Women’s Health
A conceptual model for understanding how caste-based discrimination may underlie disparities of medical sterilization of Scheduled Caste/Scheduled Tribe women in India Sage Smith* Sage Smith Parvati Singh
Historically, the caste system has formed the foundation of hierarchical discrimination in India. One of the groups most impacted by caste-based discrimination comprise women from the Scheduled Castes and Scheduled Tribes (SC/ST), which form the lowest ranked castes in the caste system. Women from these groups are viewed as “ritually polluted,” and face discrimination in the economic, political, educational, and health sectors in India. We present a conceptual framework that links caste-based discrimination to coercive reproductive suppression through female surgical sterilization among SC/ST women in India. Introduced during The Emergency by Indira Gandhi’s government in the 1970s, female surgical sterilization has been used aggressively to control India’s population crisis. Because SC/ST women are devalued in Indian society, their fertility remains highly stigmatized and continues to be viewed as the driving force behind the population crisis. It is thus plausible that SC/ST women experience coercive sterilization at higher rates relative to upper caste women in India. Consequently, SC/ST women may also exhibit higher rates of sterilization regret relative to women from the higher castes. This group also faces unique barriers in access and utilization of health care services. We propose a conceptual model that links caste based discrimination, healthcare access, government policies and coercive sterilization among SC/ST women in India. Our conceptual framework may aid research and policy towards identification and reduction of adverse reproductive health outcomes in vulnerable groups.
