COVID-19: Can A Health Crisis Become A Breeding Site For Gender Inequality?

The novel Coronavirus disease (COVID-19) outbreak has become a breeding site of gender inequality with social distancing measures that threaten to relegate women to their gendered roles as caregivers. The state response to the outbreak has been inadequate to address the safety, health, and economic inequalities that would pinch women the hardest. If India is to combat and recover from the social and economic impacts of this outbreak, it needs to take a look at gender.

By Srishti Gupta Mar 24, 2020 5 min read

Care in the Time of COVID-19

The World Health Organization (WHO) issued interim guidelines (dated 17^th March, 2020) for countries to ensure safe home care for patients of COVID-19 with mild symptoms citing the likelihood of limited healthcare facilities. While the document recommends safeguards for caregivers, it falls shy of acknowledging the gendered nature of care in most countries, including India.

In India, as opposed to 36 minutes in the case of men, women spend six hours in unpaid care responsibilities in a household. These gendered responsibilities further amplify during health crises. The current Coronavirus outbreak necessitates maximum care for higher-risk groups like children and the elderly resulting in social distancing measures like the closure of schools and childcare centers. This forces women to devote even more time to housework. However, the current policy formulations around care work fail to take cognisance of this disproportionate burden of care responsibilities on women who are more likely to come in contact with the COVID-19 virus.

The current Coronavirus outbreak necessitates maximum care for higher-risk groups like children and the elderly resulting in social distancing measures like the closure of schools and childcare centers. This forces women to devote even more time to housework.

Socio-Economic Distancing from Parity

The gendered unpaid care renders women’s economic participation invisible and thwarts their employment opportunities. Women who are employed find themselves in an unsustainable juggling act in the wake of a health emergency like COVID-19, eventually driving them out of work, even if temporarily. The Social Distancing advisory issued by the Ministry of Health and Family Welfare “encourages” working from home but falls short of mandating corporations to ensure support in the form of paid leaves to women involved in urgent care work.

Moreover, any health crisis, including COVID-19, is quickly followed by an economic slowdown with ramifications like salary cuts, layoffs, and shutting down of small businesses. Currently, the hardest hit industries are aviation, hospitality, and retail, which coincidentally are also some of the biggest employers of the female workforce. In India, where women’s income is an abysmal one-fifth of their male counterparts, the COVID-19 pandemic has disincentive effects on women’s economic participation and employment opportunities.

The female workforce also figures predominantly in vulnerable jobs in the informal sector like domestic work: bereft of any social or health security benefits and prone to unsafe working conditions, including possible contact with the COVID-19 virus. The pandemic puts their livelihoods and health in the lurch.

Stay Home, Stay Safe?

Many universities have asked their students to vacate their hostels and head home to safety as they went on lockdown to contain the COVID-19 outbreak. However, universities are the only safe places accorded to many students who come from violent homes. The assumption of a home as a safe place by enforcing lockdowns and ‘voluntary’ curfews overrides the reality of abusive family members in the domestic sphere. The incidence of such violence is higher in the case of gender and sexual minorities.

Ever since the Coronavirus outbreak and subsequent lockdown in China, the country has reported a significant rise in cases of gender-based violence/intimate partner abuse. In the case of India, 31.1% of ever-married women have reported having experienced spousal violence. The unmarried women who have experienced physical or sexual violence cited their relatives and former partner as perpetrators. At a stage where the public health system is overburdened, enforced lockdown at homes during the COVID-19 outbreak crisis may not only increase the incidence of domestic abuse but also make remedial access to medical and mental health support challenging.

Ever since the Coronavirus outbreak and subsequent lockdown in China, the country has reported a significant rise in cases of gender-based violence/intimate partner abuse. In the case of India, 31.1% of ever-married women have reported having experienced spousal violence.

Tracing the Frontlines of Health Workforce

The first responders in a health crisis are nursing professionals available in community health centers, clinics, schools and retirement homes. In India, the nurses and midwives constitute of 83.4% female health workforce who provide palliative care to the sick and infirm, and in the absence of medical doctors, deal with emergencies first-hand. They, along with Accredited Social Health Activists (ASHA), are at the frontline of the COVID-19 pandemic, tasked with educating people at the grassroots level about the disease.

Also read: Awareness, Not Xenophobia: Coronavirus And The Spreading Racism

However, their jobs are overlooked as an extension of gendered care roles and receive little attention in terms of fund allocation, training, and fair pay. Moreover, the concentration of the female workforce in nursing does not translate to higher levels as allopathic physicians and surgeons at a mere 16.8%. This gap in female representation results in health policy decision-making and management strategies that lack a gendered perspective. It becomes critical at times of health crises like the current COVID-19 outbreak, given that the exposure patterns of women differ significantly from men.

Gendered Access to Healthcare

Gender is a strong determinant in seeking healthcare in India, owing to a prevalent male preference in a household with limited economic means. However, discrimination in access to healthcare aggravates when the public healthcare system fails to meet the medical needs of women. Among many unmet needs, 37% percent of women cited a lack of female health providers as a hindrance to their treatment.

During epidemic outbreaks, when the public health system is bursting at the seams, the primary solution entails diversion of funds and reallocation from other health programmes, usually meant for the marginalised. The gender-insensitive response to the Ebola virus disease in Sierra Leone led to a decrease in the quality of maternity care and an increase in mortality rates in the aftermath of the outbreak. The COVID-19 outbreak in India could have a similar impact on the sexual and reproductive health of women.

Gendering the Preparedness to COVID-19

Past epidemics have revealed that gender roles have a marked impact on exposure, transmission, and outcome patterns of an outbreak. Since women bear an unbalanced risk of infection, the preparedness to the COVID-19 outbreak requires a reorientation through a gendered lens.

Also read: Coronavirus And Our Callous Casteist Biases In India

Public health officials should opt for sex and gender-disaggregated data collection and statistical analysis. India urgently needs sexual and gender-sensitive mitigation and health recovery strategies if it is to come even closer to combating the Coronavirus disease pandemic.