Affirmative action, minorities, and public services in India: Charting a future research and practice agenda

Indian J Med Ethics. 2019 Oct-Dec;4 (NS)(4):265-273. doi: 10.20529/IJME.2019.062.

Abstract

The National Health Policy in India mentions equity as a key policy principle and emphasises the role of affirmative action in achieving health equity for a range of excluded groups. We conducted a scoping review of literature and three multi-stakeholder workshops to better understand the available evidence on the impact of affirmative action policies in enhancing the inclusion of ethnic and religious minorities in health, education and governance in India. We consider these public services an important mechanism to enhance the social inclusion of many excluded groups. On the whole, the available empirical evidence regarding the uptake and impact of affirmative action policies is limited. Reservation policies in higher education and electoral constituencies have had a limited positive impact in enhancing the access and representation of minorities. However, reservations in government jobs remain poorly implemented. In general, class, gender and location intersect, creating inter- and intra-group differentials in the impact of these policies. Several government initiatives aimed at enhancing the access of religious minorities to public services/institutions remain poorly evaluated. Future research and practice need to focus on neglected but relevant research themes such as the role of private sector providers in supporting the inclusion of minorities, the political aspects of policy development and implementation, and the role of social mobilisation and movements. Evidence gaps also need to be filled in relation to information systems for monitoring and assessment of social disadvantage, implementation and evaluative research on inclusive policies and understanding how the pathways to inequities can be effectively addressed.

Publication types

  • Systematic Review

MeSH terms

  • Delivery of Health Care / ethics*
  • Delivery of Health Care / organization & administration*
  • Health Equity / ethics*
  • Health Equity / legislation & jurisprudence*
  • Health Policy / legislation & jurisprudence*
  • Humans
  • India
  • Minority Groups / legislation & jurisprudence*
  • Public Policy / legislation & jurisprudence*
  • Public Sector / ethics*