Aarti Devi, a Dalit woman from Patna and her husband, Govind Ram, were excited when they heard the news about her pregnancy. The couple found out through an advertisement that the government had made delivery and post-natal care easy and hassle-free and an institutional delivery would be free of cost and include transportation. Apart from this provision, the family will also eligible for a token amount under the Janani Suraksha Yojna (JSY). She got herself registered at the nearest Aanganwadi Centre and requested the Anganwadi worker for the ration proposed for pregnant women.

At the end of the first trimester (third month), Aarti felt excruciating abdominal pain. Her husband was not present at the residence at that time, so the neighbours took Aarti Devi to the closest health facility from her residence.

She was referred to a particular ward where she was illtreated by the service providers. Instead of attending Aarti they told her to leave. “Get out of here. Every now and then you people come here with a baby in your womb," she was told. On her persistence, Aarti was told by the administration to go to another ward. She went to every available ward but nobody attended Aarti. Finally, she was taken to a quack in her locality who treated her.

Aarti felt humiliated by the derogatory remarks made by the service providers at the government health centres. She took an oath not to visit any Public Health Facility and even told us that she would instead prefer to die.

During her second pregnancy, she faced extreme burns as the boiling rice water fell on her. She was advised by locals to visit the nearest hospital but she refused and went to a private hospital where she was treated. Expenditure on treatment took a toll on the finance of the household and are currently in a debt trap.

A local birth attendant performed the second delivery in an unhygienic atmosphere as Aarti was adamant not to visit any Public Health Facility and visiting any Private Hospital was out of the question due to exorbitant costs. Fortunately, both the baby and mother are safe, but Aarti is constantly haunted by the humiliation she faced at Public Health Facility.

This Oxfam India’s paper makes the following recommendations for the country’s health system:

The government should be the primary provider of healthcare, and the provision of healthcare for all should not be based on the expansion of health insurance-based models focusing on hospitalisation.



A clear roadmap to enhance budgetary spending on healthcare to 3%-5% of GDP should be drawn. Public tax-based funding and contribution from the organised sector should finance healthcare and focused funding in the form of specific central transfers should be made to promote equitable access.



Regulation of the private sector must be a priority. Establishment of standard treatment protocols and empowerment of communities to hold the healthcare system accountable will be critical to ensure the quality of healthcare in the public and private sectors.



A comprehensive review of Rashtriya Swasthya Bima Yojana (RSBY) and other currently fragmented government funded healthcare schemes like Central Government Health Scheme (CGHS) should be conducted with the aim of future consolidation for a national programme ensuring healthcare for all.

READ PRATIMA'S STORY- A CASUALTY OF INDIA'S GROWING INEQUALITY

Inequality affects us all. Join Oxfam India’s campaign to urge the government to provide quality essential services, end under taxation of corporates and rich individuals and include unpaid care work by women in the economic and budgetary decision-making process.

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