REPRODUCTIVE HEALTH AND RIGHTS
The initial thrust of SUTRA’s work on health was on service delivery. Dispensaries were opened in areas that were remote and excluded from public health services. Training was imparted to ‘dais’/ midwifes in order to increase hygiene and efficiency in their traditional methods of child birth.
Efforts were made to create awareness about simple homely remedies using herbs and plants easily available in the region.
In the 1980s, the perspective on women’s health deepened and became more rights-based. The ensuing work led to the ‘Stree shareer ki Pechahan’ (Introduction to woman’s body)- 8 booklets which cover about women’s entire life cycle. Women from Mahila Madalis deliberated on the content of these booklets and were involved in the process of finalizing them. These are a valuable resource for health workers.
During a Sammelan (gathering) of PRI representatives in 1996, those from Kangra, Una, Bilaspur and Madi districts pointed out the declining number of girl children in their areas. This was the beginning of a large campaign led by SUTRA on the grave issue of declining sex ratio in the state of Himachal Pradesh. SUTRA’s initial efforts to convince the State government about the gravity of the issue were ignored. However, SUTRA fieldworkers strove to create awareness about this at the Panchayat level. Birth registration data was collected from the Panchayats and eventually boards displaying the sex ratios of each year’s were installed outside the Panchayat offices. Data was also collected from sub-centres and district hospitals. The numbers were dismal and even the State government had to eventually take cognizance of the situation.
Over the years SUTRA- through meetings, training, formation of Kanya Bachao Samitis, street plays etc- have been working on this issue along with public health officials at various levels.
The gram panchayats were also made aware of their role in the National Rural Health Mission through meetings. SUTRA staff undertook monitoring of public institutions like govt. health facilities, anganwadi etc. to ensure necessary support and services to as measure to reduce gaps in reproductive health services.
Reproductive rights of a woman include the right to safe and accessible abortion services. Therefore, while working against sex selective abortions has, a woman’s right to abortion should not be violated. SUTRA fieldworkers are cognizant of this important fact and strive to develop this understanding in the community.
The agrarian hilly State of Himachal Pradesh having 93% rural population entered into an ‘emerging economy’ province during late 1980’s with rapid infrastructure development, shifting of subsistence agriculture to cash-crops, horticulture development and privatization in health as well as education. This development on one hand resulted in positive gender developments such as increase in mean age at marriage for girls to 22.2 years (Family Welfare Statistics in India 2011); on the other hand there was an increase in the expenses on dowry and marriage, continuous fall in child sex ratio, increase in negative gender IMR etc. Moreover, the improvement in financial status was accompanied by a decline in the reproductive health of the population. For eg- high incidence of anaemia amongst women in reproductive age group (43% according to NFHSIII), large scale use of abortion pills easily available across the counter without adequate knowledge of its usages, thrust on terminal method for limiting family even at young age resulting in menstrual and other health problems, large scale RTI/STI symptoms etc.
Efforts were made to create awareness about simple homely remedies using herbs and plants easily available in the region.
In the 1980s, the perspective on women’s health deepened and became more rights-based. The ensuing work led to the ‘Stree shareer ki Pechahan’ (Introduction to woman’s body)- 8 booklets which cover about women’s entire life cycle. Women from Mahila Madalis deliberated on the content of these booklets and were involved in the process of finalizing them. These are a valuable resource for health workers.
During a Sammelan (gathering) of PRI representatives in 1996, those from Kangra, Una, Bilaspur and Madi districts pointed out the declining number of girl children in their areas. This was the beginning of a large campaign led by SUTRA on the grave issue of declining sex ratio in the state of Himachal Pradesh. SUTRA’s initial efforts to convince the State government about the gravity of the issue were ignored. However, SUTRA fieldworkers strove to create awareness about this at the Panchayat level. Birth registration data was collected from the Panchayats and eventually boards displaying the sex ratios of each year’s were installed outside the Panchayat offices. Data was also collected from sub-centres and district hospitals. The numbers were dismal and even the State government had to eventually take cognizance of the situation.
Over the years SUTRA- through meetings, training, formation of Kanya Bachao Samitis, street plays etc- have been working on this issue along with public health officials at various levels.
The gram panchayats were also made aware of their role in the National Rural Health Mission through meetings. SUTRA staff undertook monitoring of public institutions like govt. health facilities, anganwadi etc. to ensure necessary support and services to as measure to reduce gaps in reproductive health services.
Reproductive rights of a woman include the right to safe and accessible abortion services. Therefore, while working against sex selective abortions has, a woman’s right to abortion should not be violated. SUTRA fieldworkers are cognizant of this important fact and strive to develop this understanding in the community.
The agrarian hilly State of Himachal Pradesh having 93% rural population entered into an ‘emerging economy’ province during late 1980’s with rapid infrastructure development, shifting of subsistence agriculture to cash-crops, horticulture development and privatization in health as well as education. This development on one hand resulted in positive gender developments such as increase in mean age at marriage for girls to 22.2 years (Family Welfare Statistics in India 2011); on the other hand there was an increase in the expenses on dowry and marriage, continuous fall in child sex ratio, increase in negative gender IMR etc. Moreover, the improvement in financial status was accompanied by a decline in the reproductive health of the population. For eg- high incidence of anaemia amongst women in reproductive age group (43% according to NFHSIII), large scale use of abortion pills easily available across the counter without adequate knowledge of its usages, thrust on terminal method for limiting family even at young age resulting in menstrual and other health problems, large scale RTI/STI symptoms etc.
‘Ensuring Reproductive Rights for Women in Himachal Pradesh’ was started in May 2012 with the aim of highlighting that reproductive health and Rights are an issue of governance and demonstrating that if enabling environment is created the local government - Gram Panchayat can come forward to fulfill the responsibilities according to ICPD Provisions. The essence of the project is therefore to create an enabled environment for the Gram Panchayats through mobilizing Community Based Group called the ‘Kanya Bachao Samiti’ (KBS) comprising of members of Mahila Mandals, Ekal Nari Shakti Sangathan, Self Help Groups; front line workers of ICDS and Health Department (anganwadi workers and ANMs) that will support the gram panchayat in this endeavor. This group will not only be well aware of the different aspects of reproductive health but will also disseminate information on the issue, set examples and take actions for ending gender based discrimination, develop mechanisms for community based monitoring of local health care institutions, develop a platform in the form of Mahila gram sabha for effective participation of women in local governance. Given the existing engrossment of panchayat in development activities, KBS will essentially enable the transfer of ownership of ICPD 1994 from Government of India/State to Gram Panchayats. The project is being implemented in 300 gram panchayats spread across 10 development blocks of which 9 are diverse in terms of culture as well as topography. Overall, the project covers 5 districts of Himachal Pradesh, namely, Una, Solan, Mandi, Kangra and Sirmaur and has a beneficiary population of approximately 6,90,502 persons of which 48% are women and 52% are men.
The project activities are focused on information dissemination and sensitization during monthly KBS meetings and trainings. In addition, thrust is laid on building sense of ownership and responsibility towards the KBS by encouraging discussion; experience sharing, decision making within the group and enabling the gram Panchayats to implement its decisions through convergence of ICDS Services with Health Care Services. During the last 1 year of project implementation the KBS have evolved from sensitization of members to the stage where small initiatives and actions are being undertaken collectively by the group.
The project activities are focused on information dissemination and sensitization during monthly KBS meetings and trainings. In addition, thrust is laid on building sense of ownership and responsibility towards the KBS by encouraging discussion; experience sharing, decision making within the group and enabling the gram Panchayats to implement its decisions through convergence of ICDS Services with Health Care Services. During the last 1 year of project implementation the KBS have evolved from sensitization of members to the stage where small initiatives and actions are being undertaken collectively by the group.
| pfi-executive_summary.docx |
| endterm_project_evaluation_report.docx |
