Maternal Health Pathway: How Dalit Women Access Care in Dhaka!
Reproductive health is understood to be one of the key markers of human development. Although Bangladesh has performed remarkably in increasing access to reproductive health services, gains are still somewhat distributed unevenly. Dalit women, who are doubly marginalised because of caste and gender, often stay excluded from such essential services due to low social standing and a lack of awareness.
This systemic neglect is illustrated tragically by cases of persons like Laxmi Rani from Wari, Dhaka, whose husband feared taking the ‘untouchable’ woman to a health centre during her first pregnancy. The resulting stillbirth, delivered by a traditional birth attendant (dai), led to severe complications like a fistula. This is an anecdote that underlines the abysmal health disparity faced by the nearly 70 lakh Dalits in Bangladesh, where the birth of a live child is the main concern, and science-backed maternal health gets little importance.
However, a qualitative study titled “Maternal Health-Seeking Process of Dalit Women in Dhaka,” focusing on thirty married Dalit women residing in the restricted staff quarters of Dhaka University’s Jagannath Hall, offers a contrasting and hopeful narrative. The research aimed to analyse the women’s health-seeking process when the barriers to access are lowered.
The findings challenge the narrative of total exclusion. Women in this locality demonstrate a strong and clear preference for modern, biomedical treatment. They rely heavily on nearby government facilities, such as Dhaka Medical College Hospital and Azimpur Maternity Hospital, for their healthcare and delivery services. This reliance is driven by two key factors: affordability (the low cost of public hospitals) and geographical proximity (the ability to walk to the facility).
Crucially, the women reported experiencing no caste-based discrimination within these hospitals. For them, the hospital is the central and safest arena for childbirth, a belief shared by their families. While they depend on doctors for medical guidance, the influence of close family members (kin members, like husbands, mothers, and sisters) remains paramount, with their advice being considered ‘authoritative knowledge.’
This research shows that as long as structural deprivation continues, practical target-oriented measures in the form of geographical proximity and economic access go a long way in enabling Dalit women to overcome the social obstacles to availing modern maternal health services. The model offers valuable lessons for policymakers on how accessible and nondiscriminatory health services need to be replicated in rural and slum areas in order to guarantee health rights to all.
Source: BSS and Research Report.