HEALTH AND WELL-BEING OF MARGINALIZED GROUPS

-E.
DEENASHALINI.

SCHOOL OF
EXCELLENCE.

ABSTRACT

This study examines the health and well-being of marginalized groups, including women,
children, the elderly, and socio-economically disadvantaged communities, who face systemic
discrimination and exclusion. The research aims to analyze the legal and policy frameworks that
address healthcare inequalities and evaluate the effectiveness of governmental interventions.
Employing a doctrinal research methodology, the study relies on legal provisions, judicial
precedents, international treaties, and policy documents, supplemented by secondary data from
government reports and surveys. Key findings reveal that despite constitutional guarantees and
welfare schemes like Ayushman Bharat and ICDS, marginalized groups struggle with healthcare
access due to economic barriers, geographical disparities, and inadequate implementation of
policies. Judicial interventions have reinforced the right to health as fundamental under Article
21 of the Indian Constitution, yet enforcement challenges persist. Comparative analysis with
international best practices highlights the need for stronger regulatory mechanisms, targeted
healthcare programs, and community-driven initiatives. The study underscores the necessity of
addressing financial constraints, increasing public awareness, and enhancing healthcare
infrastructure, particularly in rural and tribal areas. It concludes that legal reforms, policy
enhancements, and public-private partnerships are crucial for achieving equitable healthcare
access. Strengthening judicial oversight and ensuring accountability in policy execution can
bridge the gap between healthcare entitlements and real-world accessibility. The study
recommends targeted interventions such as subsidized healthcare, telemedicine expansion, and
community healthcare initiatives to improve health outcomes for marginalized populations.
Keywords: marginalized groups, healthcare access, legal framework, public policy, social
inclusion.

INTRODUCTION
Marginalization is a persistent global issue that affects vulnerable
communities by limiting their access to essential resources, including
healthcare. Marginalized groups, such as women, children, the elderly, and
socio-economically disadvantaged populations, face systemic barriers that
negatively impact their health and well-being. These barriers include
poverty, discrimination, inadequate healthcare infrastructure, and exclusion
from government welfare programs. In India, despite constitutional
guarantees and numerous policy initiatives, marginalized communities
continue to experience significant disparities in healthcare access.
Addressing this issue is essential to achieving social justice and inclusive
development.

The primary research problem of this study is the persistent inequality in healthcare access
among marginalized groups despite existing legal and policy frameworks. This study aims to
analyze the effectiveness of legal provisions, government initiatives, and judicial interventions in
addressing healthcare disparities. It seeks to evaluate whether current policies sufficiently
safeguard the health rights of vulnerable communities and identify gaps in their implementation.
Additionally, the study explores how legal reforms and public policy measures can be improved
to promote equitable healthcare access.

To address these issues, the research is guided by the following key questions:

1. What are the major legal and policy frameworks governing healthcare
access for marginalized groups in India?
2. How effective are government healthcare schemes in reaching
marginalized communities?
3. What are the primary barriers preventing marginalized populations
from accessing quality healthcare?
4. What role has the judiciary played in reinforcing healthcare rights as
fundamental rights?
5. What policy recommendations can be made to improve healthcare
accessibility for marginalized groups?
This study follows a doctrinal research methodology, relying on legal analysis, case law review,
and policy evaluation. It examines constitutional provisions, landmark judicial decisions, and
international treaties relevant to the right to health. Additionally, secondary data sources,
including government reports and policy documents, are analyzed to assess the impact of
existing healthcare schemes.

The structure of this paper is as follows: Section 2 discusses the legal framework governing
healthcare access. Section 3 evaluates the challenges marginalized groups face in accessing
healthcare. Section 4 analyzes government and judicial interventions. Section 5 presents findings
and recommendations, followed by the conclusion in Section 6. This study aims to provide a
comprehensive legal and policy-based perspective on strengthening healthcare accessibility for
marginalized populations.

LEGAL FRAMEWORK FOR PROTECTING THE HEALTH AND WEL BEING OF

MASRGINALIZED GROUP:

Regardless of social or economic status, everyone has the fundamental right to health care.
However, underprivileged groups are often impacted by systemic barriers to accessing
healthcare. Numerous international treaties and state laws provide the legal framework for
safeguarding the health and welfare of these vulnerable people.

International Legal Instruments:

Universal Declaration of Human Rights

Universal Declaration of Human Rights is an important document in human history that is drafte
by various representative from legal background and different cultural background all over the
World. The aim of this Declaration is to give equal rights to all the citizens. On December 10,
1948, the United Nations General Assembly in Paris adopted the Declaration (General Assembly
resolution 217 A) as an international standard for success for all peoples and all countries. It has
been translated into more than 500 languages and, for the first time, calls for the universal
protection of fundamental human rights. It is well acknowledged that the UDHR served as
inspiration and an agent for the ratification of over seventy human rights treaties that are
currently in effect permanently on a regional and international scale. 1

The main goal of Human Rights instruments is to protect the people whose fundamental rights
have been violated , those people need more protection to enjoy their human rights equally like
others . This violations oh fundamental Human Rights are done to the vulnerable and
marginalized groups2. All persons, especially those from marginalized communities, have the
right to health and well-being, according to the Universal Declaration of Human Rights (UDHR)
and international human rights treaties. Access to food, medical care, and other essentials are all
part of the right to health.3

Article 25 of UDHR:

Everyone has the right to a standard of living adequate for the health and well-being of himself
and of his family, including food, clothing, housing and medical care and necessary social
services, and the right to security in the event of unemployment, sickness, disability, widowhood,
old age or other lack of livelihood in circumstances beyond his control.4

International Covenant on Economic, Social and Cultural Rights (ICESCR), 1966

One important human rights instrument that acknowledges the right to health as an essential
element of human well-being is the International Covenant on Economic, Social, and Cultural
Rights (ICESCR). The ICESCR’s Article 12 specifically acknowledges everyone’s right to the
enjoyment of the highest attainable standard a of physical and mental health. After ratifying the
ICESCR in 1979, India is legally required to put policies in place that support medical treatment,
disease prevention, and public health. Four particular duties that nations must do out in order to
protect health rights are outlined in Article 12: that are

(a) The measures to lower the newborn death rate and stillbirth rate while promoting a child's
healthy growth; (a) Enhancing industrial and environmental hygiene in all respects; (c) The
1
United Nations. 1948. “Universal Declaration of Human Rights.” United Nations. December
10, 1948. [Link]
2
(The Human Rights Protection of Vulnerable Groups | Icelandic Human Rights Centre, n.d.)
3
United Nations. 1948. “Universal Declaration of Human Rights.” United Nations. December 10, 1948
4
United Nations General Assembly. The Universal Declaration of Human Rights (UDHR). New
York: United Nations General Assembly, 1948. (Article 25)
prevention, management, and control of occupational, endemic, and epidemic illnesses; (d) The
establishment of circumstances that would guarantee access to all medical care and treatment in
the case of illness.5

Convention on the Rights of Persons with Disabilities (CRPD), 2006

The Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006 by the
United Nations, is a landmark international treaty aimed at protecting and promoting the rights of
people with [Link] emphasizes equality, dignity, and inclusion in all aspects of life,
including education, employment, health care, and accessibility 7. The CRPD requires
governments to take action against discrimination and ensure that people with disabilities have
the same opportunities as [Link] broad global support, the treaty represents a shift from
viewing disability as a medical issue to recognizing it as a human rights matter9.

Article 25

People with disabilities have the right to quality health care without discrimination. Countries
must ensure: Equal access to affordable health services, including reproductive health.
Specialized care for disability-related needs, including early diagnosis and prevention. Health
services available close to home, even in rural areas. Respectful and informed treatment by
healthcare professionals. Fair access to health and life insurance. Protection from being denied
medical care, food, or fluids due to disability10.

Convention On Rights Of Child:

5
International Covenant on Economic, Social and Cultural Rights | Ohchr, (Article 12).
[Link]/en/instruments-mechanisms/instruments/international-covenant-economic-
social-and-cultural-rights.
6
1. United Nations. (2006). Convention on the Rights of Persons with Disabilities (CRPD).
7
United Nations. (2006). Convention on the Rights of Persons with Disabilities, Article 3 –
General Principles..
8
United Nations. (2006). Convention on the Rights of Persons with Disabilities, Article 5 –
Equality and Non-Discrimination.
9
Office of the High Commissioner for Human Rights (OHCHR). (n.d.). Overview of the
Convention on the Rights of Persons with Disabilities (CRPD).
10
United Nations. (2006). Convention on the Rights of Persons with Disabilities, Article 25 –
Health.
Another important international instrument for protection of children rights is the United
Nations convention on the rights of the child (CRC), which was adopted in the 1989 11. It ensures
that each child who is born in each and every ash that has a highlighted right to health care,
education and protection from harm12. In addition the CRC holds that children must be heard
and their views taken into account when decisions are made affecting their lives 13. The treaty
directs governments to establish laws and policies that will promote the welfare of children and
provide a safe and nurturing environment for them14. That makes the CRC one of the most
accredited agreements in history and one of our strongest obligations to create a better future for
every child on this planet15.

Article 24 – Child’s Right to Health

Every child has the right to quality healthcare. Governments must ensure that all children receive
medical services, work to lower child mortality rates, and prevent diseases and malnutrition.
Access to clean water, nutritious food, and proper medical care for mothers before and after birth
is essential. Families should be educated on child health, hygiene, nutrition, and accident
prevention. Harmful traditional practices that affect children's health must be stopped. Countries
should also collaborate to improve healthcare systems, especially in developing nations, to
ensure every child grows up healthy16.

Article 25 – Review of Child’s Care and Treatment

Children placed in care for health or protection reasons must have their treatment and living
conditions reviewed regularly. Authorities are responsible for ensuring their well-being, safety,
and proper medical attention. Continuous monitoring is necessary to make improvements and
guarantee that these children receive the care and support they need17.

11
United Nations, “Convention on the Rights of the Child,” 1989.
12
CRC, Article 6 – Right to Life, Survival, and Development.
13
CRC, Article 12 – Respect for the Views of the Child.
14
UNICEF, “Implementation of the Convention on the Rights of the Child.”
15
Office of the High Commissioner for Human Rights (OHCHR), Overview of CRC.
16
United Nations. “Convention on the Rights of the Child.” OHCHR, United Nations, 20 Nov.
1989.
17
United Nations. “Convention on the Rights of the Child.” OHCHR, United Nations, 20 Nov.
1989.
World Health Organization:

The World Health Organization (WHO) was established on April 7, 1948. This date is also
celebrated annually as World Health Day. WHO works to improve access to health for all
people, especially marginalized and vulnerable populations 18. It seeks to bridge inequities in
access to health care by addressing matters like poverty, discrimination and lack of medical
care19. WHO supports programmes these ensure that essential healthcare services are accessible
to women, children, refugees, persons with disabilities and other marginalized groups 20. It also
advocates for policies that address malnutrition, prevent disease and improve living conditions 21.
Through research, funding, and collaboration with governments, WHO helps create fair and
inclusive healthcare systems, ensuring that no one is excluded from the right to good health and
well-being22

Indian Legal Framework:

India has robust laws in place to protect the health and well-being of its citizens, mainly for the
marginalized and economically weaker sections of society. Constitutional provisions, acts and
various other legislations that enable access to healthcare, freedom from discrimination, benefit
from welfare provisions et al. support this framework.

Constitutional Provisions

Fundamental rights and directive principles laid down in the Indian Constitution reaffirm the
significance of health and social security:

Article 21 – Right to Life and Personal Liberty: The right to health was recognized by the
Supreme Court as a part of Right to Life stating that every individual is entitled to healthcare
services as a right23.

Article 39 (f) – Protection of workers, children and the vulnerable: The State shall direct its
policy towards securing that citizens, men and women equally, have the right to an adequate
18
World Health Organization, “Health Equity and Social Determinants,” WHO Official
Website.
19
WHO, “Universal Health Coverage: Leaving No One Behind.”
20
WHO, “Health and Well-Being of Refugees and Migrants,” 2022 Report.
21
WHO, “Nutrition and Food Security for Vulnerable Populations.”
22
WHO, “Global Action Plan for Healthy Lives and Well-Being.”
23
Supreme Court of India, Parmanand Katara v. Union of India (1989) – Recognized right to
health under Article 21.
means of livelihood, that workers are not abused, and that children and the vulnerable group in
society have the opportunity in proper physical and mental health for all citizens, ensuring that
their ability to walk and work at good health and proper nutrition does not go to waste24.

Article 41 – Right to Public Assistance in Cases of Sickness, Old Age, etc.: Requires the state to
endow the individuals suffering from sickness, old age, or disability25.

Article 47 – Duty of the State to Improve Public Health: It shall be the duty of the State to raise
the level of nutrition and the standard of living of its people and to improve public health, and to
prohibit the consumption of intoxicating drinks and of drugs which are injurious to health26.

Legislations and policies

India as Several important laws and policies have been enacted in India to further strengthen the
legal framework for health and social justice

National Health Policy: Envisaging universal access to good quality healthcare services,
prevention and control of diseases and strengthening of public health institutions27.

However, the Scheduled Castes and Scheduled Tribes (Prevention of Atrocities) Act, 1989 is
supposed to prevent discrimination and violence against SC/ST communities and special
provisions for their health and well-being.28

Act of 2016 – Rights of Persons with Disabilities: Secures equal opportunities for health,
education, and employment for persons with disabilities, Mandates for the policy makers to
include persons with disabilities in all policies for their development and empowerment 29.

Maternity Benefit Act, 1961 (Amendment 2017): provides maternity benefit and certain other
benefits to women employees, including paid leaves, and services for maternity healthcare 30.

24
Constitution of India, Directive Principles of State Policy, Article 39(e) & (f).
25
Constitution of India, Directive Principles of State Policy, Article 41.
26
Constitution of India, Directive Principles of State Policy, Article 47.
27
Ministry of Health & Family Welfare, National Health Policy 2017.
28
Government of India, The Scheduled Castes and Scheduled Tribes (Prevention of
Atrocities) Act, 1989.
29
Government of India, Rights of Persons with Disabilities Act, 2016.
30
Ministry of Labour & Employment, Maternity Benefit (Amendment) Act, 2017.
Mental Healthcare Act, 2017: Provides that mental health is a right and lays down affordable
mental healthcare services for all and protects a person with mental illness from discrimination
and provides for their care, treatment and recovery31.

CHALLENGESFACEDBY MARGINALIZED GROUP IN ACCESSING HEALTHCARE

Economic Barriers:

One of the greatest barriers to adequate healthcare for underserved populations is cost Poverty
and Low Income- A large population, especially when it comes to daily wages workers and
informal sectors, cannot afford medical treatment on their own which causes a lot of the
healthcare to be either delayed or neglected completely32.

Unemployment and Uninsured: A large section of marginalized groups such as SC, ST, and
seasonal laborers are not covered under health insurance, leaving private healthcare out of
reach33.

Medicines/Treatments Affordable: Even if your medicines, treatments must be cheap yet they are
the fittest just to give affordable medicine and treating is the need however the migrant peoples
are again being taken to migrate in terms of unprivileged healthcare services 34.

Social Barriers:

Discrimination and exclusion is the biggest healthcare crisis for marginalized groups:

Caste and Ethnic Discrimination: Dalit’s, Adivasi’s and other marginalized communities may
face discrimination in public hospitals; there have been reports of Dalit and Adivasi patients
being denied treatment or made to wait longer than upper-caste patients35.

Gendered Inequity: Women, especially in rural areas, often fail to secure timely medical attention
due to cultural norms that prioritize men’s health or make it difficult for women to move
freely36.

31
Government of India, Mental Healthcare Act, 2017.
32
National Sample Survey Office (NSSO), "Health and Economic Disparities in India," 2021.
33
Government of India, "Unorganized Workers’ Social Security Act, 2008," Ministry of Labour
& Employment.
34
WHO, "Affordable Access to Essential Medicines in Developing Nations," 2020.
35
Human Rights Watch, "Caste Discrimination in Healthcare Services in India," 2019.
36
UN Women, "Gender and Health: Addressing Women’s Healthcare Challenges," 2021.
Disability Discrimination: Individuals with disabilities are challenged because of healthcare
facilities that are not accessible, trained medical staff that is not available, and social stigma
regarding their medical needs37.

Even health laws have weak enforcement as private hospitals are often unwilling to treat
marginalized groups, while government hospitals suffer from corruption and public inefficiency.

Legal Barriers

Insufficient Rights Awareness: A majority of underprivileged people have zero knowledge about
the extent to which they are entitled under government schemes such as Ayushman Bharat38.

Weak Health Laws Enforcement: There are legal mandates allowing the treatment of
marginalized groups in private hospitals, but hospitals refuse access, while government hospitals
have issues of corruption and inefficiency39.

Geographical Barriers

It can be especially challenging to access healthcare services in rural and remote locations:

Lack of Healthcare Infrastructure: Many tribal and remote areas do not have a hospital making
the people travel long distances for medical aid which unnecessarily delays treatment and
worsens health outcome40.

Lack of Healthcare Professionals and Experts: Most qualified doctors prefer practicing in urban
areas, so rural places suffer from a major shortage of healthcare professionals41.

Mental health issues

Cost of Mental Health Treatment With systemic exclusion, socioeconomic obstacles and the
chronic hardships it imposes, marginalized communities are likely to face mental health
problems.

37
Government of India, "Rights of Persons with Disabilities Act, 2016," Ministry of Social
Justice.
38
Ministry of Health & Family Welfare, "Awareness and Utilization of Ayushman Bharat
Scheme," 2022.
39
The Lancet, "Corruption and Inequality in India’s Healthcare System," 2020.
40
Rural Health Statistics, "State of Healthcare Facilities in Rural and Tribal India," 2021.
41
Indian Medical Association, "Doctor Shortage in Rural India: Challenges and Solutions,"
2022.
Marginalized groups are more likely to experience discrimination, unemployment and lack of
social support, contributing to rates of depression and anxiety that are higher than those in the
general population42. Alcoholism and drug addiction are common in impoverished and ostracized
individual, particularly in tribal communities43.

GOVERNMENT AND JUDICIAL INTERVENTION:

Healthcare is a fundamental right and both the Government of India and the judiciary have been
pivotal in protecting and securing access to healthcare for marginalized sections.
SubscriptionsGovernment schemes to provide affordable healthcare, nutrition and maternity
benefits and judicial activism reinforcing the right to health as a facet of the fundamental right to
life and personal liberty enshrined under Article 21 of the Indian Constitution.

Government Initiatives & Welfare Schemes

The Government has launched many programs to widen the reach of health facilities and health
coverage for weaker section of society, women and children especially in the rural areas.

Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) : Ayushman Bharat PMJAY
scheme offers health insurance coverage of ₹5 lakh per family per year to more than 10 crore
poor and vulnerable families of India 44. It guarantees access to free hospitalization, critical
illness care, and private hospitals for low-income groups without any financial burden.

National Health Missions – NRHM & NUHM : National Rural Health Mission (NRHM):
NRHM, which was launched in 2005, seeks to strengthen rural healthcare by offering sub-
centers, primary healthcare centers (PHCs) and district hospitals in underserved places 45.
National Urban Health Mission (NUHM): It is designed to provide healthcare facilities for urban
slum dwellers and daily wage workers who do not have any formal medical access46.

42
National Mental Health Survey, "Prevalence of Depression Among Socially Disadvantaged
Groups," 2019.
43
WHO, "Substance Abuse Among Marginalized Communities in India," 2021.
44
Government of India, Ayushman Bharat – PMJAY Scheme Guidelines, Ministry of Health &
Family Welfare, 2023.
45
Government of India. (2023). Ayushman Bharat – PMJAY scheme guidelines. Ministry of
Health & Family Welfare. [Link]
46
Government of India. (2023). Ayushman Bharat – PMJAY scheme guidelines. Ministry of
Health & Family Welfare. [Link]
Midday Meal Scheme – Nutritional Support for Children : Launched to address malnutrition and
current school enrolment in government schools, this scheme involves providing children at
government schools with free nutritious meals 47. Research shows that the Midday Meal Scheme
has a positive impact on the health and cognitive development of children belonging to the
marginalised communities48.

Integrated Child Development Services (ICDS) : Nutrition, immunization and preschool

education services are provided to children under 6 years of age and health and nutrition
awareness programs are run for mothers under the ICDS (Integrated Child Development
Services) program49. The scheme runs at Anganwadi Centers in rural and tribal areas with
coverage of millions of children and pregnant women50.

Pradhan Mantri Matru Vandana Yojana (PMMVY) :Maternity Benefit SchemeProvides

financial assistance of ₹5,000 to pregnant women who are giving birth to their first child,
focusing on maternal health and preventing maternal mortality 51. It also encourages hospital
deliveries and postnatal monitoring to safeguard mother and child52.

Judicial Precedents & Role of Courts

The expansion of the interpretation of Article 21 (Right to Life) to Read the Right to Health has
had an enormous influence from the Indian judiciary. There are landmark Judgments that
reiterate the responsibility of the State to ensure accessible and affordable healthcare for all.

Peoples Union Civil Liberty V. UOI 2001, Unlike the right to (minimum) water, the right to
food was found by the Supreme Court of India to be a fundamental right under Article 21 (Right
to Life). It found that the government has a constitutional obligation to guarantee food security
47
Supreme Court of India. (2001). People’s Union for Civil Liberties v. Union of India – Right
to food and midday meals. [Link]
48
4. Ministry of Education, Government of India. (2021). Impact of the Midday Meal Scheme
on child nutrition and school enrollment. [Link]
49
5. Ministry of Women & Child Development, Government of India. (2022). Integrated Child
Development Services (ICDS) annual report. [Link] .
50
. UNICEF India. (2021). Role of Anganwadi centers in child nutrition and early education.
[Link] .
51
Ministry of Women & Child Development, Government of India. (2023). Pradhan Mantri
Matru Vandana Yojana (PMMVY), Scheme Details. [Link]
52
Ministry of Women & Child Development, Government of India. (2023). Pradhan Mantri
Matru Vandana Yojana (PMMVY), Scheme Details. [Link]
to everyone, particularly marginalized communities that are experiencing hunger and
malnutrition.

Key Directives from court: Implementation of Welfare Schemes – The government should
implement food-related schemes effectively, including: Mid-Day Meal Scheme (free meals for
school kids)53. Integrated Child Development Services (ICDS) (provisioning nutrition for
children and pregnant women)54. Antyodaya Anna Yojana (AAY) (subsidized food grains for
the poorest homes)55. Distribution of Surplus Food Stocks – The Court ordered that excess food
grains in government warehouses must be distributed to prevent starvation deaths 56.
Accountability and Monitoring – Most important the government was to constitute food
commissions (No more than it is being questioned now) and grievance redressed mechanism 57.
Impact of the Judgment: Fortifies the reading of Article 21 — the right to food security became
a juridical obligation of the state. Resulted in reforms to policy and stricter implementation of
welfare schemes and Guaranteeing free or subsidized food for millions of marginalized people.

Laxmi Mandal v. Deen Dayal Hospital Others (2010): In a tragic situation, a pregnant woman
named Laxmi Mandal experienced severe negligence at a hospital, resulting in the loss of her
child. The Delhi High Court intervened, asserting that every woman has an inherent right to
maternal healthcare as part of her right to life under Article 21 of the Constitution. This landmark
judgment shed light on the struggles faced by women from disadvantaged backgrounds in
accessing adequate healthcare, reinforcing that maternal health is a fundamental right that must
be safeguarded by the state58.

53
Government of India. (n.d.). Mid-Day Meal Scheme: A government program providing free
cooked meals to school children to improve nutrition and encourage education.
[Link]
54
Government of India. (n.d.). Integrated Child Development Services (ICDS): A welfare
program offering food, healthcare, and preschool education to children under six and
pregnant/lactating mothers. [Link]
55
Government of India. (n.d.). Antyodaya Anna Yojana (AAY): A scheme offering highly
subsidized food grains to the poorest families in India. [Link]
56
Supreme Court of India. (2001). People’s Union for Civil Liberties v. Union of India, WP (C)
No. 196.
57
Supreme Court of India. (2001). People’s Union for Civil Liberties v. Union of India – Right
to food under Article 21

58
Laxmi Mandal v. Deen Dayal Hospital Others, (2010) 168 DLT 223.
Bandhua Mukti Morcha v. Union of India (1984): This case brought to the forefront the dire
conditions faced by bonded laborers who were deprived of basic rights, including healthcare.
The Supreme Court recognized the government's obligation to provide a safe environment for all
workers, particularly those in vulnerable situations. By intertwining labor rights with health
rights, the court emphasized that living with dignity encompasses access to essential medical
care and rehabilitation services. This ruling marked a pivotal moment in advocating for the rights
of marginalized laborers59.

Delhi Domestic Working Women's Forum v. Union of India (1995): This case highlighted the
urgent need for protection and support for domestic workers who are often victims of violence
and exploitation. The Supreme Court ruled that survivors of sexual violence must receive prompt
medical attention and legal assistance. This decision reinforced the state's responsibility to ensure
the safety and dignity of vulnerable women, emphasizing the necessity of comprehensive support
systems for those affected by violence. It was a significant affirmation of women's rights within
the context of health and safety60.

Navtej Singh Johar v. Union of India (2018): By reading down Section 377 of the Indian
Penal Code (IPC) in the historic case of Navtej Singh Johar v. Union of India (2018), the
Supreme Court of India essentially decriminalized consensual same-sex relationships. More than
just a legal change, this ruling was a strong confirmation of constitutional morality, upholding
the values of equality, dignity, and privacy for LGBTQ+ people. The Court eliminated a
colonial-era clause that had long denied a vulnerable population basic human rights by
acknowledging that the statute had sustained systemic discrimination. The ruling's recognition of
the negative impact of criminalization on LGBTQ+ healthcare was one of its key features. The
Court observed that Section 377 had created institutional barriers to receiving medical care in
addition to encouraging social exclusion. LGBTQ+ people, especially those at risk for
HIV/AIDS, may put off getting treatment for fear of being harassed, facing legal repercussions,
or being denied care outright. The Court determined that their fundamental rights under Article
21, which protects the Right to Life and Personal Liberty, were immediately jeopardized by this
legal vulnerability61. The ruling called for affirmative state action to end healthcare
59
Bandhua Mukti Morcha v. Union of India, (1984) AIR 802.
60
Delhi Domestic Working Women's Forum v. Union of India, (1995) 1 SCC 14.
61
Navtej Singh Johar v. Union of India, (2018) 10 SCC1.
discrimination in addition to decriminalization. In order to guarantee that LGBTQ+ people get
treatment free from discrimination, the Court advised healthcare organizations and legislators to
sensitize healthcare professionals62. Furthermore, it emphasized that psychological well-being is
just as important as physical health, highlighting the mental health consequences of societal
stigma.

Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996), In this particular
instance, a laborer was refused emergency treatment for a lack of hospital facilities. The
Supreme Court held that it was a constitutional obligation of the State to provide timely and
adequate medical care recognizing right to emergency healthcare as a fundamental right under
Article 2163.

Vincent Panikurlangara v. Union of India (1987), The Supreme Court asserted that the
cornerstone to ensuring a good quality of life is public health and upheld the Right to Health as
encapsulated in the Right to [Link] directed the government to ban harmful drugs and ensure safe
and effective medical treatments64.

Mohini Jain v. State of Karnataka (1992), This case emphasized the need for Health
Education to be part of Right to Education. Education in medicine should be within reach and
affordably available, the Supreme Court said, so that students from marginalized communities
are able to pursue careers in the health professions65.

Francis Coralie Mullin v. The Administrator, Union Territory of Delhi (1981) , A dignified
life encompasses the right to health care, the Supreme Court stated and ordered that the State
cannot deny prisoners, detainees and marginalized populations proper medical treatment 66.

LITRATURE REVIEW

62
Ibid.
63
Supreme Court of India, Paschim Banga Khet Mazdoor Samity v. State of West Bengal, AIR
1996 SC 2426.
64
Supreme Court of India, Vincent Panikurlangara v. Union of India, AIR 1987 SC 990
65
Supreme Court of India, Mohini Jain v. State of Karnataka, AIR 1992 SC 1858.
66
Supreme Court of India, Francis Coralie Mullin v. The Administrator, Union Territory of
Delhi, AIR 1981 SC 746
The right to health is widely recognized as a fundamental human right under various
international and national legal frameworks. Scholars have extensively examined the role of
legal provisions, government schemes, and judicial interventions in ensuring healthcare
accessibility for marginalized communities.

The Universal Declaration of Human Rights (UDHR, 1948) and the International Covenant on
Economic, Social, and Cultural Rights (ICESCR, 1966) have emphasized that healthcare is an
essential aspect of human dignity. Studies highlight that Article 12 of ICESCR mandates states
to take necessary measures to ensure equitable access to healthcare services. Further,
international treaties such as the Convention on the Rights of the Child (CRC, 1989) and the
Convention on the Rights of Persons with Disabilities (CRPD, 2006) stress the need for special
protection of vulnerable groups in healthcare. However, research indicates that these
international obligations often face challenges in domestic implementation.

In the Indian context, Article 21 of the Constitution has been interpreted by the Supreme Court to
include the Right to Health as a part of the Right to Life. The Directive Principles of State Policy
(DPSP), specifically Articles 39(f), 41, and 47, reinforce the State’s duty to improve public
health. Judicial interventions in cases such as Paschim Banga Khet Mazdoor Samity v. State of
West Bengal (1996) and Francis Coralie Mullin v. Union Territory of Delhi (1981) have played a
critical role in holding the government accountable for healthcare delivery. However, scholars
argue that despite these progressive judgments, implementation remains inadequate due to
systemic inefficiencies.

Several government policies, such as the National Health Policy (2017), Ayushman Bharat
(PMJAY), and Integrated Child Development Services (ICDS), have been introduced to address
healthcare disparities. Research suggests that while these schemes have improved healthcare
access for some marginalized populations, challenges such as bureaucratic hurdles, lack of
awareness, and insufficient funding hinder their effectiveness. Empirical studies reveal that a
significant proportion of rural and socio-economically disadvantaged groups remain unaware of
or unable to access these benefits.
Additionally, studies on healthcare barriers emphasize economic constraints, gender
discrimination, and geographical disparities. Research indicates that out-of-pocket expenditures
(OOPE) in India account for over 60% of total healthcare costs, disproportionately affecting
marginalized communities. Women, particularly those from lower socio-economic backgrounds
and disabled individuals, face compounded discrimination in accessing healthcare services.
Social stigma and caste-based exclusions further worsen healthcare inequalities, as seen in
reports documenting Dalit and Adivasi experiences in public hospitals.

IDENTIFYING THE RESEARCH GAPH:

Despite extensive literature on healthcare rights and policies, several gaps remain unaddressed:

1. Limited Empirical Analysis of Policy Effectiveness – While many studies focus on

legal provisions and policy frameworks, there is a lack of empirical research assessing the
real-world impact of government schemes on marginalized communities. Future research
should focus on implementation gaps and community-level healthcare outcomes.
2. Judicial Activism and Healthcare Reform – Although court rulings have reinforced
healthcare as a fundamental right, there is limited research on the effectiveness of judicial
directives in driving long-term policy changes. A detailed analysis of how litigation has
influenced healthcare governance is needed.
3. Regional Disparities in Healthcare Access – While studies acknowledge urban-rural
divides, there is insufficient research on healthcare accessibility within specific
marginalized groups, such as tribal communities, migrant workers, and LGBTQ+
populations. Research should examine whether healthcare schemes are equitably
benefiting all regions and communities.
4. Role of Private Sector in Bridging Healthcare Gaps – Most research focuses on public
healthcare initiatives, but there is little analysis of how private-public partnerships can
enhance healthcare access for marginalized groups. Studies should explore how corporate
social responsibility (CSR) initiatives, telemedicine, and mobile healthcare solutions can
address existing disparities.
5. Mental Health and Marginalization – While physical healthcare challenges are well-
documented, there is a lack of comprehensive research on the mental health impact of
 marginalization. Studies should assess how discrimination, economic hardship, and social
exclusion contribute to mental health disorders within marginalized populations and
propose targeted interventions.

METHODOLOGY

This study employs a qualitative research design with a doctrinal approach to analyze the legal
and policy frameworks concerning the healthcare rights of marginalized groups. A doctrinal
research method is appropriate as it involves the systematic examination of statutes, case laws,
constitutional provisions, and international treaties relevant to the right to health. The study also
integrates elements of comparative legal analysis to assess international best practices in
ensuring healthcare access. Additionally, policy evaluation is used to examine the effectiveness
of government healthcare initiatives, focusing on implementation challenges and impact.

Since this study is doctrinal and primarily based on legal and policy analysis, no direct human
participants are involved. Instead, the research relies on purposive sampling to select relevant
legal documents, case laws, policy reports, and government schemes that address healthcare
access for marginalized groups. The sampling criteria include:

The study is based primarily on secondary data sources collected from legal, governmental, and
academic repositories. The key sources of data include Primary Legal Sources Constitutional
Provisions, Judicial Precedents Analysis of landmark cases, Legislations and Acts. International
Legal Instruments,Government Reports & Policy Documents, Academic Research & Scholarly
Articles

DATA ANALYSIS METHOD

This study employs content analysis and legal interpretation techniques to evaluate the
effectiveness of legal and policy frameworks. The analysis methods include:

 Legal Analysis
 Case Law Analysis
  Policy Evaluation
 Comparative Analysis

Since the study is based on secondary data sources, ethical concerns related to direct human
interactions are minimal. However, the research follows standard ethical principles, ensuring:

 Credibility and authenticity by relying on verified governmental, legal,

and academic sources.
 Objectivity and neutrality in analyzing legal judgments and policy
frameworks.
 Proper attribution and citations to acknowledge sources used in the
study.
REFERENCES
Primary Sources

Legislations and Government Acts

Government of India. (2017). Mental Healthcare Act, 2017.
Government of India. (2008). Unorganized Workers’ Social Security Act, 2008. Ministry of
Labour & Employment.
Government of India. (2016). Rights of Persons with Disabilities Act, 2016. Ministry of Social
Justice.

Judicial Decisions
Supreme Court of India. (2001). People’s Union for Civil Liberties v. Union of India, WP (C)
No. 196.
Supreme Court of India. (2001). People’s Union for Civil Liberties v. Union of India – Right to
food under Article 21.
Vincent Panikurlangara v. Union of India and Ors. (1987). AIR 1987 SC 990. Retrieved from
Global Health Rights.

Government Reports and Schemes

National Sample Survey Office (NSSO). (2021). Health and economic disparities in India.
Government of India.
Ministry of Health & Family Welfare. (2022). Awareness and utilization of Ayushman Bharat
scheme. Government of India.
Ministry of Women & Child Development. (2023). Pradhan Mantri Matru Vandana Yojana
(PMMVY): Scheme details. Government of India.
Government of India. (n.d.). Mid-Day Meal Scheme: A government program providing free
cooked meals to school children to improve nutrition and encourage education. Retrieved from
[Link]
Government of India. (n.d.). Integrated Child Development Services (ICDS): A welfare program
offering food, healthcare, and preschool education to children under six and pregnant/lactating
mothers. Retrieved from [Link]
Government of India. (n.d.). Antyodaya Anna Yojana (AAY): A scheme offering highly
subsidized food grains to the poorest families in India. Retrieved from [Link]

Secondary Sources

International Conventions and Instruments

United Nations. (1948). Universal Declaration of Human Rights (UDHR). Retrieved from
[Link]
Office of the High Commissioner for Human Rights (OHCHR). (1966). International Covenant
on Economic, Social and Cultural Rights (ICESCR). Retrieved from [Link]
Office of the High Commissioner for Human Rights (OHCHR). (2006). Convention on the
Rights of Persons with Disabilities (CRPD). Retrieved from [Link]
Office of the High Commissioner for Human Rights (OHCHR). (1989). Convention on the
Rights of the Child (CRC). Retrieved from [Link]

Reports and Studies by International Organizations

World Health Organization. (2020). Affordable access to essential medicines in developing
nations. WHO.
United Nations Women. (2021). Gender and health: Addressing women’s healthcare challenges.
UN Women.
Human Rights Watch. (2019). Caste discrimination in healthcare services in India. Retrieved
from [Link]
The Lancet. (2020). Corruption and inequality in India’s healthcare system. Retrieved from
[Link]

Web Sources

United Nations. (n.d.). Universal Declaration of Human Rights. Retrieved

from [Link]
World Health Organization. (n.d.). WHO official website. Retrieved from
[Link]
World Health Organization. (n.d.). Refugee and migrant health. Retrieved
from [Link]
World Health Organization. (2020). State of food security and nutrition in the
world 2020. Retrieved from [Link]
World Health Organization. (n.d.). SDG3 Global Action Plan. Retrieved from
[Link]
Ministry of Health & Family Welfare. (n.d.). Official website. Retrieved from
[Link]
National Health Authority. (n.d.). PM-JAY: Pradhan Mantri Jan Arogya Yojana.
Retrieved from [Link]
Ayushman Bharat Digital Mission. (n.d.). Official portal. Retrieved from
[Link]
Ministry of Tribal Affairs. (n.d.). Official website. Retrieved from
[Link]
Ministry of Labour & Employment. (n.d.). Government schemes and policies.
Retrieved from [Link]
Indian Kanoon. (n.d.). Directive Principles of State Policy. Retrieved from
[Link]