India’s healthcare system developed immensely after independence, but it still lacks inclusivity of all social groups, especially the Dalits and the Adivasis.
Story: Avani Kulshreshtha
Edit: Nitya Kaimal
The Dalits and Adivasis make up approximately 25.2% of India’s population. Being considered ‘untouchable’ and ‘lower caste,’ these groups have constantly been marginalised and excluded from the healthcare structure. This has led to persistent poverty and deprivation from all aspects of their lives.
According to the data available, a Dalit woman lives fifteen years less than an upper-caste Hindu woman. This alarming gap reflects deep-rooted inequalities in Indian society that have for years led to avoidable fatalities. These disparities are embedded in the structural inequalities that define the Indian social fabric.
The COVID-19 pandemic has exacerbated these health disparities, placing an unprecedented burden on marginalized communities. The cost of medical care during the pandemic surged, with the average cost of COVID-19 treatment reaching INR 1,12,179 in government hospitals and Rs 2,97,577 in private hospitals. The treating cost of symptoms similar to COVID-19 was INR 4,622 in government hospitals and Rs. 28,932 in private hospitals. This dramatic increase in healthcare costs has hit the poor hardest, particularly those within marginalized communities.
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India spends one of the lowest in the world, with only about 1.25% of the GDP that is used for expenditure on healthcare. This underinvestment in healthcare infrastructure and services has dire consequences for the population, particularly for marginalized communities. The COVID-19 pandemic catalyzed highlighting these existing structural inequalities within India’s healthcare system. According to the Oxfam India Inequality Report, the pandemic had huge impacts on marginalised groups including the Dalits. They have also been unable to practice social distancing or access health facilities.
The WHO has also noted that India has been unable to meet the needs of the population. The organisation has urged India to increase spending to improve the public health infrastructure, especially for the marginalised.
The policies in the country have effectively dismissed the marginalised. This manifests through the unconscious exclusion of Dalit issues and the construction of abstract and homogenous groups that obliterate caste differences. Furthermore, the people often fail to acknowledge the existence of caste-based inequalities in the health infrastructure. This social determinant discourse fails to acknowledge the significant role of caste in shaping health disparities, particularly among Dalits in states like Kerala.
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The literacy rates among the Dalits are also low as compared to the other social groups, and they usually engage in unskilled labour, which provides minimal income and is not enough to exist as an equal in society. The literacy rate of the Dalits stands at approximately 66%, against the national average of 73%.
Furthermore, the Indian healthcare delivery system is bifurcated into public and private sectors. The public system comprises limited secondary and tertiary care institutions in key cities and focuses on providing basic healthcare facilities through Primary Healthcare Centres (PHCs) in rural areas. However, the inadequacies in the public healthcare system and the high costs associated with private healthcare make quality healthcare inaccessible for many Dalits.
India’s healthcare system ranks 44th in the global healthcare index with a score of 65.4, highlighting the country’s struggle to provide equal healthcare opportunities for all its citizens. The disparities in healthcare access and outcomes for Dalits reflect the urgent need for policy interventions that address structural inequalities and ensure that marginalized communities receive the healthcare they rightfully deserve.
*दलित टाइम्स उन करोड़ो लोगो की आवाज़ है जिन्हें हाशिए पर रखा गया है। *
महिला, दलित और आदिवासियों के मुद्दों पर केंद्रित पत्रकारिता करने और मुख्यधारा की मीडिया में इनका प्रतिनिधित्व करने के लिए हमें आर्थिक सहयोग करें।
