Gender Issues in Health in Haryana

GENDER ISSUES IN HEALTH IN HARYANA

Dr. R.S. Dahiya
Sr Prof, Surgery ,PGIMS, Rohtak.
2003..2004

It is a well established fact that the biologically women are a stronger sex. In societies where women and men are treated equally, women outlive men and there are more women than men in adult populations. Naturally there are106 boys for 100 girls at birth as the more boys die in infancy and  ratio is balanced. The unequal status, unequal access to resources and lack of decision making power experienced by girls and women because of their gender would result in disadvantages in health. These disadvantages include a higher likelihood of exposure to health, greater susceptibility to adverse health consequences as a result of the exposure, and a lower probability of receiving timely, appropriate and adequate health care.
It is widely acknowledged on the bases of studies done in diverse settings, that inequalities in health across population groups arise largely as a consequence of differences in social and economic status and differential access to power and resources.. The heaviest burden of ill health is borne by those who are most deprived, not just economically, but also in terms of capabilities such as literacy levels and access to information. In the words of Noble Laureate Amartya Sen, India, with its present population of 1 billion has to account for some 25 million missing women.
On the top of that in a modern world of today this discrimination has not allowed a gender sensitive language to develop. There is mankind but no woman kind; there is house wife but no house husband; there is house mother but no house father; kitchen maid is there but no kitchen man. The unmarried woman crosses the threshold from bachelor girl to spinster to old maid but the unmarried man is always bachelor.

Discrimination means ‘treating one or more members of a specified group unfairly as compared with other people.’ A convention on this issue was held on the elimination of AlI forms of discrimination against woman CEDAW(Convention on the Elimination of All Forms of Discrimination against Women) by the United Nations in 1979. The gender discrimination in that convention was defined as:

“any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their material status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field”. This gender discrimination emanates from an ideology that favours men and boys and undervalues women and girls. It is perhaps one of the most widespread and pervasive forms of discrimination. Measures of gender empowerment measure (GEM) show that there is gender discrimination worldwide. In many countries, especially from the developing world, a much larger proportion of women than men are illiterate. In India women occupy only 12.6% of parliament seats in lower house and 11.5% seats in upper house .(Feb, 2019). Practically in all countries, developing as well as industrialized, women’s participation in the labour market is lower than that of men, women are paid less for equal work and work many more hours doing unpaid labour as compared to men. The most blatant expression of discrimination against female is the practice of sex determination in the womb and then selective sex abortion. Modern technology has now come to the aid of perpetuating culture of discrimination This has resulted in a decline in the proportion of females as compared to males in Haryana and many other states of India. In the Population Census of 2011 it was revealed that the population ratio in India 2011 is 940 females per 1000 of males. The Sex Ratio 2011 shows an upward trend from the census 2001 data. Census 2001 revealed that there were 933 females to that of 1000 males.. The sex ratio amongst literate people is 617 (economic survey of Haryana 2003-2004) which was very alarming. This brings the present education into debate.
The gender discrimination has got its roots in our older cultural practices and way of living also, of course it has got a material base. The cultural practices of Haryana have a gender bias. At the time of birth of a boy, it is celebrated by beating a ‘Thali’ whereas the birth of a girl is mourned (matka phorna) in one way or the other; at the time of delivery, if a child is male, the mother will be given 10Kg ghee (do dhari ghee) and if a child is female, the mother will be given 5 Kg ghee; the sixth day (chhath) of a male child will be celebrated; the namkaran sanskar will be done if the child is male; the girls are not allowed to fire the funeral of the family some members  where as the can burn mounds of wood in chulha at home . As the number of woman has been going down in Haryana, they are becoming more insecure in the society. The violence in home and outside has increased in Haryana and is affecting the health of women adversely. The news papers carry many news items daily in this regard. The doctors and the para medical staff also behaves as the whole society behaves on the gender issues. The number of gynecologists in govt. hospitals is very meager compounding the women’s health still further.

              There is no letup in crime against women even during Covid lockdown in Haryana. The state, which is infamous for atrocities against women (as it had third highest rate in crime against women in 2018 in the country, as per the NCRB report), has

Crime against Women in April

Rapes/Gangrapes-66,Kidnapping/Abduction-62,Molestation-142,Dowry cases-90,Dowry deaths-27 Sexual harassment-5 . . 

The unregistered cases are many more. This indicates that the price of women or the importance of woman has not increased by the decrease of their number as conceived by many people in Haryana. Violence affects the health of women in many ways.The other thing which is happening in most of the villages of Haryana is that the number of unmarried males is increasing. Beyond 30 years of age, many males can be seen without marriage in each village. Unemployment is increasing amongst boys and girls both .Also there seems to be increasing trend of impotency in males because of multiple factors. The purchase of bridegrooms is becoming an accepted cultural practice in most of the villages. All these factors are adding the miseries of the women in Haryana. Side by side son preference and the under-valuation of daughter manifests itself in discriminatory practices against daughters such as well being, including, premature and preventable death of female child.

The data from the National Family Health Surgery – 4 indicate that the median duration of breast feeding for girls was slightly lower (24.6 months) than the median duration of breast feeding for boys (26.4 months). A larger proportion of female children than male children were severely underweight (19/1% of girls and 16.9% of boys) and severely stunted (24.4% of girls and 21.8% of boys). Moreover female child mortality rate (1-4 years) during the ten years preceding 1998-99 was much higher (36.7 percent 1000 than male child mortality 24.9 per 1000). This deprivation in childhood contributes to substantial proportions of women being malnourished and stunted as adults. Non-pregnant women age 15-49 years who are anaemic (<12.0 g/dl) (%)--61.4% urban and 64.2 rural women.Pregnant women age 15-49 years who are anaemic (<11.0 g/dl) (%)--50.2% urban and 58.1% rural.All women age 15-49 years who are anaemic (%) --60.8% urban and 63.9 % rural .( NFHS-4-2015-2016)  . For a significant proportion of adolescent Indian girls, an early marriage followed soon after by a pregnancy is the norm. The percentage of women age 25-49 years married before the age of 18 in Haryana is 20% . They have no say on sexuality and reproduction. Child bearing in adolescence affects women adversely in many ways; socially, economically, psychologically and physically. It truncates their education, limits their income-earning opportunities and burdens them with responsibilities at an age when they aught to be exploring life. In developing countries, early childhood bearing carries a greater relative risk of dying in pregnancy and delivery as compared to woman in the 20-24 age groups from around 80% to as high as 400%. maternal mortality rate has also been decreased from 127 to 101 but still on higher side. .

It is very unfortunate that our legal system has not been able to remove the existing social biases. Despite the constitutional guarantee of equality between men and women the law implementing agencies failed in their execution. That is the reason the women also often lack the authority to make their health care decisions for themselves. Though more than half a century has elapsed after framing of constitution, our social customs have not changed to match the spirit of the constitution. Still customary laws and traditions are given perferance over constitutional commitment in combination with patriarchal norms that deny women the right to make decisions regarding their sexuality , reproduction and health. Women are exposed to avoidable risks of morbidity and mortality in Haryana.

Dr. R.S.Dahiya
Senior Professor,
PGIMS, Rohtak.