in this subindex.” Indian women face many challenges for their ill health, anemia, malnutrition/nutritional status, lack of MHM & WASH knowledge, maternal health, female child mortality, and survival rate are some of the common health and survival issues faced by women in India till now.

According to the National Family Health Survey (NFHS)-4 (2015–2016), 53.2 percent of non-pregnant anemic women (Hb 12.0 g/dl) in the 15–49 year age group are anemic. Furthermore, it has been found that more than half of pregnant women in the same age range are anemic (Hb 11.0 g/dl). Even though a large percentage of urban and rural women suffer from this preventable medical issue, only 30.3 percent of pregnant mothers reported taking iron supplements as advised. Only 21% of women said they had received comprehensive prenatal care. Furthermore, being underweight mixed with stunting and wasting results in undernourished mothers who are more likely to give birth to malnourished newborns, sustaining an intergenerational malnutrition cycle with the birth of a girl child. According to NFHS-4, 22.9 percent of women aged 15–49 years with a BMI of 18.5 kg/m2) are obese. Accessing healthcare facilities in rural locations is difficult for women, and the situation is even worse than in urban areas. Poor health services and a lack of healthcare infrastructure in rural India are women’s problems. Rural sections of Kashmir, for example, have inadequate healthcare facilities, which disproportionately impacts women and children. They have no choice but to rush to hospitals in Jammu and Srinagar, where the healthcare system is most developed. Due to a lack of physicians, non-availability of essential medicines, or insufficient healthcare infrastructure, available healthcare facilities cannot address even minor gynecological problems in teenage females. They had to travel from remote rural areas of Kashmir to Srinagar hospitals as their district/villages lacked proper facilities. 

Women Healthcare situation in Jammu & Kashmir – “In comparison to India’s doctor-patient ratio of 1:2000, J&K has one doctor for 3866 people, compared to the WHO (World Health Organization) norm of one doctor for 1000 people,” according to the Federal Ministry of Statistics and Program Implementation’s National Sample Survey 2014″. First, the lack of poor or no healthcare infrastructure in the remote areas, the non-availability of doctors, and finally, the low doctor-patient ratio all of these conditions have contributed to the poor health outcomes  for women in J&K. How can a society properly function when women are being left behind in the progression of all the sectors when their health is declining, but no effective measures are put in place? This doctor-patient ratio raises concern for the patient and doctors and hospitals to suffer from it. In an article reported by Athar Parvaiz (2018) – “The upshot of poor health services in district hospitals of Kashmir, especially concerning the health issues faced by the women, is that majority of the patients who need obstetric care and run even the slightest risk are referred to the region’s solitary tertiary care maternity hospital – Lal Ded Hospital – in Srinagar. “This puts a lot of strain on this facility,” said Shabir Quarashi, Lal Ded Hospital’s Medical Superintendent. “We don’t perceive any difference even though so many district hospitals have been established to relieve the pressure on this tertiary care facility.” As a result, putting the burden on metropolitan hospitals adds to the pressure on doctors who are overburdened with patients. Patients are often negatively affected by their waistlines, delays in consultation, and therapy, putting them in danger of aggravating the ailment they have, which can be cured/eradicated with appropriate intervention. According to the CAG’s performance audit of 84 community health centers (CHCs) and sub-district hospitals (SDHs) across the Union Territory, only 270 expert medical officers were present in these health institutions, despite a sanctioned strength of 504 specialists. In these health centers, there was a 46 percent shortage of specialists.”

Furthermore, healthcare delivery in rural areas needs a better technology infrastructure to improve and provide health care facilities, making it accessible for the most in need. Private dispensaries and hospitals, and private physicians (of questionable credentials) operating in and around the region are usually more of commercial nature and expensive beyond the reach of the rural community. Distance to cover to reach health facilities always poses a constraint. Expenditure incurred and time (resultant loss of day’s wage) spent overreaching health facilities is always a constraint. In contrast, uncertainty about getting needed health services due to the absence of medical staff or non-availability of drugs remains.

Removing the challenges mentioned above in accessing the healthcare facilities would improve the overall health index of the Union Territory and country altogether. Poor or lack of community health care centers, ASHA, lack of hospitals and clinics, low doctor-patient ratio, the societal stigma around health problems women face, etc., are the barriers and challenges that need to be worked upon in the remote areas. 

Improvement in Women Healthcare = Increase in Country’s GDP Index  – Improving the health of women, reduction/eradication of challenges and issues faced by women in accessing healthcare facilities, and increasing the nutrition capacity building of women is a significant factor in poverty alleviation. Healthcare expenditure can result in better provision of health opportunities, strengthening human capital, and improving productivity, thereby contributing to economic performance. Therefore, it is vital to assess the phenomenon of healthcare spending in a country. A rise in healthcare spending correlates with improved economic performance. As a result, judiciously investing in various parts of healthcare would increase income, GDP, and productivity and reduce poverty. (Wullianallur Raghupathi and Viju Raghupathi, 2020).

Concerned authorities must strengthen institutional delivery mechanisms in healthcare facilities in the districts. Community awareness and sensitization on the importance of women’s health, removal of societal stigmatization around the health issues, Education about Hygiene, sustainable menstruation practices, and providing hygienic sanitation facilities are also necessary for the holistic development of the community. 

Some age-old, man-made customs created by some patriarchs to maintain the patriarchy have been achieved. These customs are still entrenched in our communities/families, such as men getting a bigger and better share of healthcare, education, food which the women are suppressed to provide and look after. The situation is changing; the world is progressing. Nevertheless, discrimination against women done and created by society is deep-rooted and will take a much longer time to be removed than we can predict. However, improvement in the healthcare sector and its access by women can be the step for their development. It can be the first stair that will take them to the destination of equity. As “an equal world is an enabled world.” 

Suggestions: 

• Local healthcare infrastructure needs to be strengthened and developed to cater to the needs of the locals,
• Building up of healthcare facilities in the region, in remote areas where the accessibility to proper healthcare infrastructure is poor or not available, 
• There should be an emphasis upon getting healthcare to the most vulnerable population who often discriminate from it, i.e., women and young girls,
• Successful implementation of the existing women’s healthcare policies, 
• Community awareness and strengthening of existing community health centers, creating new ones wherever deemed necessary, 
• Improving awareness and health care quality through a partnership with NGOs/Civil Society Organisations who are working on the improvement and access to healthcare, and who have been successfully implementing programs for women’s healthcare, 
• Coming up of public and private health sectors to reduce the gaps and ensure that medical personnel are deployed in adequate numbers in rural India so that the rural women get complete benefits
• Handholding support to government various healthcare schemes which the people can benefit from, and enabling the community with the knowledge of these schemes and how to access them. 
• “The current requirement is for a fully redesigned national health policy that addresses existing inequities and works to promote a long-term perspective plan exclusively for rural health.”

 

References: 

• Awareness and Perception of Health Issues Among Rural Women – V. Selvam, D. Ashok, P. Pratheepkanth, 2019

            https://www.ijrte.org/wp-content/uploads/papers/v7i5s/Es211601751919.pdf 

• Healthcare Access in Rural Communities – Rural Health Information Hub

            https://www.ruralhealthinfo.org/topics/healthcare-access

• Inequality in health and social status for women in India – A long-standing bane – Sanjay Zodpey, Preeti Negandhi, 2020

https://www.ijph.in/article.asp?issn=0019-557X;year=2020;volume=64;issue=4;spage=325;epage=327;aulast=Zodpey

• NFHS Throws Up Surprising Figures On Gender Equality In J&K – Zaid Bin Shabir, 2021

https://kashmirobserver.net/2021/12/09/nfhs-throws-up-surprising-figures-on-gender-equality-in-jk/

• Nyamathi, Adeline M., et al. “Challenges experienced by rural women in India living with AIDS and implications for the delivery of HIV/AIDS care.” Health care for women international 32.4 (2011): 300-313.

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475645/

• Unique Challenges for Women’s Health in Rural India Janna Dunbar 2011 Global Health Fellow 

            https://cdn.pfizer.com/pfizercom/responsibility/global_health/janna_dunbar.pdf

• Velkoff, Victoria A., and Arjun Adlakha. “International Programs Center.” Women of the World Women’s Health in India, Issued December (1998).

https://www.census.gov/content/dam/Census/library/publications/1998/demo/wid98-3.pdf

• Women of rural Kashmir suffer because of a lack of gynecologists, anesthetists and nurses – Athar Parvaiz, 2018 

        https://scroll.in/pulse/882820/women-of-rural-kashmir-suffer-because-of-a-lack-of-gynaecologists-anaesthetists-and-nurses