Discrimination: For women in rural areas, healthcare not a basic right

Study report highlights disparities along class, rural-urban divide, gender and religion.

ISLAMABAD:

Pakistan is among 115 countries which recognise the right to public healthcare yet it discriminates against women, especially the rural population, and fares poorly with South Asian neighbours, reveals an assessment report.

The report, “Integration of Health-Related Human Rights in the Public Health Response of Pakistan” was launched during a consultation workshop organised by the World Health Organisation (WHO) recently. The assessment was conducted under Gender and Health Programme, a part of One UN Gender Equality Interventions.



“Huge health disparities exist within and between the provinces along the lines of class, rural-urban divide, gender, caste and religion. With increasing poverty and high unemployment, people’s purchasing power with regards to healthcare is diminishing fast,” states the report.

According to the study, the overall immunisation coverage is 81 per cent. Girls are at higher risk of death at 68 per cent compared to 57 per cent of boys. There is a clear urban bias in the availability of social determinants of health, according to the report, which reveals access to safe drinking water at 59 per cent of the population.

Women continue to face challenges due to lack of access to and provision of antenatal and postnatal care, safe abortions, safe deliveries through skilled birth attendants and contraception, reveals the report. Some 44 per cent of mothers in urban areas and 57 in rural areas are underweight.

Violence against women is a serious public health issue but the health delivery staff lack sensitivity, commitment and capacity to effectively deal with women survivors of violence, states the report. “Discriminatory laws against women and religious minorities need to be repealed to establish equality that is a determining factor in the health status of people,” suggests the report.



Dr Farzana Bari, chairperson, Gender Studies Department Quaid-i-Azam University and one of the study’s researchers, said, “From the rights perspective, the health sector needs to have essential elements of availability, accessibility and quality of care which currently is missing in Pakistan.”

While sharing the findings, she said non-implementation of laws is a major issue. “Pakistan has a fairly extensive legal framework with regard to health rights, but health is not explicitly recognised as a constitutional right.” The legal framework that governs the health sector in the country is by no means comprehensive, said Bari, while sharing some of the major gaps in the system including a weak legal and regulatory framework for the private sector providing 70 per cent of healthcare, absence of regulation for herbal medicine practitioners. Around 130,000 registered practitioners work without any regulatory framework, she said, adding that better regulation is also needed for drug price and quality control.

“Absenteeism, lack of professional staff and medicines and dysfunctional equipment in public health facilities undermine the public’s right to health,” Dr Bari said. “Without an effective people’s health movement, advocacy will not result in policy change.”

Published in The Express Tribune, July 8^th, 2013.