Intersection of Gender, Caste and Class in Access to Reproductive Health Services

Abstract

This study focuses on accessibility to reproductive health facility. It highlights the intersection of social factors like gender, caste and class that hinder this accessibility. Forms of Capital presented by Bourdieu, sociocultural and economic perspectives are explored in the light of ethnographic fieldwork. This work is the result of participant observation in Rasool Park, a slum area of district Faisalabad, Punjab, Pakistan during 2017-2019 intermittently. By using purposive sampling technique, field data was collected from the antenatal, delivery and postnatal patients who visited three government hospitals, one private hospital, one private clinic and one basic health unit (BHU) of the Urban and semi-urban areas of Faisalabad. Study unfolds the patterns of Pakistani society that restricts the women mobility, freedom and choice to reproductive health facilities. Tagged social roles undermine women’s autonomy regarding the choice in adaption of reproductive health facilities on the basis of gendered identity. Situation in Pakistan regarding reproductive health facilities is not up to the mark and it intensifies when women are denied of basic health legal rights by the practitioners, on the bases of belonging to the lower caste and social class. This social circumcising is multifaceted cultural experience depending on a woman’s social position. Theoretical underpinnings are borrowed from Bourdieu, who talks of ‘knowledge’ –“both of and by subject”. Node of subjectivity and objectivity, is what creates social reality for Bourdieu, this study endeavored to comprehend and present the social milieu of misery for women. Research locale comprises of different class and caste groups; hence the objectives of the study are more focused to investigate the socio-economic factors, including family income, education, employment status, which shape the sickness perception of respondents. Decision making about reproductive health is culturally shaped and family influences the decision, leaving protagonist (woman) powerless. Socio-economic status, in addition to caste and class, shapes health practitioner’s behavior towards the patients. Women narrated variety of cultural reasons and subjective experiences about difficulties in seeking and accessing reproductive health facilities. In gist, higher income status and caste make quality health care affordable and accessible. Otherwise, poverty, lower caste, and vulnerable gender position lead to denial of accessibility and provision of even the basic reproductive health facility.