Two days before ringing in the New Year, GRAVIS organized a state level workshop on women and children’s health in the Thar Desert. The UN Millennium Development Goals specifically address women and children’s development in 4 out of 8 goals. As we enter 2014, just one year away from the 2015 target, we recognize that there is still a lot of work to be done.
The harsh climate of the Thar Desert, combined with the scattered layout of villages, creates a challenging situation in which to carry out development activities. People living in rural areas of Rajasthan have limited access to health care given the isolated nature of these desert communities. Without preventative medicine and regular check-ups, villagers may wait until later stages of disease, when symptoms are at their worst and more difficult to treat, to travel to a hospital. To increase access to health care, GRAVIS trains community members to become Village Health Workers (VHWs). VHWs are trained in first aid, disease recognition, pregnancy complications and hygiene, allowing them to provide health education, basic treatments and referrals to professionals.
Two VHWs attending the workshop shared their experiences working with women and children in their communities. The first VHW expressed challenges with doctors’ absences from primary health care centers. She advocated for the government to mobilize community monitoring of health services to better serve the village. During the open discussion period, doctors who work in primary care centers explained that it is difficult for them to access villages because they do not have a vehicle or travel allowances to visit multiple villages that could be many kilometers away from each other. Therefore, the remote nature of the villages creates a problem for those who seek access to health care as well as for those who seek to provide health care.
The second VHW spoke about the challenges she encountered with regards to gender discrimination in her village. The men in her community did not recognize her work, and made it difficult for her to promote women’s health. She organized meetings with the female heads of households to encourage them to attend primary health care check-ups, and became a facilitator for women’s access to health care.
Conversations during the open discussion called attention to the issue of intra-household bargaining power. Often within a household, the mother-in-law has a great influence on the health behaviors of her daughter-in-law. This can be to the disadvantage of the mother and child’s health if certain myths are imposed upon the mother. For example, workshop participants explained that mothers-in-law, who have given birth to many children at home without check-ups throughout their pregnancy, believe that at-home births with a Traditional Birth Attendant are convenient, and routine check-ups throughout pregnancy are unnecessary. They impose these beliefs on their daughters-in-law, and restrict access to healthcare that may otherwise be available. Therefore, education programs and incentives must appeal to both the female head as well as the vulnerable household member.
This workshop provided a platform for members of the development community in Rajasthan to come together and share their knowledge and experiences. GRAVIS continues its work to improve women and children’s health in the Thar Desert by expanding current health initiatives and reaching out to isolated areas.
*Jocelyn Boiteau, Volunteer