During the last 20 years two significant demographic shifts have happened in India. Both these shifts have implications for women’s access to healthcare. The first is urban migration. As the national economy moved away from predominantly agrarian toward industrialization, metropolitan hubs became commercial centers. This meant most organized jobs were only available in major cities, leading to an influx of workers from rural India. Indeed, in the last 20 years, apart from major metropolitan cities like Chennai, Delhi, Bangalore, Kolkata, Mumbai, Hyderabad, etc, many second-tier cities have considerably grown in size. This trend has implications for the healthcare industry, especially the services directed toward women. For example, since most urban dwellers work in the organized sector – mostly for a private or public corporation – their health insurance costs are mostly recovered through their salaries. This facilitates tie-ups with established healthcare providers for covering the healthcare needs of the worker and his/her dependants. It also means that the employer signs periodical subscription with private healthcare providers for employees en masse. There are advantages and disadvantages with this system. On the positive side, it brings efficiency and standardization to healthcare availability and dispensation. On the negative side, the coverage usually includes only common or regular health issues and excludes rare disorders. Moreover, the proportion of women in the workforce is considerably lower to that of men. This means that most of their access to private healthcare happens as dependants on their husbands’ insurance policy. For rural women, even this indirect route of access to quality healthcare is not available.
An interesting feature of Indian demographic trend is the dropping average age of the population. India’s population continues to grow geometrically past the one billion mark. This means that youth comprise a disproportionately high percentage of its total population. This is best illustrated by a statistic from the recently concluded general elections. Nearly 35% of the electorate is between the age group of 18-35. And the demographic group between 0-18 represents an even bigger share. In terms of healthcare, the services required by young women are quite distinct to that of elderly women. Healthcare in India for the latter group is in a sorry state. Given that India’s population is relatively young currently, it is not surprising that specialized healthcare for the elderly has not evolved here. Terms like palliative care are rarely heard or applied. Usually, the young are more vulnerable to one-off bouts of infections or diseases, whereas the older tend to have greater instances of chronic illnesses. Given the divergent healthcare needs of these two groups, policy makers face the tough task of balancing their competing claims. (Population Briefs, 2014, p.15)
Women’s health has a cascade effect on child health. In this respect, one of the recent success stories of the Indian healthcare system is the eradication of polio. For several decades, this endemic had been a bane for lower strata of society. The polio causing virus thrives in environments of low hygiene. As a result, it has mostly affected poverty-stricken housing colonies across India. In terms of scale, the polio had caused deformities and acute suffering to hundreds of thousands of babies and their families. The ability of the Indian government to bring this blight to a halt this year is a commendable effort. When we consider that the Indian population is more than one billion and it has a sprawling geography, the scale of this feat becomes apparent. (Ridge, 2010, p.1)