By Debjani Barman, Assistant Professor, Indian Institute of Health Management & Research (IIHMR)
Debjani Barman is a recipient of a RinGs’ small research grant and currently works for the Institute of Health Management Research Kolkata, in addition to being a part of the Future Health Systems Research Consortium (FHS). Her project is titled: “Are Women of Indian Sundarbans Living in Dark: A Gender Analysis of Eye Health Problem”.
With a background in Health Economics I am presently working on the barriers to health service delivery systems in the Indian Sundarbans. Over the last decade I came across hundreds of instances of gender differences in accessing health services as I interfaced with islanders during my fieldwork. India is predominantly a male dominant society; this dominance is even more glaring in the context of rural India. Along with gender other cross-cutting social determinants like religion and caste also influence the choice of and access to health service providers. Working in Future Health Systems has provided me with first-hand knowledge of the health system and its dynamics, as well as the complex interplay with social determinants of health. The RinGs small research grant brings me the opportunity to look closely at the gender dimension.
The UNESCO World Heritage Site Sundarbans encompasses both urban and rural areas. The region is world famous for the Royal Bengal Tiger and the islanders feel that they are second class citizens. This human face of the Sundarbans is often neglected, and in the sub-optimal presence of formal health service delivery systems access to quality health care is highly doubtful. Being a part of an active delta, the region additionally suffers from the risk of recurrent climate shocks and considerable geographical inaccessibility.
Within the Indian context, females usually have lower mobility, which is further reduced in inhospitable geographical terrains. In such a setting, one can easily presume the difficulty a visually impaired person will experience to access health service delivery. In addition to these challenges, India is experiencing demographic transition where one fourth of its population is elderly, many of whom are visually impaired.
Gender wise, women experience a higher burden of visual impairments given their longer life expectancy and poor access to health care services. In fact two third of the world’s blind population is female. Evidence from India on diagnosed cataract or cataract surgery has reported gender disparity. Earlier research from Future Health Systems on Indian Sundarbans also reported higher percentage of females diagnosed with cataract compared to males. Following this I will explore the gender differentials in perception, detection, health care seeking and financing related to eye health among the elderly people of the Indian Sundarbans. Additionally I will factor in the current trend in the region of a huge exodus of the young male population to urban centers following climatic shocks, and of recent FHS evidence showing a similar trend among young married women. As a result, the elderly are often responsible for taking care of their grandchildren. Therefore along with the gender role in relation to eye health problems, I will additionally explore the difference in level of intra and inter household dependencies for eye health care seeking and in other day to day activities through a gender lens cross cutting with other social determinants of health care seeking.
This blog was originally posted on the RiNGs website.