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healthcare

By Advocate Meenu Padha and Varushi Yadav 

Introduction

It would not be wrong to argue that in India, the concept of human rights was first introduced and systematically institutionalised in 1950 when our country’s Constitution came into force. Many governmental programmes and methods have been created to supplement the rising acknowledgement of an individual’s rights, and the human rights movement has witnessed significant progress and success.

In India, the issue of reproductive rights remains uncertain. While the importance of both men and women’s rights to choose and control their own reproductive functions has grown in prominence, the concept’s introduction in India is particularly difficult due to the country’s complex social structures, where procreation is frequently seen as a social expectation and individual rights are often overlooked. Reproductive rights, in a broader sense, have received greater attention in recent years. This is due, in part, to the unwavering efforts of civil society organisations, who have emphasised the importance of international treaties in the Indian context.

Experts have pointed out that reproductive rights are an intrinsic aspect of human rights in general, as well as our Constitution on a national level, and that India owes them to all its women and those who identify as such. Reproductive rights and a larger human rights framework are mutually interdependent. Reproductive rights receive their meaning and force from long-recognized human rights, just as human rights cannot be realised without championing women’s reproductive rights. However, how the two are combined in practice is unclear. Indeed, explaining to an Indian audience that reproductive rights pertain to everyone, regardless of age or marital status, is a tough notion to grasp. It’s no surprise, then, that reproductive rights have yet to be fully established, despite the fact that they are an inalienable component of every human being.

Miserable Condition That We Need To Be Aware Of

In India, one woman dies every 15 minutes during pregnancy and childbirth due to lack of healthcare. Despite the fact that India legalised abortion over five decades ago, access is highly limited, and one woman in India is believed to die every three hours as a result of unsafe abortion. Despite national legislation prohibiting the marriage of girls under the age of 18, India continues to have the highest number of child weddings; and despite regulations and initiatives ensuring women’s maternal healthcare, India is responsible for 20% of all maternal deaths worldwide. Several states have established coercive population policies that bar families with more than two children from assistance programmes, government jobs, political engagement, and access to education and health care – all without ensuring that couples have access to a full range of contraceptive treatments.

Furthermore, Indian women face one of the world’s highest rates of HIV/AIDS infection and discrimination if infected, as well as forced abortions of female foetuses, trafficking for forced prostitution, custodial rape in government institutions, workplace sexual harassment, and harmful cultural practices that seriously undermine reproductive health. As numerous national and international stakeholders battle to give meaning to essential ideas such as women empowerment, rights, and choice, the right to reproductive health, including abortion, takes on special significance in the Indian context. A woman, for example, should have the freedom to choose whether or not she wants to marry, who she wants to marry, whether or not she wants to have children, how many children she wants to have, and the spacing between them. This is significant because, while both the male and female contribute to procreation, it is the female who is biologically responsible for ensuring the baby’ complete growth.

In the past, India’s reproductive health legislation and policies have failed to embrace a rights-based approach. Simply put, based on the various definitions of reproductive rights, they can be said to include some or all of the following rights: the right to safe and legal abortion; the right to control one’s reproductive functions; the right to access in order to make reproductive choices free of coercion, discrimination, and violence; and the right to access education about contraception and sexually transmitted diseases. The need for us to recognise and address these as rights has become even more apparent in the midst of the pandemic when women have been left to suffer as a result of massive changes in family and social dynamics, disruption in peer support, and a lack of health facilities – because they have not been informed and empowered to demand what is due to them.

According to a new survey issued, over 139 million women and girls in India currently use contemporary contraception techniques. The progress made in family planning over the last eight years is detailed in a study issued by FP2020, a global collaboration that supports the reproductive rights of women and girls.

Reproductive Laws And Rights One Should Be Aware Of

In 2021, the Medical Termination of Pregnancy Amendment Act 2021 was passed with certain amendments in the MTP Act including all women being allowed to seek safe abortion services on grounds of contraceptive failure, increase in gestation limit to 24 weeks for special categories of women, and opinion of one provider required up to 20 weeks of gestation. Abortion can be performed until 24 weeks of pregnancy after the MTP Amendment Act 2021 has come in force by notification in Gazette from 24th September 2021. The government’s public national health insurance funds, Ayushman Bharat and Employees’ State Insurance cover abortion completely, with the package rate for surgical abortion set at Rs 15,500 which includes consultation, therapy, hospital stays, medication, Ultrasonography, and any follow-up treatments. The package rate for medical abortion is Rs1,500 which includes consultation and Ultrasonography. 

Despite the fact that safe abortions are a state-mandated service, only around a quarter of abortions are performed at public health institutions. The majority of public health services in rural areas do not provide safe abortion services due to a lack of resources and equipment. Despite the fact that this law allows women to get safe abortions under specific circumstances, there are still a number of obstacles to overcome.

Covid 19 Impacts On Contraception And Safe Abortion Services

During COVID-19, the Ministry of Health and Family Welfare (MoHFW) deemed contraception and safe abortion services to be essential health care. COVID-19, on the other hand, has increased the existing difficulties in obtaining these services. Abortion is a health care service that saves lives and protects the health and well-being of women and girls. Understanding how organizations have adapted their safe abortion care programmes to maintain service delivery while seeking to protect their clients, staff and communities from contracting COVID-19, is vital, Covid-19 has wreaked havoc on many aspects of our lives across the globe, reproductive health and family planning are no exception. Over the last 18 months, access to women’s health care services, including contraception, family planning and abortion, has been severely disrupted. As a result, an estimated two million women have experienced unwanted pregnancies. Furthermore, a survey conducted by the World Health Organization suggested a 68% disruption to family planning and contraceptive services across 105 countries.

Although still reeling from the effects of the sudden pandemic onset, the health system over the last year attempted to adapt to meet the growing need for effective women’s care and foster preparedness. One shining example of this was the sudden rise in the provision and adoption of online teleconsultations and digital resources. Availability and accessibility posed two critical components that needed strengthening in care delivery. With the advent of digitalization in the country, spearheaded by the government’s flagship Digital India initiative, we have advanced every day, reaching women from more remote and far-flung corners of rural India with digital platforms. Due to a decline in in-clinic consults, travel restrictions, and overburdened infrastructure and practitioners, Covid provided a significant obstacle to getting such treatment, adding to existing limits in women’s health — social stigma, misinformation, lack of understanding, and family pressures. The health system was forced to prioritize temporary contraceptives like condoms and the oral contraceptive pill above longer-term choices like intra-uterine contraceptive devices (IUCDs) and sterilization, especially during the first lockdown, which limited the basket of treatment options for women.

Conclusion

The social backdrop in India substantially influences women’s reproductive behaviour, defining the pressures, limits, and options available to them. Gender-biased norms and practices that regulate family matters severely limit women’s ability to exercise their reproductive rights. At a higher level, there are various apparent inconsistencies in how policies are made, services are offered, and how demographic trends and aspirations concerning family size and composition impact contraception and abortion demand. Despite the fact that India was one of the first countries in the world to adopt legal and regulatory frameworks ensuring access to abortion and contraception, women and girls still face major obstacles to fully exercising their reproductive rights – it is time to change that. Let us vow to support and steer reproductive rights on this Human Rights Day, not only because we want healthier women, but also because we want empowered women and girls.

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A lot has been discussed and debated about the negative impacts of the Covid-19 pandemic on women but the contribution of women in fighting the pandemic has found very sparing mention. This is despite the fact that women health workers are the beating heart of every healthcare system which is aiding the recovery of Covid patients across the globe.

For several decades, women have played a vital role in the global healthcare workforce as nurses, midwives, community health workers and doctors. In some countries 90% of nurses are women. Although women are still less likely than men to reach senior positions in healthcare professions, recent data shows a trend reversal which ignites some confidence of rising gender parity in the Healthcare sector.

It is heartwarming to note that women represent close to 70% of the global healthcare workforce. Several studies estimate that women in health contribute 5% to global gross domestic product (GDP) (US$ 3 trillion) annually, out of which almost 50% is unrecognized and unpaid.

In 2017, almost half of all doctors in Organization for Economic Cooperation and Development (OECD) countries were women. Thirteen OECD countries exceeded gender parity for doctors in 2017, including Slovenia (63.0%), the Lithuania (69.4%), Estonia (74.0%), and Latvia (74.3%). France (44.5%), Germany (46.6%), the United Kingdom (47.6%), and Sweden (48.0%) were nearing gender parity among physicians. However, women still only made up one in five (21.0%) doctors in Japan. Globally, women represent the majority of nurses and midwives. The Americas (86%), Europe (84%), and the Western Pacific (81%) are regions with the highest proportion of women among nurses.

In Canada, women dominate the health fields in Higher Education. In 2017, women made up more than 78.7% of post-secondary graduates in health and related fields. In the past four decades, women’s share of medical degrees has substantially increased. In contrast to 2017, when only 12% of women earned MD degrees in Canada, there has been a significant spike until 2018 with 54.5% of women achieving the same feat.

In India, women are responsible for 70-80% of all the healthcare services being provided. Women healthcare providers can play an important role in educating society to recognize their health and nutrition needs. Women professionals and empowerment of women at all levels are required for improvement of the health and nutrition structure in India.

In terms of Gender Career Satisfaction, on average, women in healthcare report high satisfaction with their careers (75 percent versus 71 percent of men). They find opportunities aligned with their passions and can adapt their careers over time. Women in healthcare tend to be more happier about their careers compared with men in the same field.

Largely, the gender gap in promotion rates in healthcare, unlike in many other industries, is narrowing. Both women and men report asking for raises at the same rates, but women in healthcare say they are slightly more successful in achieving positive outcomes. Women in healthcare reported receiving more of what they requested in compensation negotiations more often than what men did. Both women and men report asking for raises at the same rates, but women in healthcare say they are slightly more successful in achieving positive outcomes. Women in healthcare reported receiving more of what they requested in compensation negotiations more often than what men did.

According to a research done collaboratively by Lean In and McKinsey, healthcare appears to be one of the best industries for working women on several counts. A broad industry that includes drug and medical-device manufacturers, as well as service providers and payers, healthcare surpasses other industries in female representation.

On the flip side, it is an uncomfortable fact that health systems are currently subsidized by the unpaid work done by women and girls delivering care to family and others in their communities. If only women were able to participate in the economy equally, it would result in nearly an estimated $160 trillion increase in global GDP or a 21.7% increase in human capital wealth.

24 million of the 28.5 million nurses and midwives globally are women. Men, on the other hand, are more likely to be physicians and specialists than women. In addition, more men reach leadership positions, leaving women under-represented in senior, higher-paid roles. However, recent studies reveal an increasing participation of women in highly paid occupations in health, a trend likely to continue over the next 20 years.

The report “Delivered by women, led by men: A gender and equity analysis of the global health and social workforce”, co-produced by WHO and Women in Global Health, confirms that women health workers are concentrated into lower status, lower paid and often, unpaid roles, facing harsh realities of gender bias and harassment.

It is unfortunate that women lead only 19% of hospitals. When it comes to companies in the healthcare industry, women only hold 13% of CEO roles and 33% of senior leadership positions. However, despite all the roadblocks, some women have made to the top of the ladder with their talent, remarkable contributions and sustained efforts. Some noteworthy names include Emma Walmsley (CEO of GlaxoSmithKline and the first woman to lead a global pharma company), Gail K. Boudreaux (president and CEO of Anthem), and Laura N. Dietch (president and CEO of BioTrace). Frances H. Arnold, who in 2018 became the fifth woman to win the Nobel Prize in Chemistry is yet another example of women in healthcare who have gained worldwide recognition for her achievements. Women are the primary consumers and decision makers in the healthcare market, and they make up almost 50 percent of the workforce: much of their advancement and leadership in the field rests on those facts.

Since women work in the frontline in providing medical care and perform some of the risky jobs, they have an increased risk of contracting infectious diseases. In the United States, the Centers for Disease Control reports that, as of April 2020, 73% of healthcare professionals who tested positive for COVID-19 were women. Exposure to infectious diseases poses a high psychological burden for women healthcare workers. A study of healthcare settings in China during the COVID-19 outbreak found that women workers reported elevated levels of stress, anxiety, and depression.

Despite all the risks taken by women, disparity continues to pervade the industry when it comes to monetary compensation. Women in healthcare are paid Less, on average, than their male counterparts. Women physicians and surgeons made $0.67 to every $1 earned by their male counterparts in 2018. Women in healthcare support occupations, which include home health aides and nursing assistants, made $0.83 for every $1 their male counterparts made in 2018.

Gender equality needs to be looked at holistically in the healthcare sector – Policies, effectiveness of programs initiated by the government, and employee experiences must be taken into consideration to promote diversity and inclusion. While the trends clearly show that significant progress has been made over the last few decades, much remains to be done.

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Shivangi Sharma (for The Womb) in Conversation with Sania Rehmani, the ideation head of Sex Education India. Sania joined us to talk about the organization and how they are bringing change by asking one uncomfortable question at a time. 

As the second most populated country in the world, we surely do not live upto the expectations of our citizens’ sexual well-being. Our children grow up in the blissful ignorance of sex education only to gain the wrong knowledge from dangerous sources. As a country while we agitate when we hear any instances of sexual offence, our understanding of it is so crooked that we don’t even acknowledge sexual crimes that happen right under our noses, committed by the very people we live with. Apart from sexual offences, there are several other social concerns that exist simply because our society is too conservative to talk about them. Topics like relationships, intimacy, physical and emotional growth during puberty, consent, gender norms, sexual orientation and many more that are essential part of a human being’s life are neglected in our growth years. The one subject that covers all of this is Sex-education. It is a topic that hits right at home for millennials who grew up knowing the importance of sex-ed, only to be deprived of it. But Gen-Z here has taken upon itself to deal with this head-on. Not only are they actively working on spreading awareness on importance of sex-ed, they are demanding the administration to wake up to their responsibilities and teach the subject, not just in a tokenistic manner but in a comprehensive and inclusive sense. The Womb had the opportunity to talk to one such proactive Gen-Z organization. Mincing no words, they are called Sex-Education for India who are aiming to normalize sex education and prioritize the need to teach consent in educational institutions.

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The Womb is an e-platform to bring together a community of people who are passionate about women rights and gender justice. It hopes to create space for women issues in the media which are oft neglected and mostly negative. For our boys and girls to grow up in a world where everyone has equal opportunity irrespective of gender, it is important to create this space for women issues and women stories, to offset the patriarchal tilt in our mainstream media and society.

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