Dalit Women: Health care Access and Health Outcomes
The caste systems found in countries such as India and Nepal are socially hierarchical systems that divide people into five primary groups: Brahmin, Kshatriya, Vaishya, Sudra and Dalit. Those in the Dalit caste rank as the lowest and are considered societal outcasts. As a result, they suffer harsh treatment and discrimination. Due to the patriarchy in these societies in addition to widespread support for caste systems, Dalit women face high levels of discrimination. This reality creates great disparities in overall life and health outcomes.
Access to Care
Dalit women’s health outcomes largely depend on their access to health care. This access, however, is limited considering Dalit women’s low socioeconomic status. For example, in the southwest Indian state of Karnataka, which is home to over 61 million people and is the eighth-largest state in India by population, about 74.4% of Dalit women reported having issues regarding health care access. This number is about 70% at the national level, according to 2018 India’s National Family Health Survey. Partially due to this struggle in accessing health care, Dalit women have a 15-year shorter lifespan on average than upper caste women.
When they do have access to care, it can be very costly. Asia-Pacific Journal of Public Health revealed that some unlicensed private doctors exploit Dalit women and other lower-caste women by charging them high fees, forcing many of them to take out loans for treatment. This practice contributes to the cycle of poverty among Dalit women and can make access for many extremely difficult. These issues with health care access often lead to negative health outcomes considering women’s greater vulnerability to diseases such as malnutrition and anemia, as well as maternal mortality.
Mental Health Disparities
Two main issues face Dalit women in terms of mental health: firstly, mental health issues are more prevalent in their caste than for those in higher-ranking castes, and secondly, these women have less access to care. In 2020, the Journal of Global Health Reports conducted a study in which 12 Dalit participants from Nepal talked about their experiences with mental health. From the outset, the researchers made it known that Dalits in Nepal “face the greatest discrimination and have a greater prevalence of depression and anxiety when compared with high castes.”
In terms of the actual results of the study, a number of the participants stated they believe that gender-based discrimination in Nepal makes issues of mental health for Dalit women more difficult, as it causes them to “receive more stigma for mental health conditions.” The stigmas that these women receive can lead to dangerous outcomes for them. Two participants in the study stated that Dalit women are at considerable risk when they are cast out from their families, as they become homeless and therefore are more vulnerable to exploitation, rape and abuse.
Some research also indicates that Dalit and other low-caste women may have experienced worsening mental health outcomes as a result of the COVID-19 pandemic. According to a 2022 study, lower-caste women tended to have a greater fear of COVID-19 than higher-caste women. The study also found that Dalit women and women of other backward castes (OBCs) suffered from more severe anxiety and stress symptoms than higher-caste women.
Feminist Dalit Organization (FEDO)
In light of the continuing discrimination against Dalit women, several organizations are taking action to create better opportunities for this underprivileged community. Perhaps one of the most prominent is the Feminist Dalit Organization (FEDO), which is a nonprofit organization that was founded by a group of Dalit women in 1994. The organization works to address and fight back against the various inequalities experienced by affected women in Nepal.
FEDO is present in 56 of Nepal’s 75 districts, seeking to improve the lives of Dalit women by advocating for human rights and economic empowerment initiatives. This includes helping Dalit women become financially literate so that they can have opportunities to own small businesses and break the cycles of poverty found in Dalit communities throughout Asia. The work of organizations like FEDO could bring about upwards social mobility for Dalit women, therefore giving them greater access to health care services and improving their overall quality of life.
– Adam Cvik