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Health services missing for women workers in India

Oct 05, 2009

Much of women’s work in India has little or no social security, reveals a new report on women wage labourers’ access to maternal health services. Absence of protection against occupational and health hazards is creating vulnerable situations for women workers in the country’s deprived regions.

New Delhi: Women’s work most of the time goes unrecognised and the benefits hardly reach them. Today many female workers in India are involved in the unorganised sector and the indifference towards their safety and rights is worrying.

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According to National Council for Applied Economic Research (NCAER), almost 97% female workers are involved in the unorganised or informal sector.

Many laws have been provided to ensure a safe and healthy working environment for the female workers – the Trade Union Act (1926), the Minimum Wages Act (1948), the Maternity Benefits Act (1961), etc.

The most recent in the litany of laws is the Unorganised Workers Social Security Act of 2008, which provides benefits to workers registered with the district administration, including some health insurance and maternity benefits.

Despite these laws, health and health services remains disheartening.

A study on Informal Sector Women Wage Labourers’ Access to Maternal Health Services conducted by SAHAYOG and partner organisations in selected districts and blocks in Uttar Pradesh, Uttarakhand and Chattisgarh highlighted the poor access to health services for women wage labourers in the informal sector.

"Working in extreme conditions has led to a number of health risks both due to the heavy work burden and nature of their work"

The focus group of the study was the socially marginalised Scheduled Castes and Scheduled Tribes among Hindus.

In all these three states a large population of female workers were found to be engaged in agriculture, forestry and stone quarrying. These women started working as early as 18 years or even earlier, and continued until past 55 years.

Working in extreme conditions has led to a number of health risks both due to the heavy work burden and nature of their work. Sufferings from muscular aches and pains, injuries, exhaustion, weakness, fever and swelling of feet were quite common and went untreated.

The findings also showed that lack of health benefits, high fertility rate, poor and unequal wages, improper sanitation and childcare facilities were becoming major concerns with these working women.

Worst of all, many of the chores women do go unnoticed, even though it substantially contributes to household economy.

Sapna Desai from SEWA–Bharat said: “Women’s work should be seen as full work and benefits should be extended to them through cooperative efforts and various financial and social schemes.”

Putting across the need for intra household food security for adequate nutrition for women, Kavita Srivastava of People’s Union for Civil Liberties, Rajasthan said: “Public policy response to intra household issues is important. In India, food security is becoming class-neutral and there is an urgency to build a discourse and find solutions at the domestic level.”

Public spending on the health in all the three regions was found to be inadequate. Irregular growth and poverty were seen to be major bottlenecks. Also wages varied from region to region.

In UP and Uttarakhand, lack of money is reported as a barrier in accessing maternal healthcare, and women in Chhattisgarh needed to take loans for childbirth expenses.

In UP working conditions are gruesome. Even after childbirth, the women got only 6-12 months off from work. No work means, no money, which put their survival at stake.

Discussion group at the report launch found that the failure of public health providers forced a large section of women to opt for delivering at home. Women preferred to seek healthcare from jhhola-chhap informal practitioners who were closer, cheaper and easier to interact with, while government hospitals were “too far away and too ill-equipped.”

"Government treatment is never perceived as being free"

In both these states, women faced harsh treatment in government hospitals. In Chhattisgarh, however, women sought care from government health centres while admitting that they did have to spend money on buying medicines anyway.

An NGO worker present at the discussion said: “Government treatment is never perceived as being free.”

In terms of access to nutrition, most women owned ration cards and managed to survive because of the Public Distribution System in their villages.

Arundhuti Dhuru, Advisor (UP) to the Supreme Court Commission on the Right to Food said: “There is a lot of formalisation about the unorganised or informal sector. The need is to create more opportunities for making equal wages and access to food possible.”

Harmeet Sarin, Senior Programme Assistant, ILO Programme for women workers in the informal sector, highlighted community programmes and empowerment for meeting development goals as essential factors.

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