Healthcare for the Marginalized

Summary

Healthcare is for all. Yet, in spite of many policies being framed to make healthcare accessible to all, there are many marginalized groups which do not get the healthcare they badly need. The blog explains the various obstacles faced by marginalized groups while accessing healthcare.

Marginalized groups refer to those groups of people who are not part of the established groups in society. They are often vulnerable and are routinely excluded by policymakers. Healthcare plans are rarely planned or implemented keeping in mind the needs of these marginalized groups. As a result, healthcare does not reach the people who need it the most.

The Marginalized in India

Women, children, scheduled castes, scheduled tribes, differently abled, migrants, etc. are some of the groups that are often discriminated against and prevented from availing the healthcare they need. These groups face barriers in the form of disability, social stigma, dependence on others, finances, etc. to name a few.

Sometimes, these groups face a number of barriers at once when it comes to accessing and availing healthcare. Take the case of a differently-abled woman – she will not only find transportation difficult but a patriarchal society will also not encourage her to avail healthcare. She is an example of a person who badly needs healthcare services yet is denied of it.

Women:

• Women’s health is never given the importance it deserves, not only by the family and the society, but sometimes by women themselves who are so used to society treating their health expenditure as unnecessary that they start believing it themselves.
• While women across society suffer due to this misconception, poor women are more affected by this than women who are economically better off.
• Women don’t have any say in the family’s finances nor in any important decision related to their own health and life.
• Health problems are further exacerbated when women marry early – around 20% of women in India are married before they turn 18.
• Domestic abuse is another issue women across all strata of society face.
• The trauma inflicted is not only physical but mental as well.
• Tribal women are the worst affected as nearly 2/3rds of them are victims of domestic abuse.
• We need to not only protect women from abuse but necessary health services should also be made available.

Scheduled Castes and Scheduled Tribes:

• Caste has always been a huge divisive factor in India.
• While efforts are being made to prevent any unfair treatment based on caste, these usually focus on areas like education, employment, etc. and healthcare is not given enough importance.
• The healthcare inequalities faced by this section of our people is rarely addressed.
• People belonging to scheduled castes and tribes are often treated badly and as a result are forced to discontinue education. Not being educationally qualified, they do not have access to good jobs. They have to take up low paying jobs in less-than-ideal conditions – they are often exposed to unhygienic conditions and increased infections.
• Being impoverished, they find quality healthcare unaffordable.
• Sometimes, health professionals avoid visiting the areas where they live and even if the people approach a health facility, they might be made to wait longer than others thus making them victims of discrimination.

Differently Abled

• There are around 1.3 billion differently abled people all over the world.
• This means that out of 6 people, 1 person has some form of disability.
• People with disabilities have double the risk of developing diabetes, asthma, obesity, mental health conditions, etc. compared to people who do not have disabilities.
• When it comes to transportation, they find it 15 times more difficult to get anywhere.
• They also face multiple barriers when it comes to accessing healthcare – lack of awareness/education, the discriminatory treatment meted out to them by indifferent health workers, difficulty in accessing healthcare facilities, insufficient knowledge on treating the health conditions faced by them, etc. all lead to reduced healthcare for this group.
• It is essential that health plans are formulated with them in mind by including their representatives.

Children

• Children are completely dependent on their parents and guardians for all their needs.
• Research shows that children’s health is affected by their economic status, their caste as well as their gender.
• These factors dictate their nutrition, the kind of environment they live in, the awareness their parents have and their healthcare accessibility.
• Children from low-income families are often victims of malnutrition.
• They are also afflicted with many preventable or treatable conditions like diarrhea, measles, etc.
• Children from scheduled castes and tribes are the worst affected as indicated by their morbidity rates compared to other children.
• The same is the case with children in rural areas when compared to urban areas.
• Vaccination coverage is also poor for these children as their parents are in most cases uneducated and do not realize the importance of vaccination.

Migrants

• According to the last available reports, the number of migrants in India (both within a state and from state to state) stands at around 450 million.
• This translates to nearly 37% of our country’s population.
• How can such a large number be ignored you would think. But they unfortunately are.
• Among the migrants, seasonal migrants are in particular ignored with policy makers not giving any attention to them.
• Migrants face many difficulties while accessing healthcare – discrimination, communication issues and cultural barriers.
• Many of them are poor and cannot afford quality healthcare.
• They are also in most cases uneducated and have no knowledge of health insurance.
• As they migrate from state to state, the benefits the state offers people below the poverty line is not available to them as they do not possess the necessary documentation.
• As a result, when they are in need of healthcare, they are forced to spend their meagre earnings.
• Sometimes, treatment has to be discontinued if their finances don’t allow it and as a result, they suffer premature deaths.
• Even when services are available for migrants, they are not aware of it and as a result do not make use of it.
• Hence, it is necessary to put plans into place for their well-being, but more importantly, they should be made aware on what is available.

Takeaway Message

Concerning as it is, what is needed now is action. Health policies need to be framed keeping in mind the barriers that marginalized people face. Including representatives from various groups while coming up with solutions will help understand their position. While the government has formulated policies to benefit the marginalized, more needs to be done to bridge the care gap. Every person has a right to quality healthcare but if we do not pay attention to these marginalized groups, healthcare coverage will never be universal.