Gender, Caste, Class, and Health Care Access

The research discussed in the report revisits the notion of access to health care in Koppal, an economically disadvantaged district in northern Karnataka. This issue is important to households experiencing the effects of economic and health sector reform. It is now common knowledge that such reforms have benefited the rich and middle classes but not the poor. Routine household health surveys do help us understand how iniquitous access to health care can be, but offer limited opportunities for a gender analysis along the crosscutting axes of caste, class, age and life stage. Such an exercise is more complex, but necessary, as a nuanced understanding would be impossible without it. In its conceptualisation of access to health care, the study draws upon the framework outlined by Meera Chatterjee, which speaks of access as requiring the negotiation of barriers beginning with the individual and progressively involving her/his family, and ultimately the state/market in health care. The study also seeks to bring in insights from the social relations framework.