Narotam Sekhsaria Foundation (NSF), a funding company was established in 2002 with a view to support individuals and organisations in the areas of education, health and livelihood. NSF works toward making a positive, that create a lasting and sustainable impact on society. Leni Chaudhuri, Programme Head, NSF, in conversation with Raelene Kambli, speaks about the domestic and health conditions of women in India and also elaborates on their endeavours in this sphere
What are the most important issues about women’s health in India? Any medical conditions that need focus currently?
| Leni Chaudhuri |
Nearly 50 per cent of women suffer from anaemia related to under nutrition. Low BMI, under weight, stunting are all because of that. The other major concerns are HIV/AIDS, reproductive tract infections (RTI) and sexually transmitted infections (STI), medical implications of domestic violence and cancer of the breast and cervix. There is enough evidence to prove that poor general health leads to poor reproductive health. In India, fertility is intertwined with women’s health. It’s seen that a large percentage of maternal deaths and severe obstetric complications are because of the mother’s poor health conditions than facility related issues. High levels of maternal mortality are especially distressing because the majority of these deaths could have been prevented if women had adequate health services.
While life threatening illnesses like cancers among women attract greater attention, more priority needs to be given to general health conditions and wellbeing of women. To begin with – nutrition related inadequacies. While at an individual patient level cancers and HIV are crucial, at the public health level, priority has be laid on adequate nutrition and access to healthcare.
Which are the social ventures that Narotam Sekhsaria Foundation (NSF) has initiated in the sphere of women’s health?
The foundation believes that the health of Indian women is intrinsically linked to their status in society. Research on women’s status has found that the contributions Indian women make to families are often overlooked, and instead they are viewed as economic burdens. There is a strong preference for a male child in India, as sons are expected to care for parents as they age. This preference for a male child, along with high dowry costs for daughters, sometimes result in the mistreatment of daughters. Further, Indian women have low levels of both education and formal labour force participation. They typically have little autonomy, living under the control of, first their fathers, then their husbands, and finally their sons. Hence, any effort to improve their status has to deal with the totality of the situation.
With this vision, the foundation aims to support programmes which have a comprehensive and holistic approach and are not aimed at episodic interventions. Some of them are as follows
MASUM: To demonstrate a model on low cost and comprehensive method of screening for cervical cancer, women from communities have been trained in using the best technology at an absolutely low cost. The model has proven to be very efficient.
SACH: Interventions to improve health status of women in an absolutely resource poor community in Barmer, Rajasthan
SAMA: Advocacy against sex selection and use of technology for gender selection
SNEHA: To strengthen the public health system for delivering better maternal and child health services
VACHA: Research on adolescent sexual and reproductive health
Arpan: It is an initiative against child sexual abuse
Nutrition Rights Programme: A model for community-based monitoring of health and nutrition related services in Maharashtra with special focus on women and children
Do you work in collaboration with the government? If yes, kindly elaborate.
The foundation believes that in a country like India, to serve the length and breadth and to scale up initiatives, government is the only one who can do it. So the foundation always supports initiatives which are either planned in partnership with the government or aim at influencing/ strengthening government programmes.
Our support to SNEHA, SAMA and the nutrition rights programme are geared towards advocacy with the government. The programme supported at SACH aims to enhance the reach of public health facilities. The programme at SNEHA is primarily towards strengthening the health posts to deliver ante natal (ANC) and post natal (PNC) services.
What has been the impact of these initiatives?
SNEHA initiative has resulted in the increased utilisation of maternal and child health services at health posts in Mumbai. Cases of medical emergency and obstetric complications could be prevented and addressed early.
MASUM has been able to demonstrate a model on low cost screening for CA Cervix. Through the health camps, thousands of women have been able to undergo examination and treatment for RTI and STI. Women diagnosed with early signs of CA have been referred for treatment thus avoiding the morbidities and mortalities.
SACH has been able to help women in the underserved areas to access modern medicine and treatment for pregnancy and child birth, thus reducing the chances of infant and maternal mortality.
What are the challenges in delivering healthcare under these initiatives?
Lack of responsiveness and accountability of the public health system which doesn’t have a gendered vision to healthcare, is often not in a position to upscale or integrate a good model which has been demonstrated by an NGO. The other challenges are underdevelopment and sheer lack of resources which make it difficult to sustain any innovation.
What is the biggest challenge in improving the health condition of women in India?
We have realised that societal factors and non medical factors in a major way contribute to the deplorable status of women’s health. Gender based inequality and discrimination plays a major role in negatively impacting women’s health. Lack of education, access to healthcare, lack of nutrition, gender based violence, poor economic conditions and the patriarchal nature of Indian society pose major challenges in successful delivery of health services to women. So, any intervention that doesn’t target the root cause, patriarchy, will not be able to achieve the desired result. The foundation believes that while innovations in modern healthcare for women need to be supported, programmes aiming at improving the social status of women should also be prioritised. If a woman has access to education, health, better nutrition and is free from discrimination, her health status with automatically improve.
What are NSF’s plans for this year?
To support programmes which aim at:
- Building strong leadership and a coherent institutional response
- Making health systems work for women
- Healthier societies: leveraging changes in public policy
- Building the knowledge base and monitoring progress
Any special message for people working for improving women health in India?
We need to think of women beyond the Millennium Development Goals (MDG) and other global commitments that have focused primarily on the entitlements and needs of women. We need to think of women’s health as a human rights issue and not merely in terms of delivery of some essential services. A life of dignity, led with choices and free from social and person fears is the dream of every women … we as advocates need to create a space for her to realise this dream.