Is Gender Invisible in India’s Healthcare System?

As many countries alter and track their vaccination policy in terms of gender, making it more accessible and gender-inclusive, how has India been faring in terms of providing adequate healthcare to its women and Trans people?

Ashoka University’s Centre for Economic Data and Analysis (CEDA) recently released a heatmap exhibiting the gender gap in India’s vaccination programme. According to the data collated by the CEDA team, as of June 3, female to male ratio of vaccine beneficiaries in India stood at 0.9, which means only 90 women received vaccination for every 100 men vaccinated.

The pandemic brought to light India’s incoherent healthcare system and its disproportionate coverage. And when it comes to the need of a gendered approach towards healthcare, there seems to be a glaring absence of cognizance of the issue. The Indian society, with patriarchy woven intrinsically into its fabric, lacks inclusive healthcare systems and infrastructure, which has eventually resulted in gender disparity in vaccination too.

The CEDA research observed that in comparison to Phase 1 of the vaccination which had covered frontline workers most of whom were women, when the vaccination was opened to the larger public the ratio gradually declined. 

According to the latest data, men accounted for 54 per cent of the total number of people who are vaccinated. Professor Ashwini Deshpande, the founding director of CEDA, argues that the discrepancy in healthcare and lack of medical accessibility for women is going to have consequences for years to come. The same is valid for Trans people as well, who continue to face discrimination and social exclusion.

The constant suffering

The unpaid and unrecognised labour done by women at homes is yet to be addressed by the Indian society. The pandemic has evidently made the situation only worse for them. 

Society for Women’s Action and Training Initiatives(SWATI), a non-profit venture, who reached out to women in villages found out that women were looking after the Covid-19 patients in their family with inadequate to no precautions. Many of the women who were infected were found to be continuing to do the house chores.

They also noted incidents where women who were unable to quarantine themselves, get frequently tested or avail medical checkups, consequently succumbing to the disease with no one to identify or tend to their worsening conditions. Several Covid-19 care centres were found to be lacking hygienic rooms, water and sanitation facilities for women.

The pandemic-induced job loss dealt a heavy blow on those who worked in the unorganised sector, rendering several women jobless. In the first month of the national lockdown, between March to April 2020, 15.4 million women lost their jobs, of which 12 million were rural women. This too led to an increased number of vaccination rates among men who were thought of as at higher risk than women as they had to travel to work. 

The digital divide

Digital illiteracy appears to be another stumbling block. Women, in many cases, weren’t able to register themselves on the CoWIN platform and hence, had to depend on the men or the family for the same. According to media reports, vaccine hesitancy is high among women, thanks to the misinformation about the vaccine’s impact on menstruation and fertility.

When it comes to the case of pregnant women, maternal mortality due to Covid-19 was reported to be four times more in the second wave according to a new study in the US. While the US and the UK have prioritised pregnant women for vaccination and many countries like Brazil, France, Italy, Argentina, Spain, Mexico and Netherlands have included them in their vaccination drive, the Indian administration is yet to be seen doing much in that direction.

In the rural areas, SWATI, on talking to the ASHA workers, found out that nutrition and food intake in families have suffered during this period leading to increased complaints of anaemia, malnutrition and miscarriages among women in the last year. The report observes that the needs of pregnant women were neglected in families with Covid patients.

The invisible

Meanwhile, thousands of Trans people still remain invisible, even in data. When India went into a nationwide lockdown in March 2020, the Centre had announced a relief amount of Rs 1500 as direct transfer and ration supplies for each transgender person. However, only 5711 trans people were reported to have received the bank transfer and 1229 received the ration supplies. The estimated population of trans people in the country is 4.8 million.

Experts and activists note that the decision-making around healthcare, safety and various other sectors which define living for women and trans people is still being done without enough consultation with research groups focusing on these communities. India still has a very long way to go as far as inclusive healthcare is concerned and has to do a lot more to make its women and Trans people safe, they say.

Also see: Thirteen Facts on Girl Children in India

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