Preeti Dwivedi, Assistant ProfessorMahila Mahavidyalaya (P.G.) College,

Kidwai Nagar, Kanpur

Health is the state of complete physical,mental and spiritual well – being and notmerely an absence of disease or infirmity.(WHO, 1978) (Medical Model of Health)

Health refers to proper functioning of thebody and the mind, as well as, the capacity toparticipate in social activities performing theroles expected by society. (Social Model ofHealth)

Health is an important factor that contributeto human well – being and economic growth.On the other hand presently women in Indiaexperience a multitude of health problems,which ultimately affect the aggregateeconomic output and contribute to barrier ofeconomic gain.

Nutritional deprivation has majorconsequence of different ailments. Only smallproportion of women in India are consuminga balanced diet.

Deficient intakes of essential nutrients suchas Calcium, Iron, Magnesium, Zinc, Folic acid,Vit. A, Vit B6, Vit. C are found more in largeproportion to young women than young Menin a study in India.

Malnutrition is a major consequence ofanemia. 50 – 90% of all pregnant women inIndia suffer from anemia. Sever anemiaaccounts for 20% of all maternal deaths inIndia. (World Bank, 1996)

The prevalence of Osteoporosis,Osteoarthritis, backache are the commonhealth problems among elderly women inIndia and its prevalence is more in womenthan men.

Osteoporosis and Osteoarthritis are silentlyprogressing metabolic bone disease is widelyprevalent in India and is a common cause ofmorbidity and mortality in women. Low calciumdiet and lack of health awareness are two majorcauses behind this health problem.

India has high Maternal mortality ratio. Accordingto National Family Health Survey (NFHS)conducted in 1992 -93, in the four yearspreceding the survey 37% of all the pregnantwomen in India received no prenatal care duringpregnancies (International Institute of PopulationScience, IIPS,1995).

Through NFHS Survey (1992-93) it was alsofound that nearly three – quarters of all birthstake place at home and two – thirds of allbirths were not attended by trained medicalpersonnel.

Differential treatment of girls and boys interms of feeding practices, utilization ofhousehold resources and access to health –care are some factors responsible for higherfemale morbidity and mortality in India.

Boys are breast – fed longer than girls, 25.3months versus, 23.6 months average (IIPS, 1995).Boys who are ill are more likely to be taken formedical treatment than a girls in India.

Domestic Violence is widespread, deeplyingrained and has serious impacts on women’shealth and well – being. An average of 125women face domestic violence everyday in 2000in India and it stood at 160 in 2005 (NationalCrime Record Bureau, NCRB, 2005).

Battered women are subjected to twice therisk of miscarriage and four times the risk ofhaving a baby that is below average weight.Domestic violence also accounts for asizeable portion of maternal deaths (WHO,2001).

The present study is empirical in nature. Through the presentstudy an attempt has been made to investigate the problemsof health among Indian women, its causes and consequences.Common health practices adopted by these women are alsoexplored in this study. The study is comparative andcompared the health problems of rural and urban Indianwomen. In this sequence , 100 women from an urban areaknown as Kanpur city and 100 women from a rural areaknown as Ramabai Nagar of Uttar Pradesh, India wereselected purposively as a sample. All the women selected inthe sample were suffering from some health problems andpresently have at least one child. Interview schedule was usedfor data collection having both open and closed endedquestions.

Age of about half of the respondents (48% ofthe rural and 51% of the urban women)having health problems were more than 50years, while age of 35.5% of the respondents(34% of the rural and 37% of the urbanwomen) were in between 35 – 50 years.

Educational status of the respondent’s showsthat most of them were either illiterate (47%of the rural and 30% of the urbanrespondents) or primary educated (20% of therural and 28% of the urban women).

Most of them belong to the families havingLower Economic Class (49% of the rural and35% of the urban women) or Lower MiddleEconomic Class (27% of the rural and 25% ofthe urban women).

66% of the rural and 42% of the urbanwomen was living in the joint families.

Numbers of the children given birth by awoman and gap between two births alsoaffect the health of a woman.

Data of the present study show that presently55% of the rural and 33% of the urban womenhad four or more than four children.

Only 11% of the rural and 18% of the urbanrespondents presently has one child.

Out of those respondents presently have atleast two children (89% of the rural and 82%of the urban), 29.5% of them (35% of the ruraland 24% of the urban women) informed thatthere was approximately one to two yearsgap between last two births.

On the other hand 19% of the rural and 12%of the urban respondents reported that theygave next birth within one year.

Anemia was accessed as most common healthproblem suffered by a total of 24% (30% of therural and 18% of the urban women) of therespondents than different respiratory problemslike Asthma, T.B. etc. reported by 20% (18% ofthe rural, 22% of the urban women) of them.

24% of the rural and 12% of the urbanrespondents informed that they had reproductivehealth problems like vaginal infections, excessivebleeding, no bleeding, painful bleeding andmiscarriage etc.

Different bone problems like osteoporosis,arthritis, backache were reported by 12% ofthe rural respondents in against to 18% of theurban respondents.

Breast Cancer (8% of the rural & 6% of theurban women), Heart diseases (6% of the rural& 10% of the urban women), Depression (2%of the rural & 8% of the urban women) andsome others health problems (6% of theurban women) were also reported by therespondents.

When the respondents were asked to reportabout the different sources of seeking helpafter their health problems?

28% of the rural and 14% of the urbanrespondents informed that they were ignoringtheir health problems and thus did notapproach to any health centers till now.

On the other hand 22% of the rural and 15%of the urban respondents were seeking helpfrom untrained practitioners.

18% of the rural and 9% of the urbanrespondents were depending upon homeremedies.

Only 22% of the rural and 38% of the urbanwomen approached to the governmenthospital for seeking help. On the other hand10% of the rural and 24 % of the urbanrespondents take help from privatepractitioners.

Out of the total respondents 86% of the ruraland 72% of the urban respondents informedthat they ignore their ailment at the earlystage. They approach to the medical centersat the later stage of their ailment.

Why the respondents ignore their healthproblems at the early stage (86% of the ruraland 72% of the urban respondents)

30.4% of the respondents (30.2% rural, 30.6%urban) informed that they ignore their healthproblems as they prefer their other familymembers first during their sickness andapproaching them to the health centers.

22.1% of the rural and 25% of the urbanrespondents seek help from the healthcenters at the later stage as their healthproblems are ignored by their familymembers especially by their husbands. Theyfurther informed that in most of the timesthey are not accompanied by their familymembers to the hospital.

Economic dependence (18.6% of the rural &30.6% of the urban women), carelessness (10.5%of the rural & 15.3% of the urban women) andlong distance of the hospitals from their home(11.6% of the rural, 4.2% of the urban women),are also access as different causes behind theignorance of their health problems at the earlystage.

Living in joint family is also found as constraintin access to the medical centers at the early stagein case of 7% of the rural respondents.

Only 22% of the rural and 32% of the urbanrespondents informed that they went forroutine check-ups and take their medicinesregularly during pregnancy.

Place of delivery of 24% of the respondents(36% of the rural and 12% of the urban) wasnot safe as their delivery take place at home.

16% of the rural and 8% of the urbanrespondents informed that their delivery wasnot attended by trained workers.

46% of the rural and 21% of the urbanrespondents reported that males eat first in theirfamilies and they are typically the last to eat withother female members in their family.

Only 20% of the rural and 28% of the urbanrespondents informed that they drink milk dailyor eat fruit regularly.

Only 27% of the rural and 35% of the urbanrespondents reported that they eat properly twotimes daily and took proper diet in their meal.

Gender is one of the social determinant,which play a major role in the healthoutcomes of women in India.

India is considered as one of the worstcountries in the world in terms of gender –discrimination. According to United NationsDevelopment programme’s report onHuman Development India was ranked as132 out of 187 countries in terms of gender– inequality.

Gender – inequality is an output of patriarchalfamily structure found in India. Women areconfine to domestic duties and refrain fromdecision making process while male avail alleconomic and social powers in suchpatriarchal form of family.

In such society different values, norms,beliefs and behavior all are internalizethrough socialization among girls since theirchildhood.

In the patriarchal family through socializationfemales are to internalize the concept ofdependency, obedience, powerless and shynature. Thus In such society women givepreference to other members of their family firstwith respect to intake of nutritious food andapproaching them to the health centers duringtheir sickness. Thus most of the women ignoretheir health problem at the early stage andapproach only after the advancement of theirailment in most of the cases.

Duration of breast feeding, immunization,food – habits, intake of nutritious food items,reporting of illness, rates of admission to thehospitals, access to the health services and totake medical treatment all are concerned withpatriarchy, different socialization and gender– inequality in India.

Due to gender – inequality females are moremalnourished than men in India and resultingto the poor health outcomes. Malnutritionamong women starts from infancy andcontinues throughout their lifetime. In thepatriarchal society like India women and girlsare typically the last to eat in the family and ifthere is not enough to eat then women suffermost.

Women in villages often become a victim ofmore number of health problems than theurban one. Inadequate medical facilities inrural areas, long distance of health centersfrom their home and poor resources obtainfor treatment from private medicalpractitioners are some major barriers foravailing health care for rural women.

Right to health is a basic human right.unfortunately women in India do not access suchbasic right.

Historically discrimination of women on thegender – basis is one of the major causes behindpoor health outcomes of them. InternationalCovenant on Economics, Social and CulturalRights (ICESCR) emphasized the responsibilitiesof the state to protect the right of all groups andindividuals to the enjoyment of the highestattainable standard of physical and mentalhealth.

Government of India has been making severalefforts in developing health and populationpolicies. However, there are several obstacles inits implementation due to poverty, illiteracy andgender discrimination in India.

There is a need for necessary steps for morecommunity participation in various developmentprogrammes of government as it may be helpfulto remove the poverty and improve the literacyrate among the females, which may be positivelyaffect the health outcomes of them.

Health education also has to be strengthenedthrough department of health and ICDS as itmay be significantly bring awareness andbehavioral change for better health andnutritional practices to improve the healthstatus of women in India.

Problem of health is deep rooted in the socio– cultural practices. Socio – cultural normwhich is responsible for gender – inequalityand different socialization process should betransformed.

In this respect media, social activists, NGOs,different government agencies can bring amassive awareness towards gender – equalityand empowered them socially andeconomically.

Thus there is need to promote gender –equality by the international developmentorganizations as gender – equity positivelyassociated with better health outcomes ofwomen as well as economic development.

THANK YOU