Unequal access to healthcare has long been a challenge for societies across the world. Want to know how to address it and do your bit? Read on to find out..
The COVID-19 pandemic only highlighted the issues of inadequate health facilities in India. Even as some of the country’s biggest cities struggled due to hospitals filled with patients, our more remote areas did not even have the facilities in place to help address the crisis. This was clear in regions such as rural Bihar, where there was an average of one doctor available for every 43,788 people.
Healthcare today is a fundamental right and needs to be available to people irrespective of their socioeconomic backgrounds. However, those at the bottom of most social systems in India today struggle to access high-quality care. Age-old societal evils shape this discrimination — sexism affects Indian sex workers from accessing quality care, while casteist structures restrict Dalit and Bahujan communities from receiving quality medical care.
The Many Forms Of Inequality
Let’s start with the most visible perpetuator of inequality: gender. A study in 2018 conducted by AIIMS, Harvard University, and the Prime Minister’s Economic Advisory Council examined the records of nearly 2.5 lakh patients who visited the AIIMS medical facilities in 2016. Research revealed that out of the total visitors seeking treatment, only 37% were women.
There are several reasons for this discrimination that go beyond just healthcare. Indian women may have additional responsibilities at home and do not always find the time to seek treatment. Lack of financial independence also means that they are unable to handle medical expenses without involving a man. Therefore, all medical care solutions must keep in mind the various barriers a woman may face while asking for the treatment she needs.
The study, in itself, only examined one possible factor for unequal access to healthcare: gender. Economic conditions, caste, and other socioeconomic factors further break this data down, highlighting the stifling nature of inequality.
What Is Representation’s Relationship With Equality?
Why is the presence of diverse medical professionals necessary to address inequality? The answer lies in human behaviour. Professionals that hail from marginalised communities have a higher probability of understanding the unique issues these groups face. There is also a greater chance of them working in the service of these specific communities. Furthermore, they help challenge the status quo that exists in the healthcare industry today and address present biases.
To quote another gender-discrimination based example, a paper published in 2018 showed that medical professionals viewed men with chronic pain as ‘brave’ or ‘stoic,’ while women suffering through similar issues were labelled as ‘emotional’ or ‘hysteric’. This, in turn, influenced the care they received. Such issues can be addressed by the presence of more women in the medical industry, along with current doctors being made aware of their inherent biases. These biases are in no manner an attack on their character but simply a byproduct of them being human.
Inclusive Healthcare: The Beginning Of A Long Journey
Inclusive healthcare caters to the belief that medical and health services should be accessible to all, irrespective of their age, sexual orientation, gender, or caste. This is achieved by bringing in the measures required for underrepresented members to get the care they need. This includes having members of such communities on the staff to voice their unique requirements and diverting resources to the marginalised corners of the country.
Availability and affordability of healthcare is just the first step in this journey. We must also acknowledge and celebrate these groups and their needs, addressing their sociocultural background and its impact on their treatment.
Social stigma and discrimination against communities pose another enormous problem. A story by Vice India in 2017 spoke about how the medical services working with sex workers had the facilities to address STDs, but not issues like arthritis. Even those with the best intentions at heart are unable to plan for the range of problems various communities face. Such instances are a reminder that vulnerable populations need to play a far more prominent role in developing and delivering healthcare provisions.
A Story Of Price, Privilege, And Policy
75% of India’s healthcare facilities are present in urban areas, spaces that are home to only 27% of our nation’s population. A recent KPMG study states that 80 percent of the available doctors and nurses are located in urban areas. Professionals prefer working in these regions as they benefit from better living conditions and higher wage earning opportunities.
So, how do we address this systematic inequality? Through a combination of public policy changes and private sector innovation. With the increasing usage of digital tools in rural regions, physicians and medical experts can treat individuals thousands of kilometres away. Similarly, government partnerships with private players can help provide India’s rural population with excellent insurance cover, making treatment affordable for all.
Incentivising public health in rural areas is essential for private players to enter and impact the market. Additionally, we must look to include the most neglected communities in our healthcare systems, empowering them to aid others. Much like treating a patient, the solution to inequality lies in one simple decision: Choosing comprehensive care over the mere treatment of symptoms.
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