Table of Contents:

Purpose of the Study

With this background, therefore, the present paper aims to understand the nature and patterns of caste-based discrimination (henceforth referred as discrimination) in access to health care practised in different forms; and the consequences of such practices. This is one of the initial studies to explore caste-based discrimination in health sector. There are problems in defining the very concept of discrimination in health. Typology to understand it; and empirical methodology to measure it are still evolving and yet to fully develop. Thus, the specific objectives are to:

  • 1. Identify forms of social discrimination experienced in accessing health services.
  • 2. Study the consequences of discrimination; and identify the best practices that improve access to health care.

Study Design

The Study was conducted in Kusumpur Pahari, a notified slum, located behind the Central Bureau of Investigation (CBI) colony in Vasant Vihar. It is inhabited by more than two lakh migrants. Social composition of the population suggests that about one-fourth belong to Other Backward Castes (OBC); more than half are high caste; about 17 % belong to scheduled castes and about 8 % are scheduled tribes.

The methodology adopted in the present study deals with database and sample design. The second part is on methods of measurements which includes selection of indicators; ranking of indicators; construction of a composite index; and content analysis of the narratives obtained from the Consultative Meetings and discussions held during the fieldwork.

The methods used included both qualitative and quantitative techniques. Tools and techniques used for the primary data include individual interviews, in-depth interviews, group discussions, consultative meetings, exit interviews and observation through structured household schedule and semi-structured questionnaires, check lists and field notes. Some of the GIS (Geographic Information System) based images of the selected villages were also used for mapping purposes. In addition to these, photography has also been used to illustrate some observations.

The field work was done in selected Blocks with the women aged 18-45 years age; health care providers, government officials, NGO personnel, activists, community leaders and policy makers were identified for the conduct of the field work. Houselisting was done to identify households with mothers and children.

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