How Technology is Improving Maternal & Child Health

mMitra, started in Mumbai slums with the support of the civic body, is a free mobile voice call service that gives information on preventive care and simple interventions to reduce maternal and infant deaths. It is given in the language of the user’s choice and sent weekly or twice a week. Launched in 2014, it reaches over 5 lakh women in slums in Mumbai city, up to its far suburbs.

Domestic violence accounts for five in 10 of reported crimes against women in India. Many cases go undocumented, nearly 7 out of 10 women have suffered some form of domestic violence. Domestic violence is linked to posttraumatic stress disorder, gastrointestinal infections, suicide, chronic pain, and increased risk of unintended pregnancy, which, in turn, compromises maternal, infant and child health. The Little Sister’s Project, an initiative that works among victims of domestic violence in Mumbai, has 160 local women to identify and report incidents of gender violence using Android smartphones and an app called EyeWatch.

This documentary was done for the NDTV-Gates Foundation campaign, Every Life Counts. To watch click here 

With Support From An App, Women Stand Up To Domestic Violence In Dharavi

A two-year-old app is helping women in Asia’s largest slum, Dharavi, to stand up against domestic violence. The Little Sister app, working in 3 languages, is helping women report instances, however small, and get help.

Home to a population of over one million, Mumbai’s Dharavi sees many such cases, say the women who are part of the initiative started in 2014 by a non-profit, SNEHA – the Society for Nutrition, Education and Health Action.

“Physical abuse and sexual violence is most common,” said Rashida, a sangini or worker in Little Sister.

Violence against women is listed as one of the top 10 reasons of death for women and domestic violence, also known as intimate partner violence, accounts for five in 10 reported crimes against women in India. Even so, many cases go undocumented, and various studies show nearly seven out of 10 women in India have suffered some form of domestic violence.

A report released last year by Population Reference Bureau, a Washington DC-based think-tank, said India — along with Nepal, Pakistan and Sri Lanka – shows a very high rate of violence,  with one in three women reporting sexual and/or physical violence, mainly from a partner.

One of the many reasons why domestic violence goes unreported is because it has cultural sanction. “Everyone, including the mother-in-law, thinks the man has rights over the woman’s bodies, regardless of her feelings,” said Rashida.

“We recently counselled a woman who had been beaten by her husband for 22 years, right through their marriage,” added Saira Shaikh, another Little Sister sangini. “She kept thinking it was OK because her husband was providing for the family.”

Married twice, Rashida was abused both times. She finally found the courage to walk out when she nearly died after consuming poison in a fit of despair. “While in hospital I realised that by suffering violence, I was damaging my children.”

These are not easy decisions for any woman, especially those who are poor, uneducated and lack family support.

This is where the app greatly helps, believes Rashida – its biggest advantage being that women can express their pain in safety and secrecy, until they are ready to speak out.

Registering instances on the app gets immediate response.

Depending on what she wishes, the sanginis contact her and provide counselling. In case of physical violence, they can even contact the police and hold family counselling sessions.

“The project was designed to mitigate under-reporting of violence by providing a tool for women to record instances,” said programme coordinator Damini Mohan. “Most cases are reported to authorities as a last resort, when the violence has severely escalated. It helps us capture instances of violence at an early stage and helps us prevent its escalation.”

Since it was launched in June 2014, Little Sister has recorded 1,062 cases of domestic violence, compared to 200 cases recorded in 2013-2014.

While there are laws against domestic violence, what is not widely understood at the policy level are the health consequences, doctors say.

Women who suffer domestic violence are twice as likely to suffer from depression and about 50% more likely to become HIV positive. Other outcomes are post-traumatic stress disorder, gastrointestinal infections, suicide, and chronic pain. It is also linked with higher risk of unintended pregnancy that compromises maternal, infant and child health.

“Whenever there is violence, physical or otherwise, the physical impact shows up in the form of scars but the impact, internally, is 25% more,” said Praful Kamble of SNEHA. “There is depression, a sense of shock and a major impact on children who witness it. Even verbal abuse can affect pregnancy outcomes.”

This article was published on the NDTV website. To view the video report click here

The Young Rise Against Child Marriage in Bihar

The latest Census report says that nearly one in every three married women in India were married off below the legal age of 18 years, a grim reminder of how widespread child marriage is in the country.

Clearly, the practice continues despite the Prohibition of Child Marriage Act because it has strong social sanction.

What is needed is a change in mindset, and that is what the Jagriti Trust, a youth-driven intervention in Bihar, Uttar Pradesh and Rajasthan is trying to achieve. Bihar reports the highest number of underage marriages in India – nearly 60% girls are married off before they are 18, and 74% before they are 20.

The Jagriti Trust tries to motivate young boys and girls from the community to get involved in local issues like sanitation, hygiene and education of girls and become agents of change.

The strongest challenge sometimes comes from within the families.

Pooja, 20, who refused to go along with her parents’ wishes and marry at the age of 14 like her sisters did, said, “My father stopped talking to me and I was ignored in my house. It was very hard to cope but I saw what my sisters were going through and was determined to avoid that fate.”

Today. Pooja is a youth leader with the Jagriti Trust and encourages other girls’ to find their voices. She leads workshops where young boys and girls are taught to question the mindset behind practices like early marriage and dowry.

The Jagriti Trust has set up youth councils in three districts of Bihar. The causes they take up are sensitive, but their patient approach seems to have paid off.

“Village elders initially opposed us”, said Premnath, 19, from Ismailpur, who continues to face intense family pressure to marry.  “But we took our time in explaining our side and participated in other village activities and gained their trust.”

Dr Rema Nanda, founder of the Jagriti Trust says that by reaching out to boys and girls, it hopes to achieve a larger behavioral  change.

“Reaching out to girls alone is not enough because boys too are victims of patriarchal norms and we need to teach them the value of questioning stereotypes. It is time we stopped regarding them as the Other and keeping them out”, she said.

This article was published  in the NDTV website

Not enough in this Budget for Family Planning

Among the most widely reported statements at the International Conference on Family Planning held in Indonesia in January this year was that of the Indian Health Minister JP Nadda who said that the country was committed to meeting the FP2020 goal of providing 48 million additional women and girls with access to modern contraceptives by 2020.

A global partnership, Family Planning 2020, works with governments, civil society and the private sector to enable women and girls to make decisions regarding if, when, and how many children they want.

The Indian Health Ministry team also announced that women would have access to better quality family planning services. A promise that is being met with. Since April, injectable contraceptives and pills are being supplied to all district hospitals across the country.

However, the recent report by the Population Foundation of India points out just how distant that goal of reaching 48 million women and girls is.

While the provision for health in 2016 has grown by 22% over 2015, with FP seeing a substantial increase of 67% compared to previous years, health remains hugely underfunded in India. The rise this year, it points out, is insufficient to compensate for the whopping 54% decline in allocations to family welfare between 2013-14 and 2015-16.

Meeting the 48 million number needs more than simply expanding the basket of choices. It needs awareness campaigns and better rural health facilities to ensure that babies and mothers survive. Campaigns have to be tailored to meet the specific challenges that a country as varied as India throws up.

While the shift away from female sterilization is welcome, there seems to be widespread official myopia in acknowledging just how deep the links between family planning and broader development goals go, and this is disturbing.