Nav: Home

'Extensive gender discrimination in healthcare access' for women in India, suggests study

August 07, 2019

"Extensive gender discrimination in healthcare access" for women in India, suggests study

Younger and older women and those living furthest away from major hospital most likely to miss out on healthcare

Women in India face "extensive gender discrimination" in access to healthcare, suggests a study of outpatient appointments at one major tertiary care hospital in Delhi, and published in the online journal BMJ Open.

Younger (30 and below) and older (60 and above) women and those living furthest away from the hospital were most likely to miss out.

The findings prompt the researchers to call for "systemic societal and governmental action to correct this gender discrimination."

Previous research on gender discrimination in developing countries has largely focused on the higher death rates among women compared to men. And unreliable data have primarily hindered systematic study of gender discrimination.

In a bid to rectify this, the researchers drew on 2,377,028 outpatient clinic appointments for all departments except obstetrics and gynaecology at a large public tertiary care hospital in Delhi in 2016.

They wanted to see if there were any gender differences in access and whether a patient's age and distance from the hospital might have any bearing on this.

Outpatients were split into five age groups: 0-16 years; 19-30; 31-44; 45-59; and 60 and above. More than 90% of them travelled from Delhi and three adjoining states: Haryana; Uttar Pradesh; and Bihar.

A total of 882,324 people visited the outpatient departments of the hospital an average of 2.69 times in 2016, adding up to a total of 2,377,028 visits.

The researchers calculated the number of 'missing' patients by looking at the difference between the actual number of women who visited the hospital and those that should have come, had men and women visited in the same proportions as the sex ratio of the overall population would suggest, based on the 2011 census.

Almost two thirds (63%) of these visits were made by male patients, with a total of 1,494,444 visits compared to 882,584 (37%) visits by female patients, equivalent to a sex ratio of 1.69.

This is significantly greater than the overall sex ratio of the population of 1.09, say the researchers.

After adjusting for different hospital departments, they estimated that nearly twice as many hospital visits were made by men and boys as were made by women and girls in the younger age groups, with sex ratios of 1.93 and 2.01 for 0-18 year olds and 19-30 year olds, respectively.

The ratio fell to 1.43 and 1.4 for those aged 31-44 and 45-59, respectively, but rose again to 1.75 for those aged 60 and above.

This U-shaped curve was the same for patients from all four locations.

After taking account of age and hospital department, the overall sex ratio increased with distance from the hospital: 1.41 for Delhi; 1.70 for Haryana, the neighbouring state, 1.98 for Uttar Pradesh, a state further away; and 2.37 for Bihar, the state furthest away from Delhi.

Comparing the total number of actual visits to those that should have taken place based on the population sex ratio, 402,722 female outpatient visits were 'missing' from these four locations--nearly half (49%) the actual number, calculate the researchers.

This is an observational study, and as such, can't establish cause. The study also relied on data from one hospital and so may not have covered all referrals from each state, including women from more distant states who might have preferred to use healthcare facilities closer to home.

Nevertheless, the findings suggest "extensive" discrimination in access to healthcare, with younger and older women and those living further away from the hospital, especially likely to miss out.

"This calls for systematic societal and governmental action," say the researchers, who go on to say that their study "has important implications for gender-related health policy which has so far focused on maternal health."

They conclude: "The findings suggest local healthcare infrastructure should be strengthened, with the biggest beneficiaries being younger and older women who are most neglected and discriminated against."
-end-
Peer reviewed? Yes
Evidence type: Observational
Subjects: People

BMJ

Related Science Articles:

75 science societies urge the education department to base Title IX sexual harassment regulations on evidence and science
The American Educational Research Association (AERA) and the American Association for the Advancement of Science (AAAS) today led 75 scientific societies in submitting comments on the US Department of Education's proposed changes to Title IX regulations.
Science/Science Careers' survey ranks top biotech, biopharma, and pharma employers
The Science and Science Careers' 2018 annual Top Employers Survey polled employees in the biotechnology, biopharmaceutical, pharmaceutical, and related industries to determine the 20 best employers in these industries as well as their driving characteristics.
Science in the palm of your hand: How citizen science transforms passive learners
Citizen science projects can engage even children who previously were not interested in science.
Applied science may yield more translational research publications than basic science
While translational research can happen at any stage of the research process, a recent investigation of behavioral and social science research awards granted by the NIH between 2008 and 2014 revealed that applied science yielded a higher volume of translational research publications than basic science, according to a study published May 9, 2018 in the open-access journal PLOS ONE by Xueying Han from the Science and Technology Policy Institute, USA, and colleagues.
Prominent academics, including Salk's Thomas Albright, call for more science in forensic science
Six scientists who recently served on the National Commission on Forensic Science are calling on the scientific community at large to advocate for increased research and financial support of forensic science as well as the introduction of empirical testing requirements to ensure the validity of outcomes.
More Science News and Science Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...