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July 19th, 2021
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The vaccine gap: why more men than women are getting vaccinated in India
By Sarita Santoshini
When Sonam Patel’s husband went to get his first shot at the Covid vaccination centre near his village in India’s central state of Madhya Pradesh, he did not take her with him. Patel, 22, is petite and the mother of a two-year-old daughter. Her husband said she would not be able to tolerate the vaccine’s side-effects, and she agreed. “I am scared,” Patel said, “but I will get vaccinated in the future. »
Patel’s experience is emblematic of India’s vaccine gender gap. As of July 16, the country had administered vaccines to 182 million women compared to 210 million men. Approximately 55,000 doses were administered to people with other gender identities.
Since women make up a large proportion of India’s frontline health workers, some received their vaccines in the initial phase of the rollout, but that hasn’t been the case for those who fall outside that
category. While releasing vaccine data during a recent press conference, government official V K Paul said he wanted to see more women coming to vaccination booths so the gender gap could be addressed. But for most Indian women, it’s not that simple.
India is recovering from a devastating second wave of COVID-19, which arrived in March, quickly overwhelming its health system and causing thousands of deaths – more than 4,500 were recorded in a single day at its peak in May, though experts say this is an underestimate. The number of cases have since fallen and most states have now relaxed strict lockdowns, but vaccination rates are low – just 5% of India’s population is fully vaccinated, amid warnings of an approaching third wave.
The government updated its vaccine procurement policy in June and promised free vaccines for all adults after facing severe criticism from health experts and the Supreme Court. For now, vaccine shortages continue to be reported from different parts of the country.
Experts say the gender gap in vaccine access is not simply a result of India’s skewed sex ratio — according to the 2011 census, there were 940 women to every 1000 men in the country — but a sign of deeper structural inequalities.
Numerous reports and studies have found that healthcare expenditure in India was lower for women than it is for men. More men visited large hospitals for outpatient care, and even when free hospital care was provided, the gender disparity continued.
« It is thought in families that women need not be taken to a hospital, » said Vineeta Bal, an immunologist and professor at the Indian Institute of Science Education and Research. « If a man is the breadwinner … it is assumed his health is the most important thing for the family. But if a woman falls ill, she doesn’t amount to much anyway, »
Heloísa Marques for Impact x Les Glorieuses
Information asymmetry further aggravates this problem. India opened up vaccination for the 18-45 age group through a laborious online registration system and in doing so made it inaccessible to a large part of its population. Just 42% of women said they had ever used the internet in India’s most recent national family health survey. And only 30% of women in India use the internet on their phones, compared to 45% of men. The government has since allowed walk-in registrations.
Patel said she knows how to use her husband’s smartphone but can only do so with his permission, and does not own a phone herself.
When women do not have access to timely and accurate information, it is bound to make them anxious about how the vaccine or its side-effects will affect their
household and familial responsibilities, said Manisha Dutta, a public health professional who worked in Rajasthan until recently. « In most households, she cannot afford the luxury of resting, » Dutta said.
In Uttar Pradesh, India’s most populous state, 736 women were vaccinated for every 1000 men as of July 1. For Pramila Devi, a community health worker in the state’s Azamgarh district, the quest to be vaccinated has been tiresome.
The first time she showed up at a vaccination centre, back in February, and told health workers she was still breast-feeding her child, they advised her to not take the vaccine. Soon after, the second wave hit and misinformation was rife. « Everyone said the vaccine isn’t right and that people are dying because of it. They were all hesitant and so was I, » she said.
Devi and several of her fellow villagers are now more willing to take the vaccine, thanks partly to the efforts of female Accredited Social Health Workers, or ASHAs, who have been going door-to-door with information about vaccination.
But in late June, when Devi was on duty at a village-level vaccination camp organised by local officials and considered being vaccinated herself, she happened to be menstruating and was once again advised to wait it out. In April, social media rumours had begun making the rounds advising women not to take the vaccine during their periods, which experts and government officials tried to dispel.
Vaccination centres in the region continue to be short on supplies, often unable to provide for all who show up. « There are long queues and a lot of chaos. The men show up first. Many women, especially young brides, are either uncomfortable or not allowed to travel by themselves there, and are missing out, » said Kanchan Pandey, an ASHA supervisor who also lives in the village.
Despite all this, Devi was determined to get her first dose when the next vaccination drive passed through her village. « I want to take the shot. I will get it, » she told Les Glorieuses in June. On July 6, she was finally able to do so.
In some states, local governments and non-profit organisations are working with women’s self-help groups, to improve vaccination uptake among women. In Madhya Pradesh’s Mandla district, Chhoti Potta leads one such group in addressing concerns and raising awareness about vaccination among women, encouraging those who’ve received a shot to share their photo on Whatsapp to encourage others, and doing home-visits so no one is left without information.
« There is trust and unity among us. If we put forth a point, the others listen to us, » she said. Potta said there are now more women in her village coming forward to be vaccinated than men.
Nicaragua – On June 30, Nicaraguan women demonstrated under the slogan #SolidaridadFeministaConNicaragua in cities around the world, including Buenos Aires, Mexico City and Barcelona. María Teresa Blandón, a feminist activist who heads the organization La Corriente, says women’s collectives have been some of the few groups to consistently protest Daniel Ortega’s government in recent years. « There is not a single front of resistance that we have not been in since the 2018 protests, » she told Les Glorieuses. Since coming to power in 2007, the government has criminalised abortion without exception, refused to provide sex education in schools and hidden crime statistics, including femicide.
Malawi – The LGBTQ+ community in Malawi closed off global Pride Month with the country’s first-ever Pride parade held in the capital, Lilongwe,
on June 26. The march was organised by the Nyasa Rainbow Alliance, an LGBTQ+ led membership organisation, and attracted more than 50 attendees. Marchers delivered a petition to the city’s officials demanding the government repeal laws that criminalise same-sex marriage and provide better access to healthcare for LGBTQ+ people. Homosexuality is still illegal in Malawi – sex between two men carries a prison term of eight to 14 years while sex between two women is punishable by up to five years.
Argentina – One percent of positions in the public sector will be reserved for transgender people in a new law in Argentina. The legislation was signed by president Alberto Fernández on July 7. It aims to improve the dire living situation faced by the country’s trans community. Trans people in Argentina have a life expectancy of between 35 and 41 years, and only 18% have ever held formal employment. « This law is an approach to repair all the violence we have suffered and is going to be a paradigm shift not only for our community, but for the whole society, » activist Florencia Guimaraes told Les Glorieuses. « By working, we can break the structural poverty we suffer, and have access to housing and health care. »
Turkey – President Recep Tayyip Erdoğan has withdrawn Turkey from the Istanbul Convention – a Council of Europe treaty designed to prevent gender-based violence and hold perpetrators to account. The legally binding treaty was opened for signatures in 2011 and came into effect in 2014. Turkey was the first country to sign. Erdoğan’s communications directorate said the treaty, which covers 34 countries and is named after Turkey’s largest city, had been « hijacked » by those « attempting to normalise homosexuality ».
Mexico – The Mexican state of Hidalgo has approved legal abortion up to 12 weeks of gestation, becoming the third state in the country to allow women to decide to terminate their pregnancy without restriction. The law came into force on July 7 following its publication in the official government gazette. In Mexico, where each state determines its own legislation, all 32 federal entities have penal codes that permit abortion in case of rape. Until now, only Mexico City (2007) and Oaxaca (2019) passed legislation allowing for legal abortion on request. State governments in Puebla and Quintana Roo are studying similar initiatives.
Gibraltar – The tiny British territory of Gibraltar has voted to legalise abortion up to 12 weeks, or longer in case of fatal abnormalities of the foetus. In a referendum, 62% of the territory’s 32,000 residents voted yes to overturning a total ban on abortion, a procedure that was previously punishable by life imprisonment. Campaigners hope this will bring an end to Gibraltans having to travel to Spain or the UK to terminate unwanted pregnancies.
Colombia – Colombia has extended paternity leave from eight days to five weeks. The initiative, passed by the senate on June 20, seeks to balance the burden of care work and close the gender gap in the labor market. “Many women interrupt their working life or stop their professional growth to take care of their children,” said Juliana Morad Acero, a labour market expert at Javeriana University in Bogotá. This results in lower pensions for women and doubles the burden on those who have paid and unpaid work, and leads women to take flexible or informal jobs. « Men sharing care work is necessary for women’s integration into the labour market and the consolidation of their careers, » Acero said.
Egypt – Influencers Haneen Hossam and Mawadda al-Adham have been sentenced 10 and six years in prison, respectively, by the Egyptian courts. In 2018, Egypt enacted a cyber crimes law that effectively criminalises the right to freedom of expression and association. The pair, known as the “TikTok Girls”, were convicted on charges of “human trafficking” arising from their social media activities. They were arrested in April 2020 for violating “public morals” and “undermining family values” in the videos they posted to their social media platforms.
Chile – Elisa Loncon, an indigenous Mapuche woman, has been elected to lead the process of creating Chile’s new constitution. The Constitutional Assembly, composed equally of men and women, aspires to set a new, egalitarian basis for the country. Meanwhile, Chilean president Sebastián Piñera has announced his intention to urgently pass an equal marriage bill. « All people, regardless of their sexual orientation, will be able to live, love and form a family with all the protection and dignity they need and deserve”, Piñera said. If it becomes a law, Chile will be the eighth country in Latin America to legalise same-sex marriage. In June, the Women and Gender Equality Committee of the Lower House restarted the debate on a bill that would decriminalise abortion up to 14 weeks of gestation. The procedure was illegal in all circumstances until 2017.
France – Lesbian and single women have been given access to fertility treatment in France for the first time. Until now, women without male partners were forced to travel abroad to access IVF and other fertility treatments. The bill, which passed on June 22, allows for the French state to cover medically assisted reproduction for any woman under the age of 43. However, some activists have pointed out that trans couples have been neglected under the new legislation, and will still struggle to access treatment.
Namibia – Two Namibian athletes have been banned from competing in the women’s 400-metre race at the Tokyo Olympics, because their natural levels of testosterone are considered to be too high by the sport’s governing body, World Athletics. Christine Mboma and Beatrice Masilingi may still compete in the 200 metre event, but have been ruled out of competing in the longer race under rules that have also curtailed the career of South African runner Caster Semenya. Meanwhile, the International Swimming Federation has barred swimmers from competing in swim caps designed for Black hair, effectively ruling out their use at the games, which begin on July 23.
Africa – African women working in the media industry were twice as likely to experience sexual harassment at work than their male counterparts, a recent report has found. Researchers from City, University of London surveyed 584 media professionals in eight African countries — Botswana, Malawi, Kenya, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe. Almost half of women surveyed (47%) reported they had been sexually harassed at work. For one in two, the harassment was verbal and for one in three, it was physical. Rachel Ombaka, online sub-editor for The Africa Report, said: « I don’t think there is a right time to talk about sexual harassment. The time to talk about it is now, the time to talk about it was yesterday! »
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This issue of IMPACT was prepared by Agustina Ordoqui, Heloísa Marques, Megan Clement, Pontsho Pilane, Rebecca Amsellem, Sarita Santoshini and Steph Williamson from the team at Les Glorieuses.
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