Healthy women’s day

Rehan A Khan | Updated on March 07, 2021

Vital sign: Public healthcare can close the gender gap in access   -  THE HINDU

Rehan A Khan, Managing Director, MSD-India

Why we should #Choosetochallenge gender biases in healthcare access

Rosalind Franklin was a brilliant scientist whose data and research using X-ray crystallography led to the discovery of the double-helix DNA model. James Watson and Francis Crick were awarded the 1962 Nobel Prize for the discovery, but they couldn’t have done it without the pioneering research by Franklin.

Her significant contribution wasn’t acknowledged by Watson or Crick until after her death in 1958. In 2020, based on what she started, scientists were able to uncover the complete genetic sequence of the SARS-CoV2 or Covid-19 virus, in just 10 days, after the first cases were reported from Wuhan. Six vaccines — one in India — were developed in barely 10 months.

On International Women’s Day (IWD), we celebrate Rosalind Franklin’s achievement, and those of others like her. IWD also has another purpose: Focus attention on the absence of gender parity in almost every area of our daily lives. The theme of IWD 2021 — #choosetochallenge — focuses on achievements by women such as Franklin that challenge the status quo.

While challenges abound with regard to gender bias, a critical one, and the need of the hour, continues to be access to healthcare. A study by the Indian Statistical Institute, Harvard University and the Prime Minister’s Council of Economic Advisors (published in August 2019) reviewed 2.377 million outpatient visits to the All-India Institute of Medical Sciences (AIIMS) in New Delhi in 2016. Researchers were trying to answer two questions: With an increase in healthcare costs, are women less likely to go to hospital; and, second, whether households would be less likely to send women for treatment. Variations in age and distance were also factored in.

Here’s what they discovered: Of the nearly 0.8 million patients, 63 per cent was male, and 37 per cent female. The male-female ratio is 1.69, compared to the population sex ratio of 1.09. When age was taken into account, the ratio went up to 1.92 for those below 30, and 1.72 for those above 60. This is an overwhelming evidence of discrimination in healthcare access.

Patients included those travelling from Bihar, Uttar Pradesh and Haryana, besides New Delhi. Researchers found that women below the age of 30 were less likely to seek healthcare in Bihar and UP, while women over 60 were more discriminated against in Haryana. One lesson for policymaking is that publicly financed local hospital infrastructure is more likely to have a greater positive impact on the gender-related gap in access.

Evidence of discrimination against women also persists in health expenditure. Another 2019 study revealed that average inpatient healthcare expenditure is substantially lower among adult females than males in India. Discrimination is especially higher when families have to borrow money or sell assets to pay for healthcare access.

Healthcare financing is the second key policy measure that can have a positive impact on healthcare access for women. Health insurance — including Ayushman Bharat and private sector insurance — has been growing, but there is much more ground to cover. Union Budget 2021-22 makes a clear statement of intent, but we need an accelerated agenda on healthcare access for women.

We have the opportunity to bring healthcare access to women by creating and strengthening local healthcare infrastructure and financing. A strong ecosystem of public-private partnerships with the Government leading the way will ensure long-term commitment while adding significant value to the health of women.

In 1977, the world’s first successful anti-viral drug — acyclovir, to treat herpesvirus infections — was created by Gertrude Elion, biochemist, pharmacologist and the winner of the Nobel Prize for Medicine in 1988. Scientists had believed that drugs to kill viruses would be too toxic for the human body. Elion chose to challenge them. She said, “I hadn’t been aware that there were doors closed to me until I started knocking on them.”

There is a need to move away from the status quo on gender-based health differences and strengthen the participation of women in making their own health choices. This calls for a systematic societal action and a larger focus on gender-related health policy. Clearly, the challenge to healthcare access for women is not linear and it’s time we started to view healthcare from the lens of equality.

The writer is Managing Director MSD-India (MSD is the trade name of the US-headquartered Merck & Co Inc) Views expressed are personal

Published on March 07, 2021

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