Caste affecting rural health plans in Bihar

In what could be perceived as a disturbing trend, vaccination in rural Bihar has been adversely affected due to casteism.

According to the recent survey report, which was prepared after an on-the-spot study in 14 villages of Bihar’s nine districts, several instances of “caste discrimination” have came to fore.

For instance, such was the social divide in a Rohtas village that vaccinations could not take place either in Brahmin’s tola (colony) or Paswan’s tola simply because the Brahmins refused to go to the Paswan tola, or allowed them to enter their area. All this, when the vaccination had to take place at the anganwadi centre.

Equally disturbing was the trend at Dewan Parsa village in the Gopalganj district where Paswan children were summoned only when there was an inspection, although the head count was regularly maintained. Similarly, the caste of “Asha workers” (accredited social health activist)  too played a role in non-inclusion of poorer groups in the social welfare programmes.

While, the Asha workers are key functionaries and integral part of the rural health system related to deprived sections of the society, it was found in the study that they received cooperation (or no cooperation) depending on their own caste.

Surprisingly, in the Dewan Parsa village, upper caste Brahmin women had no inhibitions in admitting that they did not cooperate with the Asha workers because they belonged to lower castes.

Notably, it’s the Asha workers who, of late, have replaced village mid-wives and play a crucial role in child delivery. The report, prepared by the Institute for Development Research (IDR), however, has something positive to suggest.  

Villagers now look for institutional deliveries and believe that hospitals are much safer place to give birth. Under the Centre’s ambitious scheme - “Janani Suraksha Yojna”, institutional deliveries have escalated from 8,38,481 in 2007-08 to 11,43,039 in 2008-09.
The saving grace, as per the report, is that there is no caste discrimination at the primary health centres (PHCs).