Disparities in Healthcare Accessibility in West Bengal - Through a Gender Lens
Updated: Jan 22
This piece is drafted by Swaniti Initiative, a social enterprise working towards improving public service delivery, as a token of knowledge support in favour of the Bengal Policy Hackathon - co-hosted by Bengal Development Collective and Public Policy Club - IIM Calcutta
In recent years, the state of West Bengal has seen an acceleration in social change due to globalization trends. However, this change has also brought to light the issue of gender inequality in the region. Despite a history of political, social, economic, and cultural movements, West Bengal has not effectively organized a movement for the development and upliftment of women as a whole. This serves as an example of the significant gender inequality that persists in the region. There have been several findings which suggest how gender inequality is created and perpetuated in households, markets, and societies in West Bengal. Women in West Bengal are often depicted as among the most oppressed and are frequently caught in the intersection of poverty and patriarchy.
There are several underlying factors contributing to this inequality. Women’s mobility is restricted and their access to education and information is limited. Incidents of physical violence against women in West Bengal are increasingly being reported in the media, but are rarely contextualized within the broader issues of gender discrimination. Women and girls, particularly those in rural areas, continue to face preventable diseases and unequal access to healthcare. The HIV infection rate among women is also on the rise which makes it appropriate to investigate the access to healthcare facilities for women in West Bengal.
State of Health In West Bengal’s Context
According to the National Health Profile 2018¹, there are significant concerns about the health status of women in West Bengal, especially their reproductive health. The report shows that 71.9% of pregnant women in the state do not have access to iron and folic acid (IFA) tablets and only 21.8% of expectant mothers receive full antenatal care. The report suggests that the primary causes of this neglect are the improper implementation of policies, and lack of equitable access to healthcare facilities and monitoring. The issues surrounding the healthcare of women go beyond problems with policies and extend to deep-seated societal attitudes. One such instance being expectations from women to eat after the rest of the family in traditional settings, leading to a lack of nutrient-rich food in their diet and contributing to iron deficiency.
Lack of equitable access to PHCs and CHCs² is another major reason which has issues spurting from societal and cultural norms. There is also a stigma surrounding women's health, particularly during menstruation, which prevents women from seeking help and can lead to exclusionary practices such as segregation. This results in a high burden of illnesses, the most common one being anaemia, which not only affects women of reproductive age but in turn leads to high infant and maternal mortality rates and malnutrition in children.
Challenges to Healthcare Access in West Bengal
According to NFHS-5³ report, there is a multitude of reasons that suggest the challenges faced by women in accessing healthcare and medical facilities for treatment. The significant issues preventing women from obtaining medical care are inadequate infrastructure and a shortage of healthcare workers. Social, cultural and economic reasons such as getting permission to go for treatment, getting money for treatment, distance to the healthcare facility, transportation access, having a companion to go with, availability of female healthcare providers, concerns regarding medical service providers and drug availability. Research suggests these reasons to be major obstacles in accessing healthcare facilities in West Bengal from across rural and urban areas, as reported by women of the age group 15-49.
Source: Swaniti Initiative
To improve women's access to healthcare, it is necessary to create a healthcare infrastructure that is welcoming and accommodating to women. Many community health centres lack sufficient seating for patients and attendants, and private and public healthcare facilities often do not have designated spaces for even basic facilities such as breastfeeding for mothers. There are several issues that need to be addressed in order to ensure equitable healthcare access to women in the state including cultural practices and institutional revamps.
Bengal Policy Hackathon: Round II Problem Statement
In response to these inequalities, though the West Bengal government has taken several measures committed to providing accessible, equitable, and high-quality healthcare to all people, without discrimination based on social or economic status, it is important to understand the root causes of disparities in healthcare access in West Bengal and to develop strategies to mitigate these disparities. To that end, the following question needs to be addressed:
‘What are the key factors contributing to gender inequality in health in West Bengal, and what strategies can be implemented to address these inequalities?’
In answering this problem statement, you are required to conduct research on the topic and analyze data on gender disparities in health in West Bengal. You will also be required to identify potential solutions that could be implemented to address them.
National Health Profile 2018, http://www.cbhidghs.nic.in/
PHCs- Primary Health Centres, CHCs- Community Health Centres