Jatan recognizes the need to improve the health and status of women and adolescent girls. We work with Panchayats, political leaders, health service providers, the media as well as community members in order to create awareness on health and rights of women. Jatan has formed various special groups of pregnant women for better provisioning of ante and post-natal care. We’ve also had the privilege of being responsible for carrying out the capacity building of ASHA workers. Changing the perception of institutional delivery and improving the access of public health services have been two major achievements in this effort.
Strengthening Accountability for Maternal Health
Jatan is a partner of CHETNA, Ahmedabad under the Women’s Health and Rights Advocacy Partnership (WHRAP) initiative. The WRHAP programme is a South Asian Partnership for Advocacy on Women’s Sexual and Reproductive health and Rights.
The major achievement of the reporting period has been the organization of a public hearing on maternal health issues with a view to enable women to claim maternal health entitlements. Approximately 350 men and women participated from 15 villages of Railmagra block, Rajsamand district. Overall 21 cases of denial of health care were presented. These were brought to the attention of public health officials and expert panellists so as to emphasize the structural deficiencies in particular health facilities underlying such cases.
Through public hearings, Jatan has lent support to a unique opportunity that bridges the gap between the government and the civil society. This was not just an opportunity to speak out about the discrimination, atrocities, and violence they faced, but also a chance to attain justice, with the guilty being punished.
The Jansunwai (a public dialogue) demonstrated the proportion of embezzlement and the urgency with which, the issue needs to be tackled. It demonstrated the leakages are the main problem, not inadequacy of funds, which are responsible for poor development. Likewise, the unwillingness of the staff to work in the rural areas, insensitive attitude of the health service providers towards poor women and lack of information about government schemes are largely responsible for the plight of women.
Advocacy for Maternal Health Entitlements
Jatan is a part of “SUMA” network (White Ribbon Alliance for Safe Motherhood) in Rajasthan that is working on maternal health issues and entitlements. It has partnered with CHETNA - secretariat of the Rajasthan White Ribbon Alliance and PRAYAS - Chittorgarh, for Safe Motherhood coordinated Maternal Health Right Awareness programme in Railmagra block of Rajsamand.
Jatan initiated its activities in Dariba and Kuraj PHC’s of Railmagra block. A study was conducted in Dariba PHC. On basis of its findings, field experiences and community contact, it was found that in a majority of PHC’s there is a lack of basic facilities such as sufficient staff, operation facility, etc.:
- There is a lack of information among the people about health services
- Many health service providers are insensitive and unfriendly
- Health-related government schemes are not being publicized effectively and information is not reaching the people
- Women health issues are not included in Gram Panchayat agenda
- People are not receiving the benefits of JSY (government scheme giving money to women having institutionalized births who are below the poverty line)
- In case of complications, people have to come to R.K. Hospital, Rajsamand or to Udaipur. In the whole district, only two gynaecologists are appointed.
A capacity building programme was organized for the workers with the support and guidance of CHETNA, Ahmedabad to develop an understanding on topics like available health services, MMR and advocacy programmes.
Efforts were made to carry this issue to general public through regular contact with the village, meetings with health workers, PRI members/SHG (self-help groups) members and participation in MCHN (Mother and child health and nutrition) day. Dialogue on women’s health was initiated through participation in panchayat meetings. The PRI members were informed about the health status of the area and, at the same time, they were encouraged to work on these issues at the panchayat level.
Two groups of pregnant women were formed in Dariba, and, at the same time, work was done to provide them counselling and health services. Access to counselling and health services was made easy through coordination with the families of migrant labourers, especially the pregnant women.
Seven ASHA workers were selected as para health workers and trained to provide health care to the families of migrant labourers. Each para-health worker was primed to provide services in one Gram Panchayat area. In the past year, about 450 people were provided counselling and linked with other health services.
Working with SUMA and WHRAP network has helped Jatan in understanding maternal health issues and advocacy for these issues. The contribution of ASHA has been significant in linking the women of 35 villages from 9 panchayats of 2 PHCs directly with the health services. As a result of all these efforts, there was an increase in community awareness and understanding of maternal health rights.
- Proper planning and organized strategies make it easy to work with the community at the local level and service providers at block and district level
- Irregularities of health services can be stopped by regular identification of women’s health issues and by sharing them with public
- VHSC is a strong medium to enhance the participation of village people on health issues. At the same time, it helps to ensure quality health services are reaching to the people
There is a need to do regular and intensive work on advocacy of women health entitlements from block to district, state and national level.