Women's Health Care example essay topic

India- An overview of the Country India, a country in South East Asia, has the world's second highest population. Out of the one billion people residing in the nation, 120 million of its women live in poverty. The male to female birth ratio is 1.05 males to 1 female. The life expectancy of the average person is sixty-four years of age. They have a literacy rate (people over the age of fifteen that can read and write) of 59.5 percent, with 70.2 percent of males being literate and 48.3 percent of females that are able to read and write (cia. gov). India's economy is based mainly on traditional village farming, modern agriculture, handicrafts, a wide range of modern industries, and a multitude of support services.

It is a patriarchal society, which means that men are the head of societal and familial matters. Women are not thought of as equal to their male counter parts and are expected to be obedient of males. Because of the large, unfavorable shift of power, women face injustices and inequalities in almost every aspect of their lives. A main issue that has always been present and continues to be problematic is the inequalities women must deal with when it comes to health care.

What types of services are available to women when they are pregnant and what types of conditions result from these limited services? The common belief when it comes to pregnancy is that it is an ordinary part of every woman's life. Even though child birth is an extremely exciting and happy moment for a family, "the mother and child are considered 'impure' and 'polluting' " (Hussain, 2001). When a woman is pregnant, she is given special treatment in her family, often not expected to do housework and is fed much better, but only if the expected child will be a son. Often, if it is known that the woman will have a daughter, she will still be expected to perform all of her domestic duties, no matter how dangerous it may be for the fetus. Prenatal and post-natal health care are usually not given to a women.

Most women, more than 50 percent, give birth to their child in their own homes. The times when she is taken to a hospital is when she will be delivering a male child. In the article, "Do Women really Have a Voice? Reproductive Behavior and Practices of Two Religious Communities", Sabiha Hussain (2001) tells the story of a woman named Salma. During Salma's last pregnancy, her mother-in-law thought she saw symptoms that indicated that Salma may be pregnant with a boy. Salma was then taken for an ultra sound to verify these thoughts, and once they were sure that she was pregnant with a son, Salma was given a special diet, extra care during her pregnancy and delivery and was even allowed to rest for twenty days after she gave birth.

In another case study, Hussain tells the story of Anita, who was put into an isolated room after her seventh month of pregnancy. When she went into labor, she requested for her mother-in-law to take her to the hospital, but instead her mother-in-law tried to call the dai (midwife). The dai did not arrive in time to assist Anita with her child birth, and as soon as she had the baby, she was left unattended in the room with no one to help clean her or the new born. During pregnancies, there are some beliefs that families practice. They often prefer 'hot' versus 'cold' foods during pregnancy, reduced food consumption during pregnancy, son preference, use herbal medicines, home delivery by a traditional birth attendant, exclusion of men from most aspects of childbirth, the role of extended family, confinement after delivery, delayed onset of breast feeding, and perform rituals aimed at warding off the 'evil eye" (Chaudhry). In most parts of India, the services available to most pregnant women are only the care they receive from their own families.

There are not too many gynecologists or obstetricians available for pregnant women, unless they are extremely wealthy. The estimates nation wide are that only forty to fifty percent of women receive antenatal care (Coonrod). In other states such as Bihar and Rajasthan, maternal health services are given to five to twenty-two percent in rural areas and twenty-one to fifty-one percent in urban areas (Coonrod). Families that traditionally care for the women themselves will make an exception to take her to a professional only if they know that the baby will be a boy. As a result of neglecting the special needs of a pregnant woman, there are often complications during her pregnancy or while she is giving birth.

Women are often unable to completely recover from their deliveries and the female babies are not very well taken care of. It is estimated that pregnancy related deaths account for twenty-five percent of mortality in women between the ages of fifteen and twenty-nine. For every one death, twenty more women suffer from other issues that impair their health. In a village called Maharashtra, based on physical exams, ninety-two percent of the women endure at least one genealogical problem (Coonrod).

How does violence and mistreatment of women play a role in the inequality of health-care? Gender based violence is extremely prevalent throughout the country. "All women, regardless of age, class, caste, and community are vulnerable to domestic violence-marriage, a joint family, education, economic security and social status do not provide any real protection" (Zucker, 2001). A main factor of violence towards women is dowry murders.

Every year, there are about 6,000. Often, when a woman's family does not give the groom a large enough dowry, the bride is murdered. Members of the working class will often save their entire lifetime to make a dowry for their daughter. Instead of being able to spend all of their wages on things that would benefit their health, such as food or clothing, people sacrifice their well -being, just to save enough to give to their daughter's groom (Douglas). Another main issue is sexual violence. According to the article, "Women and Health: India; The 'Male Factor' in Women's Reproductive Ill-Health", in India, "every twenty-six minutes, a woman is molested.

Every thirty-four minutes, a rape takes place. Every forty-two minutes, a sexual harassment incident occurs. Every forty-three minutes a woman is kidnapped. And every ninety-three minutes a woman is burned to death over a dowry". Also, women are not safe from harm even from authorities of the law.

Police have been known to rape women that are poor or from low castes. Rape within cities and slums is a huge problem. In Bombay, a major city, there was a march against rape because a working class woman was gang-raped and as a result of this horrendous act, the woman's five month old fetus was aborted (Douglas). According to the article, "Women and Health: India; The 'Male Factor' in Women's Reproductive Ill-Health,"A recent study from Nagpur, states that domestic violence is a major health concern. The report says that 25.3% of women were abused in non-pregnant state and 22% during pregnancy. The episodes of abuse were most often multiple and were inflicted by the husband or jointly along with other family members".

In order for healthful living, a person needs all of her human rights to be preserved. By being exposed to violence constantly, a woman does is not receiving any kind of beneficial health care. Even when a woman is victimized, it is rare that law authorities actually prosecute the attacker. If a woman is raped, she is not given any form of counseling; instead, the woman is often blamed of shaming her family.

When it comes to healthcare of women, the violence that exists in India only helps to make the inequalities between men and women more extreme. By holding a woman responsible for the violence unjustly inflicted on her, the balance of power is once again in the hand of males. How do cultural factors affect a women and the contribution to inequalities of health care? When it comes to the institution of marriage, women are subordinate to males. The major religion in India is Hinduism, which is hierarchical and dominated by men.

Once a woman marries, she is expected to move in with her husband's family and are brought up to believe that "her own wishes and interests are subordinate to those of her husband and his family" (Coonrod, 1998). By putting other people in front of herself, a woman often ignores her own health. Even if a new bride feels ill or knows that something is wrong with her health, she is less likely to complain about her ailment or seek help. It is her duty to be more concerned with her husband and his family, than to take care of herself.

In many rural areas, there are child marriages. Girls as young as ten are married off to men that often more than twice their own age. A survey in 2001 showed that of more than five thousand woman in Rajasthan, fifty six percent of them had married before the age of fifteen (Burns, 2002). Marriage at such a young age effects women's health greatly. First of all, most girls are not mentally or physically ready for marriage at fifteen. They often get pregnant at very young age, which causes severe problems to the mother, as well as the new child's health.

Both are often not given the proper nutrients during pregnancy and end up severely malnourished. A girl as young as fifteen has also gone through puberty very recently and her body is not strong or developed enough yet to have a baby. Females have a huge disadvantage in India when it comes to education. Although there have been significant improvements made in female literacy since independence, the rapidly growing population means that there are more illiterate females today than a decade ago.

A variety of socioeconomic factors are responsible for women's lower educational levels, including direct costs, the need for female labor, the low expected returns, and social restrictions. Because women's education and improvements in their health status are closely linked, increasing female education is the key to improving their health (World Bank, 2003). Culturally, women are kept oppressed purposely in India. In order for women to learn about their own bodies and make progress in healthcare, they need freedom and education.

By taking away many of the rights that women deserve, the male dominated society is able to maintain the majority of power. With women powerless, they are unable to take the necessary steps to improve their health status. How does their food availability and eating habits contribute to their health status? One of the most pervasive problems women have as a result of malnutrition is Iron deficiency anemia (IDA). It especially affects pregnant women, as well as infants, young children, and adolescent girls. Various estimates from different parts of the country indicate that more than seventy percent of pregnant women, approximately fifty percent of all women, and sixty-five to seventy percent of adolescent girls may suffer from IDA (OMNI Micronutrient Fact Sheets: India).

Approximately ten to twenty million children in India have mild to severe vitamin A deficiency (VAD). Each year, about sixty thousand of these children go blind as a consequence of the deficiency. The burden of iodine deficiency disorders (IDD) is another major health issue; approximately 150 million people are at risk of IDD, of whom 54 million have goiter, 2.2 million are cretins, and 6.6 million have milder neurological deficits. Females are undernourished starting at a very young age.

Since a son is more desirable than a daughter, the girl child is breast fed for a shorter period of time than a boy. As they grow up, the girls are still fed much less (Women and Health, 2002). Tradition requires that women eat less than their husbands and eat last, after all the males have eaten a satisfactory amount. Because of these traditional values, women and girls end up with problems such as anemia, VAD, and IDD much more frequently than males. What kinds of jobs do women hold that contribute to their ill health?

In India, women tend to work twice as many hours as men. When it comes to agriculture, they perform the manual labor for longer periods of time where as the males use machinery and animals to assist their work. A woman may spend fifteen hours, from 4 am to 8 pm, rice transplanting ("the most arduous and labor intensive job in rice cultivation") and weeding, without the help of any tools (Coonrod, 1998). Males are outside in the fields from 5 am to 10 am and 11 am to 3 pm, performing tasks such as plowing or watering fields. Since the last decade and a half, there has been a huge growth in industry in India. Many women living in cities have started to work in garments factories.

In most of these factories, women work ten hours a day, without getting paid overtime, and without the right to sick or maternity leaves. They are "exploited with low wages and overburdened with work" (Johnson, 2003). The demand for Indian garments and other goods abroad has forced factory owners to go for large-scale production without investing in workers's af ety and financial security. While factory owners and shop owners continue to earn huge profits, the women workers who contribute to their profits earn barely enough for two meals a day.

In their own homes, women are now expected to help with not only family income, but also with domestic duties. They are responsible for the cooking, cleaning, feeding her family, the "maintenance of kitchen gardens and poultry, grinding food grains, collecting water, and firewood, etc". (Women and Health, 2002). Women in India are overworked and under appreciated. Their bodies are under a tremendous amount of physical stress and they are never given the chance to relax. They are expected to handle a majority of the household duties and work outside of the home, without having physical breakdowns.

This contributes to their ill health because it is not realistic to expect that a person can handle so much all at once. What is the government doing to improve women's health care? Overall, the government spends only about 1.3 percent of the gross domestic product on health care. In addition to general health services provided to all people, public sector services to meet the specific health and nutritional needs of Indian women are provided through the Family Welfare Program of the Ministry of Health and Family Welfare and the Integrated Child Development Services (I CDS) Program of the Ministry of Human Resources Development. Over the years, there have been numerous legislative acts passed to try and equalize men and women in India. Equal rights and education would create a path for women to gain improved healthcare.

The following are some steps that have been taken to try and help women with in the last fifteen years: 1) 'The Women's Health Equity Act, first introduced in 1990, focused on addressing, in an overall manner, women's health concerns and was designed to be encompassing in numerous areas. The first area addressed in the bill is research. The second area is services, and the third prevention... ' (Kasturi, 2001). 2) The Family Welfare Program administers family planning and mate mal and child health services that are provided through sub centers (which serve a group of villages), primary health centers, community health centers, and district and subdistrict hospitals. The Family Welfare Program was originally the National Family Planning Program but has evolved over the years.

Recently, it has focused mainly on sterilization. The program has been criticized because it has prescriptive methods, narrow scope of services, and inadequate outreach. In order to try and improve the program, the government is developing a more decentralized method by taking a broader approach to reproductive health, and recognizing the importance of issues such as female education and women's status (world bank. org). 3) The Child Survival and Safe Motherhood Program was initiated in 1992.

"It is designed to improve the health status of women and children and reduce maternal, infant, and child mortality rates by addressing the main causes of morbidity and mortality. The initiative builds on services provided by the Family Welfare Program but is more targeted. The child survival component of the program, particularly the efforts to expand immunization coverage, has received the most attention. The safe motherhood component has developed more slowly, primarily because implementing the program's ambitious goals requires a significant expansion of the existing maternal care services. Current facilities for providing care of obstetric complications (a key program goal) are inadequate, and it is difficult to recruit trained female personnel for posts in remote areas" (world bank. org). 4) The Intensified Training of Dais Program is designed to provide training for dais, who are present at many births in rural areas instead of professionally trained doctors.

The women are given hands-on training that focuses on "antenatal care, safe delivery practices, including hygiene, and detection and referral of complications" (world bank. org). The dais are also provided with kits containing essential items for hygienic delivery. Although the government is passing these legislation's and plans, they are not being carried out very well. There has been some what of an improvement in women's heath care in more recent years, because of more education and awareness, but there is still a long way to go. The rate of improvement in a country like this will be very slow because of the deep rooted beliefs and attitude of inferiority towards women.

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