It is without a doubt that women have been subjugated at the hands of the patriarchy, historically speaking but also presently. Although the ways in which women are currently affected by sexism are far less drastic than before, women’s perceived inferiority to men makes healthcare very difficult to obtain, most notably in developing countries.
McGill Students for the Foundation for International Medical Relief of Children (FIMRC) and the Student Association for Medical Aid (SAMA) panel discussion on February 16th focused on the accessibility of healthcare for women on a global scale. The speakers from very diverse backgrounds took three very distinct approaches to women’s accessibility to healthcare: the racial/ethnic disparities in maternal and infant health, women in the political sphere, and demography.
Dr. Zoua Vang of McGill’s Sociology Department began with a discussion that honed in on the inequality experienced by women and their children due to race and ethnicity. Dr. Vang’s perspective is that “social factors impact people’s health outcomes,” and that social determinants such as immigrant status, race and ethnicity must be taken into account. For immigrant status in the United States for example, where universal healthcare does not exist, immigrants are far less likely to be insured. Dr. Vang is concerned with group differences and socio-economic status (SES), “because we know that there is a very strong correlation between SES, that is your income, and how educated you are and how healthy you are.” Further, it is important to consider interpersonal discrimination – namely, how much discrimination one experiences on a person-to-person level based on their race or ethnicity. For example, do hospital workers treat you differently because you are black?
Dr. Vang continuously revealed snapshots of her in-depth research regarding how racial and ethnic disparities affect maternal and infant health. Pre-term birth, defined as a birth before thirty seven weeks of full gestation, is a very important indicator of the health of both the mother and the baby, which is why it has gained Dr. Vang’s attention.
“This is problematic because prematurity is indicative of both short-term and long-term difficulties. In the short-term, babies who are born pre-maturely have a much higher chance of dying before the first month of life. […] The effect on cognitive development will manifest itself in the long run, into adulthood, as it could affect non-health concerns, like employment.” Using a graph, Dr. Vang revealed drastic differences in pre-mature birth rates across all races in the US.
“This tells us that if we just look at aggregate statistics, […] we realize that specific ethnic groups are at a higher risk of giving birth pre-maturely.”
There is a lot of variation across ethnicities, and policy needs to reflect the needs of all. What we need to focus on is that even within racial or ethnic groups, factors like SES will affect a woman’s access to healthcare within a developed country. Amendments to healthcare systems will not be successful if they do not recognize all the differences among women, not just their race and ethnicity.
The second speaker, Amm Quamruzzaman, a PhD candidate in McGill’s Sociology Department, discussed women’s political agency and how this affects access to healthcare services in developing countries.
What we know to be true on a global level is that most developing countries have little to no governance, or the governance is fragile and politically unstable due to previous conflict. This means there is little to no enforcement of the rule of law, and there is a lack of infrastructure to prevent corruption. Simply put, this causal downstream creates a lack of stable and easily accessible healthcare services. This means that not only do women struggle to access healthcare because they are women, but also because there is a general lack of infrastructure for such a resource.
Quamruzzaman argues that “it is imperative that countries improve their quality of governance by improving healthcare service infrastructure, removing barriers from access and committing to adequate resources. However, the physical presence of service alone does not mean that they are easily accessible. Often times, services are too expensive and there can be a lack of medicine or other resources.” His research has revealed that approximately 41% of women say that they faced obstacles preventing their access to healthcare services, and they mostly identified these obstacles to be a lack of attention or respect from hospital staff, absent doctors, long waiting times and dirty facilities.
“Countries with more female representation within governance infrastructure have a direct correlation to better healthcare for women,” argues Quamruzzaman. But how do we increase female participation in national government? Quamruzzaman says that it is imperative that gender quotas are implemented within government systems.
“Women put more emphases on family-friendly and child-friendly legislation. Women’s representation in politics significantly reduces infant and maternal mortality rates.” Before closing, Quamruzzaman politely made participants aware that not all countries will benefit from the gender quota implementation, but there is accurate evidence to suggest that it is beginning to make a noticeable difference.
Gender quotas are a good start, because they force governance systems to recognize the presence, necessities and force of women and families within society. Further, female government officials will affect the focus of legislation, presumably shifting it from general overarching problems to more strategic changes so as to improve the lives of women.
Dr. Simona Bignami was the third and final speaker. She is a professor at the Université de Montréal specializing in Demography, and she discussed the available data regarding women in Sub-Saharan Africa.
The main problem with policy regarding healthcare in the developing world, argues Dr. Bignami, is that the policy is based off of weak resources. In Sub-Saharan Africa, there are no birth certificates or death certificates, which provided the foundation for Dr. Vang’s research. “Data only comes from surveys and demographic surveillance systems,” says Dr. Bignami. “Data is collected for a singular reason, and most of these surveys are not aimed at understanding female access to healthcare.”
The reliable indicators for understanding maternal and infant health care in these areas of Africa are scarce, but the two main sources of information are Body Mass Index and malaria testing. Sexual reproductive health is the most difficult type of data to collect, and is also of the poorest quality. The data collected pertaining to sexual reproductive health is highly controversial because information is based on self-reporting, which cannot pinpoint the exact causes of the spreading of illnesses, such as HIV/AIDS. In many places in Sub-Saharan Africa, it is rare to have a medical professional present for birth and to give birth in a medical facility. This lack of medical resources severely impacts the quality of health for mothers and their children. Sadly, there is little access to healthcare for most people, let alone women, in this part of the world.
Dr. Bignami emphasizes the importance of research and collective data in the formation of policy. “Because there is hardly any administrative data, all we can base our knowledge on is self-report. This means that everything we know is biased, and could not have even happened in the way it is described,” says Dr. Bignami. She believes that this is a big impacting factor on the access to healthcare .
The takeawy from Dr. Bignami’s talk is that an international organization, particularly the United Nations, needs to fund many more forms of research and data collection in impoverished areas such as Sub-Saharan Africa. There needs to be biological research done, and biomarkers need to be established to most accurately form an image of the health landscape in this region.
Overall, this panel was extremely informative on the topic of women’s access to healthcare. It revealed how huge the problem is, and how there are many different angles with which to approach it.
Images obtained from McGill Students for FIMRC