Systematic Hierarchies and Systemic Failures: Gender and Health Inequities in Koppal District

Health and health care inequities in Koppal reflect systematic hierarchies based on gender, caste, economic class, and life-stage; they also reveal systemic failures in health care services, both public and private. The unfortunate interplay between systematic hierarchies and systemic failures makes it possible for families and communities on the one side and health providers on the other to exonerate themselves and hold the other side responsible for poor health status and outcomes. The paper will present empirical evidence and analysis of health inequities, and will draw on insights gained through research, community mobilisation and institution building efforts over the past three years with the Gender and Health Equity Project in Koppal since 2001. It will argue that both the systemic and the systematic elements need to be tackled if any policy or programme changes are to really take hold.