Women and Health Care in Mumbai : A Study of Morbidity, Utilisation and Expenditure on Health Care in the households of the metropolis
(ABSTRACT)
This report, an outcome of a study conducted by the centre in a marginalised community in Mumbai, investigated morbidity pattern, utilisation of health care facilities and expenditure by making use of a unique sampling method that is free of gender blindness. The salient findings of the study and its implications are presented here.
Morbidity
A higher burden of morbidity was reported among women, which was complemented by high prevalence rate of specific types of illnesses. For example, illnesses related to reproduction and childbearing form more than one-fourths while aches, pains, injuries and weaknesses form nearly one-fourths.
Married women experience an additional burden of morbidity, which might be due to morbidity related to reproduction.
A vast gender difference observed on the monthly prevalence rate of illness. Females' monthly prevalence rate was nearly double that of males.
The reported lower sense of 'well being' might be a consequence of poverty.
Utilisation of Health Care
Utilisation of health care has been found low. This is true even for maternal care.
Non-institutionalised births are high in the community.
A high preference for private health services was found. A similar trend has been observed for reproductive health services and contraception. It is especially because of their convenient location and timings.
Private clinics and dispensaries located near the place of residence and public hospitals were preferred for treatment.
Majority preferred to consult doctors for illnesses. Female doctors are preferred for illnesses relating to reproduction and childbirth.
Gender bias against females in health seeking observed in such a way that out of the total of 271 not treated illness episodes, male episodes accounted for only 17 and female episodes accounted for 254. More women than men used home remedies. Females in younger ages utilise health facilities than their older counterparts.
Utilisation of health facilities for women are not determined by their earning status, occupation or education. But it is true that low status of women in the household set-up and the society leads to a very significant gender bias in health care utilisation.
Expenditure on health care
A major share of expenditure were for treating illnesses while that for maternity services account for only 15 percent.
The per capita health expenditure works out to be Rs. 493.08 (per household expenditure works out to be Rs. 1,973.51. This is much higher than government spending (which is Rs. 250) in Mumbai city and very much higher than the national per capita expenditure (which is Rs. 90).
A major share of the expenditure (nearly 85.41 percent) was on private health facilities. But the per episode cost was found higher at public facilities than private facilities.
A major share of the expenditure was from the non-slum area. People in the slums to whom illness strike more often do not spend for health care, which could be due to their low income and lower socio-economic status.
Gender bias in expenditure of illness is evident, as spending for female's illness episodes was much lower than that for males. Per episode cost for females is half that of males. This trend holds true in both slum and non-slum area.
With increases in age, difference in expenditure sharpens between males and females.
The gender difference in health expenditure was high among lower level professionals.
Access to health services is determined by factors operating within the household and outside. The factors related to issues within the household need to be dealt at a societal level. The forces that operate at the broader level need to be examined in a more gender sensitive manner so that more women can avail of the services. And so, it is needed to sensitise women's perceptions about their health problems.
Price Rs. 60/-
*******************************************************************************************************************************
Order this publication-rc07
Sitemap
© Copyright Centre for Enquiry into Health and Allied Themes