REVIEW OF RELATED LITERATURE
This chapter includes different studies that will shed light on the topic under study. The chapter also includes the theoretical and conceptual framework used In the study.
A. Gender-differentials in the Timing of Measles Vaccination in rural India
Measles is a highly contagious yet vaccine-preventable respiratory infection, and a major cause of child morbidity and mortality in developing countries (Rammohan, 2014). It is considered as a deadly disease and most children are the ones being affected by it.
Globally, immunization is estimated to have helped prevent nearly 7.5 million measles-related deaths over the period 19992005 (Wolfson et al. 2007).
India on the other hand, has the lowest number of vaccinated children. Furthermore, previous literature shows that there is wide heterogeneity in vaccination status by the childs gender, socio-economic characteristics, rural/urban location, and state of residence (Rammohan, 2014). This has been one of India’s major concerns. Rammohan stated that “Gender-induced disparities are of particular concern in India, given the widely documented evidence of pro-con bias and its influence on child health outcomes (2014).
Critically, girls face lower access to preventive care and treatment of disease compared to boys (Fikree and Pasha 2004).
Moreover, according to the study done by Rammohan et. al, household wealth and mothers education significantly improve vaccination outcomes for children while fathers education has no statistically significant influence (2014). The study shows that mothers who have attended school tend to have their children vaccinated against measles rather than those who didn’t. Obviously, wealth is also an important factor since some health care facilities, even in rural areas, has a charge for measles vaccination.
Most families in rural India prefer a son, thus even if there is a presence of health care facilities, boys considered as priorities. Also, because of it, there has been a higher rate of girls dying due to measles since they do not receive vaccination against the said disease. Nevertheless, different NGOs in India are finding ways and doing actions in order to at least lessen the gender differentials in terms of health.
B. Gendering in the Water System of the Indigenous Peoples of Asia
“Modern” water is a complex blend of gendered and historical narratives. The manner in which water has been and is defined, and the ways in which it is managed, are products of a hegemonic and now normalized perception of water (Hayman, 2012). According again from Hayman, modern water is coded as a lifeless item to be directed and overseen: it has a “social life” isolated from the human creature. For all its lack of bias, the impression of water soaks, prepared, and permeated in gendered mediums. Water’s gendered materiality comes into question when seen in the light of ecological frameworks, poisonous substances, and natural bodies.
In order that canals can serve women’s needs of water for domestic use, women should be involved in designing canal systems when it is close, to villages. If it is not close, a channel loop may be constructed taking it closer to the village. It should have a facility for women to use the canal for washing clothes and for animals to drink and wash. An alternative design for this purpose should be developed that provide a convenient facility to women without damaging canal (Shah, 2002).
In comparison, very little research has examined the effects of water insecurity on mental well-being. Although the biophysical impacts of water insecurity – which include at least two million deaths and four billion cases of diarrhea annually (Gleick, 2004). There are surely knew however we know less about the effects of water weakness on mental wellbeing.
Assumptions had been made in the new policy that ability and willingness to pay would reflect water needs and translate into voice and choice in water management. Additionally, it had been presumed that domestic water sector agencies and actors aligned in new institutional arrangements would somehow coherently address the technical and social wrongs identified in earlier arrangements (Joshi, 2011).
According to Anil Shah (when she visited Vadbar, Gujarat, India), every women were illiterate. There was water near the gathering place where animals were drinking water and ladies were showering and washing materials, that is considered now to be unhygienic since animals were also drinking from the same water source and it is also where they wash and bath (2008). Water scarcity exploded in the mid-1990s whereas attention has moved past the specialized measurements of water arrangement to the political also, social settings in which water administration happens. In numerous spots, particularly where water is rare, control over water gives control, according to Vivienne Bennett, Sonia D?vila-Poblete and Maria Nieves Rico (2008).
In the literature on gender and water, there is growing recognition of the role of the intersection of caste, class, and gender in shaping water insecurity at the household level (Mehretu and Mutambirwa, 1992; Cleaver and Elson, 1995; Crow and Sultana, 2002; van Koppen, 2002; Sultana, 2009; Zwarteveen et al 2012; Joshi, 2013; Kulkarni, 2014).
Despite the policy initiatives and attendant programmes to expand access to water users, given our hierarchical society, the conversion of drinking water into a private good where the market plays an important role in who can benefit and who pays the cost adversely affects women and the lower castes and classes (Krishnaraj, 2011). Also, according to Krishnaraj (2011) power and authority are ostensibly conceded to ladies to oversee water assets in the new decentralized administration structures on the presumption that domestic water supply is the genuine space of women whereas there stay numerous inquiry.
These authors have different knowledge on how they understand women and water and how are the two related. It is not surprising that women in other countries are struggling with water since there are still countries that think little of women. “Water is a public good and as such should be available, accessible and affordable to all the people in society. To enable this outcome the nature of governance is important. Appropriate decentralization, giving powers to local communities to manage their resources is an important avenue for both equity and equality. However local communities are not homogeneous.” (Kulkarni, 2011).
According to activist and ecologist Vandana Shiva, water shortage is the most pervasive a most severe of all the ecological devastations on earth. A recent international symposium of environmentalists was titled “Water, more than two billion people are dying for it.”
Kulkarni (2014) takes note of that the time spared gathering water in view of drinking water supply programs is frequently utilized for other family exercises and does not really convert into recreation time for ladies.
C. Health-related Problems of Women in the Indigenous Communities of Laos and India
Reproductive health problems remain the leading cause of ill health and death for women of child-bearing age (Krishnammal, et.al, 2013). In Lao PDR, maternal, neonatal and child mortality levels are high, and coverage of skilled birth attendance and antenatal care differs significantly between urban and rural areas (Alvesson, et.al, 2013). This is due to that the attitudes of the community, private practitioners, and people and service providers discouraged the use of antenatal care (ANC) by the tribal women. Also, according to Rahman, et, al (2012), the tribal women of most communities disregard the use of any medicine that is not from the traditional healers of the tribe. A reason for this is that even though the remote areas of Laos receive outreach services, there is little evidence on the conditions for their effective delivery including on integration of broader maternal health services (Jacobs, et,al., 2012). Cambodia, on the other hand, despite being a poor country, had done some major efforts in order to reduce maternal mortality by providing more trained midwives in the health facilities. This is an excellent project since giving birth in a health care facility will not automatically lead to better maternity care if the attending staffs are not sufficiently skilled (Liljestrand & Sambath, 2012). In the rural and indigenous communities of India, women have lower access to preventive care and treatment of disease compared to men (Rammohan, et.al, 2014). In conclusion, the concept of reproductive health recognizes the diversity of the special health needs of women before, during and beyond child-bearing (Krishnammal, et.al, 2013).
Moreover, Malnutrition is another serious health concern that women face. It threatens their survival as well as that of their children (Krishnammal, et.al, 2013). This is due to the amount of work they do in the household, poverty, and giving birth.
Extracted from the work of M.C. Gray, B.H. Hunter and J. Taylor, stated: Data on hospital separations are often used as indicators of morbidity. However, as Deeble et al. (1998: 46) point out, these are imperfect measures as high rates may reflect not only serious morbidity but inadequate primary care or specialist services (especially in areas where Indigenous people are the predominant population). Low rates, on the other hand, may simply be the result of difficulties of access. In either event, the decision to hospitalize is often subjective and based on different perceptions of the need for hospital care on the part of doctors and health workers.
D. Traditional Health Care Services for the Tribal People of Murias, Bastar
Limited access to basic health services remains a big problem among indigenous peoples in Asia (AIPP, 2014). In addition to that, women, however, were often limited in their ability to access formal health services, because they were responsible for looking after the household and had only limited resources (Caldwell, et.al, 2014). Also, reasons would include the location of indigenous communities, security problems in the area, and the price to have access to the health services are too expensive for the indigenous peoples. Therefore, indigenous peoples turn to traditional healing since it is more affordable and in most cases, the faith healers do not ask for cash in exchange for his/her service.
In the case of the tribal areas of Bastar, the government has made some endeavors to involve the local people in delivering medical services (Agarwal, 2014). But the result of this was not good. However, the ideology that people living in urban areas receive better health care services rather than those who are living in rural and remote areas like most indigenous communities is not always true. For example, according to Caldwell, et.al (2014), the government of Bangladesh established health centers in the tribal areas of the country. These health services are said to be better than those that can be found in the urban areas. In conclusion, according to Cook & Pincus (2014), due to the diversity of Asia, the innovations towards poverty of the ASEAN, UN, other International organizations, and the central government of each country showed slow and little results.
Moreover, Indigenous peoples in Asia exhibit similar characteristics in their traditional knowledge and practices related to health (AIPP, 2014). Many of them use traditional healers; a variety of different healers practice folk medicine, including faith healers such as the Kobiraj, who are the indigenous practitioners of the tribes in Bangladesh (Caldwell, et.al, 2014). This was supported by Agarwals (2014) statement that the indigenous people have a strong belief in supernatural healing practices. Thus, the indigenous communities like the Murias of Bastar wont be able to easily accept the modern ways of healing. A reason could be because most indigenous communities find these faith healers more convenient and are more comfortable with them. However, as time went by, different diseases have emerged that cannot be treated anymore by traditional healing practices. Ergo, different Indigenous communities in Asia then demanded for health care services.
F. Theoretical Framework
Figure 1. Intersectionality Theory by Kimberl? Crenshaw
The Intersectionality Theory was first used by Kimberl? Crenshaw in her 1989 paper entitled “Demarginalizing The Intersection Of Race And Sex: A Black Feminist Critique Of Antidiscrimination Doctrine, Feminist Theory, And Antiracist Politics.” This theory was already present 2 decades before the paper was written however it was during this time when black women could not relate to the problems of the white feminists who were pressured to be homemakers since they had to work in order to feed their family. Also, these women of color experienced discrimination in the Civil Rights movement because of their gender. The perspective of the theory further reveals that the individuals social identities profoundly influence ones beliefs about and experience of gender. As a result, feminist researchers have come to understand that the individuals social location as reflected in intersecting identities must be at the forefront in any investigation of gender. In particular, gender must be understood in the context of power relations embedded in social identities (Collins 1990; 2000). Intersectionality, the mutually constitutive relations among social identities, has become a central tenet of feminist thinking, one that McCall (2005) and others have suggested is the most important contribution of feminist theory to our present understanding of gender (Shields, 2008). It is also widely agreed that intersections create both oppression and opportunity (Baca Zinn and Thornton Dill 1996). The origins of the intersectionality framework grew out of feminist and womanist scholars of color pressing the position that most feminist scholarship at that time was about middle-class, educated, white women, and that an inclusive view of womens position should substantively acknowledge the intersections of gender with other significant social identities, most notably race (e.g., Moraga and Anzald?a 1981; Hull et al. 1982; Dill 1983). One basic assumption of intersectionality is that different dimensions of social life cannot be separated into discrete or pure strands (Brah & Phoenix, 2004, p. 76). Some social sciences have been more open to the transformative effects of an intersectionality perspective than others. The intersectionality perspective has had more impact on academic specializations already concerned with questions of power relations between groups (Shields, 2008). Intersectionality is transforming gender studies, cultural studies, and migration studies and has started to influence the disciplines of economics, political science, psychology, geography, criminology, history, sociology, and anthropology (Havinsky; Cormier; de Merich, 2009)
G. Conceptual Framework
Figure 2. The Conceptual Framework
The Intersectionality theory suggests that one’s gender may influence how society treats a person. The diagram shows that the men of the Aeta Community of Barangay Villa Maria and the health care providers of Porac, Pampanga agrees that the Aeta women should be receiving more health care needs than the men. One variable is that the community believes that the women have weaker bodies than the men thus being the homemakers they need the right health care supplements in order for them to do their responsibilities as a wife and a mother. Moreover, traditional healing is a part of the Aetas culture and women are mostly the ones who perform the traditional healing processes such as pagtatawas. Therefore, the Aeta women are seen as important key elements as to the health of its people for they are more knowledgeable about it.