August 16, 2013

National Consultation on Maternal Health

NAMHHR in collaboration with Commonhealth, SAMA, CEHAT, SOCHARA, SAHAJ organised a two day National Consultation on Maternal Health on 12th-13th of August in New Delhi.

On the first day, health activists and civil society organizations came together from various states including Jharkhand, Gujarat, Maharashtra, Uttar Pradesh, Karnataka, Tamil Nadu to share experiences on various government schemes and policies as well as concerns with implementation and accountability within health systems. The following concerns came out during the discussions:

        In spite of the fact that the poorest and most vulnerable women are the most affected, the government has fallen short in addressing maternal health with a comprehensive strategy and being accountable for it. Specific issues need specific focus for example malaria prevention, sickle cell anemia screening, blood storage, hot cooked meals.
        Undignified treatment of women during childbirth from minorities particularly has been reported from various parts of the country, which makes them reluctant to use public health facilities.
        Several issues that affect maternal health - such as access to abortion services, access to choice of contraception, dignified childbirth, domestic abuse, nutrition, poverty, caste and gender – remain blind spots in policy. Thus, the solutions proposed often fail to capture or be relevant to the lived realities of women.
        Maternal death reviews, though mandated since 2010, are not being carried out in several states, especially in rural areas or in the private sector.

A set of recommendations were then developed on the cross cutting themes about some aspects of the maternal health care situation that were presented to the policy makers on the following day.

Key recommendations:
  •  Maternal health cannot be improved in isolation without looking into health systems and social determinants. 
  •  Since many women continue to deliver at home, we need to continue investing in trained dais and dai kits.
  • Verbal and physical abuse by health care providers, during labour in public health facilities must be stopped and action taken against concerned health care providers.
  •   Mechanisms to address grievances must be put in place in health systems.
  •  Maternal death reviews should be done in a women centred way with the inclusion of social and technical factors in the analysis. Greater transparency and accountability is needed in sharing the reports as well as remedial measures being instituted to ensure that other women will not die for the same reasons in that area.
 Dr. Syeda Hameed, Member Planning Commission and Shri Keshav Desiraju, Secretary MoHFW attended the event. Dr. Syeda Hameed acknowledged that civil society groups in India play a crucial role in strengthening government systems. She added, Planning Commission is considering strengthening its convening role with multiple Ministries on urgent cross-cutting issues, for example, health and nutrition (MoHFW and WCD). She suggested that the issues and recommendations be shared with the NRHM Mission Steering Group meeting that would be held soon in August.

Addressing the gathering Shri Keshav Desiraju, stated that while the Government’s policy had led to a reduction in maternal mortality, it was also true that focusing on Institutional delivery numbers alone had led to neglecting what happened to women and children after the birth.  He also acknowledged that it was important to strengthen a team in communities to support safer home births, such as ASHA, ANM, SBA and local TBAs. He promised to revive the Technical Resource Group on Maternal Health that had been set up by the MOHFW two years ago.

The event received favourable press coverage. Please click on the links to read media coverage:

August 14, 2013

Domestic Workers demand for Better working Conditions and Fair wages

More than a thousand of domestic workers from 14 states demonstrated at Jantar Mantar,   demanding a law to protect their rights and provide them social security. They demanded for better working conditions, which will include fixation of wages, child care facilities, housing, training and skill formation for the domestic help.

Organized by the National Platform for Domestic Workers (NPDW)[1] the rally held at Jantar Mantar on 31st of July demanded for the implementation of comprehensive rights and workplace benefits under the National Policy on Domestic Workers formulated by the Labour ministry.   
A petition drafted for the Petition Committee of the Lok Sabha and the Rajya Sabha and signed by thousands of domestic workers across the country was handed over to the Prime Minister and the members of the Parliamentary Standing Committee of Ministry of Labour.

 Many eminent people attended the dharna expressing solidarity with the domestic workers including Basudev Bhatacharya – CPM member of Parliament, Ali Akbar Ansari of the Janata Dal United, Sanjay Paswan - a former minister in the NDA government, Mohini Giri - former chairperson of the National Commission for Women, Vijayalakshmi Reddy from AITUC and Annie Raja of NFIW.

Ms. Aditi Sood, on behalf of NAMHHR Secretariat  participated in the rally in solidarity to support the cause of domestic workers.
Click on the link below to read the petition.

[1] NPDW is the umbrella forum of 17 unions of domestic workers and action groups scattered across the country. It was created in 2012 to pursue a Comprehensive Legislation for Domestic Workers in India.

Revamping Jan Swasthya Abhiyan in Delhi

Jan Swasthya Abhiyan (JSA) is a network of 22 different organizations which includes other networks, organizations working only on health issues, those working on women’s rights and issues as well as academic bodies such as the Centre for Social Medicine and Community Health (CSMCH), Jawaharlal Nehru University. 

JSA provides a platform to organizations that work on many different issues to come together on issues of health and health care. JSA has state units and each state unit has its own activities.  The National Secretariat rotates across the state units. Currently the National Secretariat is being hosted by JSA Delhi.

JSA organized a meeting on 12th of July to discuss revival strategies for JSA, Delhi and also to create a support group for the secretariat of the JSA at the National level.  NAMHHR members including Dr. Mira Shiva and YK Sandhya attended the meeting who raised the issue of maternal health and maternity benefits.

Is India’s Population Policies any better today?

On the eve of the World Population Day, Centre for Health and Social Justice along with the National Coalition against Coercive Population Policies, National Alliance for Maternal Health and Human Rights and Human Rights Law Network organised a Media Dialogue on July 10, 2013.

The media dialogue brought together a panel of parliamentarians, health and human rights advocates and senior media persons who questioned if government’s population policies had changed over time and sought to advocate with them for the need to address contemporary population issues and bring in new perspectives into these discussions. 

In the plenary session chaired by Mr. A.R. Nanda, former Secretary of the Department of Family Welfare, GOI  focused on the need for a more comprehensive and far less coercive mechanism then the currently followed Expected Level of Achievement (ELA) which is still a target approach followed by all the states.  He stressed the need for a shift from treating individuals as targets to improving quality of care indicators which needs to go beyond purely clinical indicators with clear monitoring mechanisms”

Dr. Abhijit Das, Director of Centre for Health and Social Justice in his presentation strongly stated the need to address migration from rural to urban cities which was the reason for ‘overcrowding’ in cities and not population growth. The Ministry of Health and Family Welfare needs to educate everyone about the ‘population momentum’ effect. China is facing the brunt due to its one-child norm and soon going to face the situation where there will be very low productive population and huge imbalance in sex ratios. If India takes the same path of the two-child norm, it will land up in the same boat.  Instead of worrying about increasing numbers, India needs to concentrate on build the skills of the workforce as we will have a large young population who could be turned into an asset for the country.

Advocate Colin Gonsalves, Supreme Court Advocate and Director of Human Rights Law Network pressed on the need for greater accountability of the government towards people. He highlighted the subhuman conditions in the public health sector in which women are sterilized in different parts of the country which is exactly like as it happened during the, ‘emergency era’.

Dr. S.K. Sikdar, Deputy Commissioner and head of Family Planning Division, Government of India, shared that National Population Policy 2000 is not about ‘population control’. India’s decadal growth rate is on a massive decline, nothing can hasten this decline. The government is focusing on the continuum of care including maternal, child and adolescent health and spacing. He acknowledged that ‘quality of care’ continues to be a concern for the government. 

Ms Jagmati Sangwan, the National Vice President of All India Democratic Woman’s Association (AIDWA) stressed that development is the best contraceptive, and the need to focus on empowering the Dalit’s and the marginalised communities through education and economic empowerment so that they have the right to choose their family size instead of forcing them into sterilisation.

Dr Indu Agnihotri, director of Centre for Women Development Studies, a research organisation in Delhi, shared her concern about the way new contraceptive in the garb of spacing is pushed across within the country, and the need for the government to take notice of this unhealthy trend which compromises the health of women and leads to poor reproductive health outcomes for a number of women in India. 

Ms Usha Rai and Ms. Rajalakshmi, senior media persons stressed on the need for stronger media and civil society collaboration. The focus of media writings needs to be brought back to reproductive health and ‘rights’ angle. 

Twenty one civil society organisation representatives from Delhi, Bihar, Odisha and Thirteen media persons were part of this dialogue.