wow-inequalities/02-data/intermediate/wos_sample/9c8af3f1e771d65d1d7df61582190792-ramprakash-rajalaks/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'BackgroundThe continuing impetus for universal health coverage has given
rise to publicly funded health insurance schemes in lower-middle income
countries. However, there is insufficient understanding of how universal
health coverage schemes impact gender equality and equity. This paper
attempts to understand why utilization of a publicly funded health
insurance scheme has been found to be lower among women compared to men
in a southern Indian state. It aims to identify the gender barriers
across various social institutions that thwart the policy objectives of
providing financial protection and improved access to inpatient care for
women.MethodsA qualitative study on the Chief Minister''s Comprehensive
Health Insurance Scheme was carried out in urban and rural impoverished
localities in Tamil Nadu, a southern state in India. Thirty-three women
and 16 men who had a recent history of hospitalization and 14
stakeholders were purposefully interviewed. Transcribed interviews were
content analyzed based on Naila Kabeer''s Social Relations Framework
using gender as an analytical category.ResultsWhile unpacking the
navigation pathways of women to utilize publicly funded health insurance
to access inpatient care, gender barriers are found operating at the
household, community, and programmatic levels. Unpaid care work,
financial dependence, mobility constraints, and gender norms emerged as
the major gender-specific barriers arising from the household.
Exclusions from insurance enrollment activities at the community level
were mediated by a variety of social inequities. Market ideologies in
insurance and health, combined with poor governance by State, resulted
in out-of-pocket health expenditures, acute information asymmetry,
selective availability of care, and poor acceptability. These gender
barriers were found to be mediated by all four institutions-household,
community, market, and State-resulting in lower utilization of the
scheme by women.ConclusionsHealth policies which aim to provide
financial protection and improve access to healthcare services need to
address gender as a crucial social determinant. A gender-blind health
insurance can not only leave many pre-existing gender barriers
unaddressed but also accentuate others. This paper stresses that
universal health coverage policy and programs need to have an explicit
focus on gender and other social determinants to promote access and
equity.'
affiliation: 'RamPrakash, R (Corresponding Author), Loyola Coll Campus, Loyola Inst
Business Adm, Chennai 600034, Tamil Nadu, India.
RamPrakash, Rajalakshmi, Loyola Coll Campus, Loyola Inst Business Adm, Chennai 600034,
Tamil Nadu, India.
Lingam, Lakshmi, Inst Social Sci, VN Purav Marg, Mumbai 400088, Maharashtra, India.'
article-number: '350'
author: RamPrakash, Rajalakshmi and Lingam, Lakshmi
author-email: rajalaksh@gmail.com
author_list:
- family: RamPrakash
given: Rajalakshmi
- family: Lingam
given: Lakshmi
da: '2023-09-28'
doi: 10.1186/s12889-021-10352-4
eissn: 1471-2458
files: []
journal: BMC PUBLIC HEALTH
keywords: 'Gender; Publicly funded health insurance (PFHI); Universal health
coverage (UHC); Social relations (SR) framework; India; Gender analysis'
keywords-plus: EQUITY; CARE; INTERVIEWS; RESOURCE; GENDER; POLICY
language: English
month: FEB 12
number: '1'
number-of-cited-references: '61'
orcid-numbers: RamPrakash, Rajalakshmi/0000-0001-6785-5239
papis_id: 498cbe7b2661f28b04b0e121cbc752ee
ref: Ramprakash2021whyis
times-cited: '7'
title: 'Why is women''s utilization of a publicly funded health insurance low?: a
qualitative study in Tamil Nadu, India'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000619749900006
usage-count-last-180-days: '2'
usage-count-since-2013: '6'
volume: '21'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2021'