Social Identity and the Take-Up of Healthcare: Exploring the Intersection of Caste, Gender, and Public Policy in Nepal (thesis)

Abstract

To reach equality in health outcomes, Nepal -- in concert with most developing countries -- has focused on the decentralization of healthcare. Although accessibility to health services is now relatively uniform, health deficits persist among marginalized groups. This study focuses on social identity, measured by caste, and examines how preferences for health services may systematically vary with group norms and status. This study finds that women in low-status castes consistently utilize less healthcare than women in high-status castes. Evidence shows that caste status can be as strong of a determinant to take-up as wealth. This relationship is, however, nuanced as its strength varies with specific caste affiliation. Additionally, this study finds that household agency does little to bolster women's care-seeking behavior in the presence of caste. Given its results, this thesis culminates with the question: does social vulnerability undermine current policy interventions?