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From The Mother To The Girl Child: Unequal Treatment In Healthcare

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Free institutional delivery is not the only thing that is sufficient to bring a child into this world. A child is not just a baby born from the womb but an act of creating a life that can truly catalyze a change in the world. The entire process however complicated it may be, is one that makes us most human. While we may have technologized this process in leaps and bounds, it is essentially one that reminds us of who we really are.

It is important to acknowledge the above because maternal healthcare should go beyond providing basic public health. It is the most natural, most ubiquitous, and at the risk of sounding biased, most beautiful. While public healthcare in all forms is necessary to be tackled, maternal healthcare lacks the same for a variety of unassociated reasons. Right from when girls are conceived, they are treated inadequately. Our problem truly starts in the very womb.

Source: Global Health Photo

Lack Of Nutrition

From day one of their lives, the quality of a girl child’s life is at risk because society somehow snips her very right to nutrition.  A study discovered that when considered, on average, about 2,39,000 girls under the age of five die each year in India – solely based on gendered repercussions. This happens due to the main issue of the girl child being unwanted which leads to further neglect and complete apathy. This whole host of issues begins from prenatal mortality to premature deaths and all the way up to vulnerability to nutrition in one’s growing years.

Multiple studies have actually suggested that in rural households in India, where girls are born, they are breastfed for a shorter duration than the boys and thus they consume less milk. This troublesome and subtle practice puts women at a great disadvantage at the earliest of ages. Despite this, people question women’s physical strength in contemporary discourse. It is a shame really how the girl child is weaned earlier so that the parents can focus on trying to get a boy child.

Until 2016, a heavy 54 percent of adolescent girls were anemic in India. And this cycle doesn’t end here. Undernourished girls become weaker and further give birth to undernourished babies when they are of age. A pregnant woman with anemia is at much higher risk of preterm delivery, excessive bleeding, stillbirth, low birth-weight babies, and even the death of the mother. Along with their lives, the motherhood of the girl child is also at ultimate stake, which is interestingly one of the only things we consider them capable of.

Source: CARE India

Maternal Mortality And Failure Of The Healthcare System

Maternal mortality refers to the death of a woman associated with maternal reasons or causes associated with pregnancy. This can refer to mishaps during pregnancy, after it, post-abortion consequences, or post-birth periods. As the reproductive health of women suffers, the girl child suffers at multiple stages in her life.

The maternal mortality rate is much higher in Asia as compared to Northern Europe. While socio-economic causes, lack of want for a girl child, and neglected infants are the socio-economic hurdles, that is only the tip of the iceberg. Direct obstetric causes is another war to be fought. Sepsis, infection, hemorrhage, and a ruptured uterus are not incidental or accidental in the maternal healthcare ecosystem of India. Illegal adoptions are still practiced rampantly which cause 50% of maternal deaths due to sepsis.

In 1985, the WHO reported that 63-80% of maternal deaths were due to obstetric infallibilities and 88-98% of those could have actually been prevented if it would have been handled with better care.

The public health infrastructure in India has only expanded since independence. However, there are some basic problems that we are still far away from resolving. From basic telephone access to hospital linkages to blood banks, the Indian healthcare system has been suffering for a long time. It is even unclear how many maternity wards in the country are actually equipped and functional.

About 50% of the community health centers (CHCs) and 30% of the FRUs (First Referral Units) in India do not have anesthetists or obstetricians. The WHO recommends at least four antenatal care checkups (ANC) for pregnant women in the age group ranging from 14-49. Unfortunately, in the Indian scenario, only a staggering 51% of that demographic had four or more ANC visits.

Source: Mathermatics

Conclusion

From bringing a girl child into the world to being one – the struggle for girls in India is endless. How shocking it is that we may risk so easily the very survival of the ones that are half of what contributes to our population. Pregnancy or childbirth-related complications are as real and natural as the process itself. But as a society, whether from a socio-economic point of view or a healthcare standpoint, we have failed women and their right to a healthy life.

Many schemes and programs have been underway for the same. But a review of these is essential because we still stand far from our goal. Not only a sound healthcare system but even a public distribution system for supplying foods and grains should be encouraged. Proper sanitation and menstrual health sound like personal and situational aspects but are largely determined by societal taboos, distribution, access, and availability. The health of the girl child is in our hands much more than we assume.

Written by: Gaurvi Narang

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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.

Read more about his campaign.

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.

Read more about her campaign. 

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.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

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.

Read more about the campaign here.

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.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

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

Bidisha was selected in Change.org’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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