The Indian Women’s Health Charter
The Indian Women’s Health Charter was released at the second National People’s Health Assembly in Bhopal on March 23, 2007. The Assembly was organised by Jan Swasthya Abhiyan (People’s Health Movement - India), a national network of health activists and groups. The Charter highlights and advocates for women’s healthcare issues.
The formulation of the Charter began in 2004, with more than 2,000 participants discussing health-related issues specific to their regions and social groups over several meetings. The process continued after the 10th International Women’s Heath Meet which took place in New Delhi in September 2005. The Charter was drafted and debated at an event titled ‘National Dialogue: Women, Health and Development’ held in November 2006 in Mumbai.
As a result of neoliberal economic policies, government expenditure in the sectors of education, healthcare and food security, has reduced considerably – the Charter notes. This has had adverse effects on poor and marginalised women. These changes, along with the rise of religious fundamentalism worldwide, challenge women’s access to social equality and justice. The Charter describes ‘corporate globalisation’ as an “...onslaught on the country’s poor and a second wave of neo-colonialism.” The document attempts to list the health rights of all Indian women, keeping in mind the structures of caste, class, religion, culture, gender, sexuality and ability status.The 41-page Charter has 13 parts: The Process of Making the Charter (part 1); Preamble (part 2); Declaration at the ‘National Dialogue: Women, Health and Development' (part 3); The Social Determinants of Health (part 4); Women’s Right to Health Care (part 5); State Obligations towards Women’s Health Rights (part 6); Medical Ethics and the Rights of Women as Patients (part 7); Laws and Policies related to Health (part 8); Other Health Care Services and Related Sectors (part 9); Violence as a Public Health and Human Rights Issue (part 10); Health Rights of Women with Special Needs (part 11); Epilogue (part 12); and Glossary of Acronyms and Word Meanings (part 13).
What does the Charter say about the state of women’s health in India?
Women’s health is determined by such social and economic factors as access to health services, education, safe living and working conditions, the absence of discrimination, access to land and water, and more. The denial of these rights – including the right to universal, comprehensive and affordable healthcare – is a form of violence against women.
Neoliberalism and patriarchy severely impact the social determinants of women’s health, the Charter says. Private sector domination in India’s healthcare system, along with the government’s reduced public expenditure in education, healthcare, and food security, have made health services less accessible, and essential drugs less affordable.
While basic healthcare and diagnostic procedures are out of reach for a vast majority in India, others are often subject to unnecessary interventions – such as unwarranted hysterectomies and sex-selective abortions – that are expensive and potentially hazardous. Further, the unwillingness of health professionals to identify domestic and sexual abuse, along with the discrediting of traditional practices and women-centered knowledge, likewise pose threats to women’s health.
Which specific threats to marginalised women’s health does the Charter discuss?
Violence against women – disproportionately experienced by women from marginalised social groups – is a major cause of death and illness. In most communities, dominant practices tend to undermine the security, autonomy and well-being of women.
The Charter says that refugees, those who challenge gender norms, women with disabilities and incarcerated women are highly vulnerable to gender-based violence and sexual abuse, even by doctors and caregivers. Sex workers too face social exclusion and discrimination by their families, communities, and the State, dissuading them from accessing public health care.
Women engaged in informal employment often work for long hours and in poor conditions, with inadequate pay and a high risk of workplace injuries and miscarriages. The lack of financial, social, and cultural recognition for women’s domestic work and agricultural labour contributes to severe health impacts for many. The Charter states that maternity, health and childcare benefits should be extended to all women irrespective of their employment since they are doing socially productive work.
What are some of the Charter’s demands for women's health?
The Charter demands universal, comprehensive, affordable and gender-just healthcare that caters to the needs of all women – including access to mental, reproductive and sexual healthcare. The State must ensure women’s rights to bodily autonomy and to express their sexuality without discrimination, coercion or violence. The Charter urges a public health response to violence against women, including counseling for survivors, and condemns all forms of coercive contraception, abortion and population control.
The Charter calls for an end to the commodification of water and water bodies, especially for development projects that cause evictions and environmental destruction. It also advocates compensation for women’s unpaid work, the right to safe housing, the inclusion of women in planning and monitoring resource distribution, the provision of maternity benefits and abortion services, as well as the introduction of sexual education in schools.
The Charter demands that marginalised women have access to healthcare, education, gainful employment and freedom of movement. It says that the State must provide for the basic needs of persons with disabilities living in rural areas or urban slums, alongside public education on disability rights. Rather than building more psychiatric hospitals, the Charter advocates the proliferation of community mental health programmes.
Moreover, the Charter demands the inclusion of indigenous medicine and women healers such as dais (midwives) in the public health system, and the limiting of patents on indigenous medicinal knowledge and resources. It advocates an end to the forced rehabilitation and eviction of sex workers, and instead urges the State to consider their perspective in creating health and social policies. The Charter also demands the full recognition of lesbian, bisexual and trans women’s rights.
Focus and Factoids by Darren Gens.
PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.
National People’s Health Assembly
National People’s Health Assembly
23 Mar, 2007