GENDER ISSUES IN HEALTH IN HARYANA
Dr. R.S. Dahiya
Dr R.S.Dahiya
Ex. Sr.Prof, PGIMS, Rohtak.
It is a well established fact 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. More girls die during course of pregnancy in our country. Naturally there are106 boys for 100 girls at birth as the more boys die in infancy& 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 ACI forms of discrimination against woman (CEDAW) 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. World wide women occupy only 26.1 % of parliament seats. 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 resulted in a decline in the proportion of females as compared to males in Haryana in past years op opand many other states of India.
Overall, more females die during pregnancy than do males. So that's why there's an excess number of males at birth,” said Orzack, who has published research on this issue.24-Jan-2019
After birth more male children die .
Director Neerja Sekhar while sharing the details of provisional census data maintained the co-relation between literacy rate and sex ratio suggested inverse relationship, however the exact relation would be deduced after final data has been compiled.
There were 18.02 lakh boys under the age of 6 in Haryana; the number of girls in the same age group was 14.95 lakh. (2011 census)
The highest sex ratio was observed in Mewat at 907, followed by Fatehabad at 902, as per Census 2011.
According to the Census of 2021,
Child sex ratio (0-6 Age Group) of Haryana is 902 females per 1000 males.
Sex Ratio in Haryana
According to last Census of India in 2011, Haryana has the lowest sex ratio (834 females) in India. The state is known all over India for female feticide. However, with Government schemes and initiatives, the sex ratio in Haryana has started to show an upward movement. The state recorded a child sex ratio (0-6 age group) of over 900 for the first time in December, 2015. This is the first time since 2011 that Haryana sex ratio crossed the 900 mark.
The highest sex ratio was observed in Mewat at 907, followed by Fatehabad at 902, as per Census 2011.
Haryana’s gender ratio was 903 (2016) according to state’s health department. .
According to the Census of 2021,
Child sex ratio (0-6 Age Group) of Haryana is 902 females per 1000 males.
Haryana’s skewed sex ratio reflects in adoption data too.
Providing specific details about adoption applications received from Haryana, CARA’s central public information officer said the current waiting list for adoption of female children in Haryana is 367 and the waiting list for the adoption of male child in Haryana is 886.
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 members some where as the can burn mounds of wood in chulha at home . As the number of woman is 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. Health department Haryana 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.
Rape cases up as Haryana sees sharp rise in crimes against women. The data shows there were 944 rape cases in 2014, 839 in 2015, 802 in 2016, 955 in 2017, 1178 in 2018, 1360 in 2019, 1211 in 2020 and 1546 in 2021.
(04-Mar-2022 https://www.dailypioneer.com › rap...)
The number of dowry deaths from the period of January 1 to July 11, a total of 13 deaths have been recorded, in 2022 whereas, this number stood at 4 in 2021.(9 deaths more)
(24-Jul-2022 https://www.tribuneindia.com › news)
Haryana is infamous for crimes against women and its share in sexual crimes in India is 2.4 per cent, more than Punjab and Himachal. Around 32 per cent women are victims of spousal violence. Besides, 88 cases of child sex abuse, and 93 cases of rape had been registered every month since 2015.
(04-Aug-2018 https://www.tribuneindia.com › news)
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.
Similarly if there is some increase , even then the atrocities on women are not coming down. Violence affects the health of women in many ways.
Even today women have to go through many struggles, small and big. Women have achieved this day on the strength of their struggles and on this occasion women should fight against discrimination, injustice and all kinds of oppression.
Because even today, no value is assessed for the work done by women, whereas money has to be paid in the market for the same work. Women themselves are also unable to register their work which they should get done. He told that women have more stamina than men and they raise their children even in very bad conditions.
. Think of a situation that in a dream when a man had to go through the trouble of getting pregnant and giving birth to a child. That's when she felt the pain of labor. That's why men should also realize that women have to go through a lot of hardships while giving birth to a child and men can never bear those pains. But unfortunately, the whole process of producing and raising a child is never recorded as a big task.
Women need justice, respect and equality the most, that is why they have to struggle again and again. Whereas there is no difference between male and female except physical structure. But even then, women do not get all the opportunities that they deserve.
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 Survey – 5 and NFHS 4
The data from the National Family Health Survey 5 and 4 indicates that
Infant and Child Mortality Rates(per1000 live births )
Neonate Mortality Rate..NNMR.. ..21.6
Infantil Mortality Rate(IMR)..33.3
NFHS 4..32.8
Under Five Mortality Rate(U5MR)..38.7
Children under 5 years who are stunted (height for age)%..27.5
Children under 5 years who are wasted (weight for height)%..11.5
Children under 5 years who are severely wasted (weight for height)%..4.4
Children under 5 years who are underweight (weight for age)%..21.5
Children under 5 years who are over weight (weight for height)%..3.3
Anaemia among children
Children age 6-59 months who are anaemic ( less than 11 g/dl)%..70.4
NFHS4..71.7
NFHS 5 data revealed stunting, wasting , under weighting, adequate diet and anaemia as 27.5%,11.5%,21.5%,11.8% and 70.4% as compared to NFHS4 34.0%,21.2%,29.4%,7.5% and 71.7%
Anaemia is very high almost same as in earlier survey. Diet intake has improved by 4.3 % but still very low percentage .
V . Gupta et all have found in their study that stunting and underweight were more prevalent amongst girls.
. The median duration of breast feeding for girls has been slightly lower than the median duration of breast feeding for boys .
. This deprivation in childhood contributes to substantial proportions of women being malnourished and stunted as adults.
Pregnant women age 15--49 years who are anaemic ( Hb less than 11gm) are 56.5 % whereas they were 55% in NFHS 4.
It has increased in last five years or so . All women age 15-19 years 62.3 % where as 29.9 % men of this age are anaemic. Clear gender hisse here.
For a significant proportion of adolescent Indian girls, an early marriage followed soon after by a pregnancy is the norm.
About 25 per cent of women aged 18-29 and 15 per cent of men aged 21-29 got married before reaching the minimum legal age of marriage, according to the latest National Family Health Survey (NFHS) conducted between 2019-21.
The women 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 .
India’s maternal mortality rat
(MMR) improved to 103 for the period 2017-19, but the ratio has worsened in states such as West Bengal, Haryana, Uttarakhand and Chhattisgarh, according to official data just released.
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 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
Ex Senior Professor,
PGIMS, Rohtak.
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