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Why Is India Ignoring The Imperative Need For A Sound Health Care Policy?

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By Sneha Roychoudhury:

In the 21st century, there has risen the ultimate quest- a race of sorts- for States to taste the manna of “superpower”. Drunk with the idea of the ultimate superiority- a child nursed by post Second World War politics- government apparatuses all over the world have allowed the true motive and goal of a “welfare state” to slide and take an absolute backseat. And the greatest reflection of this unfortunate fact is very evident in the lack of an efficient health policy in some of the most developed nations of the world. India too, rather regretfully, is party to this list. The real question remains to be- what parameters are being set by the international community in general, and India in particular, for a country to be in the running for utmost glory and superiority, because human upliftment certainly doesn’t seem to have made it to that list.

health care policy

While most of us do not realise the huge and significant role health care must play in the development scheme of a nation, it becomes the prerogative of the State system and the various Government machineries, in power, to pointedly make it one of the biggest priorities of nation-building. This however has been found absolutely and entirely lacking in the Indian planning and policies in the sixty-eight odd years of independence. This however does not take away from the various successive governments what they do best- the tall promises that have been made in terms of health care ever since the very high aiming United Nations’ “Health for All” Declaration in Alma Ata in 1978. Following this the High-Level Expert Group (HLEG) was created in 2010 by the Planning Commission of India which, after a very long hiatus, sought to advice and change the face of Indian medicine and health care.

The committee describes Universal Health Care in the lines of- “Ensuring equitable access for all Indian citizens, resident in any part of the country, regardless of income level, social status, gender, caste, or religion, to affordable, accountable, appropriate health services of assured quality (promotive, preventive, curative, and rehabilitative) as well as public health services addressing the wider determinants of health delivered to individuals and populations, with the government being the guarantor and enabler, although not necessarily the only provider, of health and related services”. To be able to implement a goal and an ambition as farfetched as this one is rather impossible, for India, in the times of disparity for health care in the nation (the irony lying in the fact that, as a developing and prospective world power, one of our greatest concerns should be enforcement and not mere legislation in the field of health care. All having been said, this committee (like committees are generally inclined and meant to do) did recommend some effective reformations in the Indian Health Care scenario. The most striking of this was the identification of a larger scale of public expenditure in the sector, including a more intensive execution of implementation that trickles and seeps right down to the grass roots. An inspiration to the Planning Commission’s 12th Five year plan of 2013, the recommendations have not been rendered redundant after all.

Having said that, it is however imperative to point out that the Plan did not consider a higher investment of public spending in the area, entirely ignoring the higher expenditure involved in privatising this sector, making some of the most essential aspects of health-care unreachable and unaffordable for more than half the population in India. This does not begin to cover the inefficiencies in the Rashtriya Swasthiya Bhima Yojna or the National Health Insurance Policy, whose clauses hardly cover some of the most basic amenities. There is no ignoring the fact that the Indian Health Care Policy has hardly gone through any positive and constructive change since 2002, and while I say this I have to emphasise on the failing of the latest health plan in meeting any proper goal as a much required initiative, that was meant to step up to a certain standard when it comes so many years later.

Even though we gloat about the “eradication” of polio or malaria, is the Indian conscience truly convinced of the legitimacy of these statistics? Is that, again, the beginning and end of the State machinery’s responsibility in the area of health-care? And how much truly has the Government had to do with these initiatives in the first place, when they are generally engineered and pioneered by International or Non-Profit Organisations? Pressing as they may be, these questions are hardly, if ever, addressed. It is a matter of much regret that in an age when the face of medicine changes and improves each day, we in India do fall rather far behind. Plans are made, legislations passed and yet there seems to be no perforation of its implementation. The scheme selectively and conspicuously neglects major health concerns in India, mentioning the high out-of-pocket (OOP) expenditure in the passing, but not allowing or allotting it the much needed attention.

While we’re on it, there are some serious matters that are entirely overlooked by policy makers of our nation while dealing with health care. The fact that child malnourishment has gone down by one percent, even though the economy has grown by 50% according to a statistic taken for the time between 2001 and 2006, leaves India strikingly lagging behind the nations with a similar growth rate and speaks volumes about the neglect in places that need it the most and for the people who can least afford it. We live in a nation that, as it struggles up the climb of development, ignores some of the most imperative givens which aid the making of greatness and prosperity. When the citizens aren’t ensured protection against lack of sanitation, unaware and a fundamental negligence towards the availability of clean and safe necessities, what could one possibly make of its highly developed status in official records stacked away in obscure departments of public offices?

Till the time an effective and strongly enforced set of measures are not wilfully implanted in areas such as female health (including the rampant incidence of Breast Cancer and PCOD) and the very alarming state of rural health; not much can be expected in terms of striking change in the field of health care. There is a screeching need, but the real and glaring question is — who is willing to step up?

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

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Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

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She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

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A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

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A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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