For pregnant women gender injustice is THE obstacle to wellness.

#genderinequality #maternalhealth #storytelling #digitaldivide

United Nations Population Fund (UNFPA) has released its "State of World Population Report 2020" highlighting the scale and pervasiveness of gender injustice and stereotyping in the world today. The statistics are appalling and makes me at times wonder in despair why we continue to be stuck in medieval attitudes, beliefs and practices in the 21st century.

UNFPA advocates for a world where every woman and girl should be free to chart her own future. That’s a no brainer and why not! Yet, as the report highlights the reality is quite different. Causative factors are detailed in the report, and some of these are that we experience in Kushal day to day and work towards. For example, when we speak to family members of pregnant women, we are often told,

“Why does she have to learn what happens to her body in pregnancy? My mother and aunt live with us. They tell her what to do. They are who should make decisions for her and for us as a couple.”

It’s easy to get upset and react angrily. But to change mindsets of those who hold power and deny bodily autonomy demands patience. It can’t be done by sermonising, which is why we rely on story-telling, an effective tool for social change and by engaging male members of the family.

The report also presents data from 57 countries, stating that only 55 per cent of women aged 15 to 49 years who are married or in a union make their own decisions about sexual relations and the use of contraceptives and reproductive health services (UNFPA, 2020). We have some preliminary data to this affect as well, and continue to monitor so that we can come up with innovative ways and approaches to address gender related barriers.

For those who would like to know more about gender-biased sex selection, Female Genital Cutting and child marriage the report is a good read. However, I would have liked for the report to articulate strongly enough how and why it is essential to also address the digital divide in today’s world. To make a better case for leveraging technology effectively in order to facilitate autonomy, decision making and wellness in women.

You can also read Prof. Maya Unnithan's commentary who heads Centre for Cultures of Reproduction, Technologies and Health (CORTH) at Sussex University. She concludes by pointing out,

"Although rights have arrived, justice has not followed!"

"Men as husbands, fathers, policymakers, healthcare providers need to use their privilege to redress gender discrimination for greater social justice."

Training frontline workers on COVID

We have been getting requests for COVID -19 Training for frontline workers nearly everyday. That is not surprising.

Pregnant women in urban slum and rural communities are facing unexpected hardship because of COVID -19. The antenatal support provided through Government of India's Janani Sishu Suraksha Karyakram programme in Andhra Pradesh has come to a standstill as Anganwadi Centres (AWCs) have had to be closed because of the COVID - 19 related lockdown.

The closure has not only meant that services such as routine checkups, educational sessions, peer support and distribution of food has been affected. It has also compounded pregnancy related anxiety. In such circumstances, front line community health workers, that is, ASHA and AWC workers who are from the communities too feel helpless and despondent that they are not able to do more.

Most of these frontline champions have been reassigned to COVID related general awareness raising duties. However, there remains a huge gap in knowledge and information in relation to pregnancy at the time of the COVID-19 pandemic.

We keep getting requests from our frontline colleagues for information and training on pregnancy and COVID - 19. In response, we have developed a one hour training session curriculum which helps community health workers answer questions and give advice on antenatal issues in relation to COVID. The training will equip them to reach out and advice and support pregnant women with wellness and allay anxiety.

To know more about the training curriculum you can view the deck here.

COVID – 19 and pregnancy related anxiety

20 July 2020

Pregnancy related anxiety has shot up because of COVID and needs to be recognised and addressed.

The number of people with COVID – 19 continues to spike in India. The Hindu (www.thehindu.com) reports that the number of people who have tested positive for the coronavirus has been nearly 2000 a day for three days straight. The Health Department has confirmed 408 COVID – 19 related deaths so far in the state. Krishna district where Kushal is present has been hit hardest with a 3.17% death rate. Not surprisingly, COVID - 19 anxiety in pregnancy has sky rocketed in Andhra Pradesh.

Communities in Andhra Pradesh are concerned. In ordinary circumstances, perinatal mood and anxiety disorders are among the most common complications that occur in pregnancy or in the first 12 months after delivery (The American College of Gynaecologists and Obstetricians). And these are unprecedented times.

Our beneficiaries are worried, and there is little recourse to advise and comfort because of strict lockdown being enforced.  Antenatal services have been stripped resulting in limited access to information and education. Kushal India is proactively filling the gap by responding to requests with urgency and using digital technologies to surpass these barriers.

Poorer communities are affected the most. All Anganwadi Centres in the state where women from disadvantaged communities generally access government antenatal services have been shut down. We are supporting the local health department to reach out to 700 pregnant women who are linked to urban health centres on their mobile phones with counselling and befriending sessions.

A difficult question colleagues working in the front line are increasingly facing these days is -

“Amma, if I get infected, can I pass the coronavirus to my unborn baby? Will that lead to my child having problems or deformities in the future? My mother-in-law has suggested that I should terminate my pregnancy.”

Difficulty in accessing reliable information and having to take recourse on attention grabbing headlines in the media has spread misinformation and consequently led to fear and panic in communities. Most of our beneficiaries are first time pregnant and young. To have to be under pressure to resort to termination because of myths and misinformation is unfortunate.

We make sure to advise women –

  • The COVID-19 pandemic is a rapidly evolving situation and each day scientists and researchers are learning more on how to prevent and mitigate the impact of the virus. New information comes out nearly each day and at times can contradict previous knowledge. So, it is important to remain updated on information.
  • However, it is crucial that you seek information from reliable and reputable sources, for e.g. WHO, UNICEF and the National Health Mission.
  • If you come across a piece of information in the media and especially social media such as YouTube that makes you curious or worries you, please verify that information from reliable and authentic sources. Do not act on a single source of information.
  • Do not be hasty in taking actions or decisions. Verify your doubts. Consult your doctor first.

To read more about our activities, please click here.