Author: Tanya Dikshit
The second in a two-part series on the pivotal role millions of women frontline workers play in rural helath governance. Tanya Dikshit, engaged with PRIA’s maternal health project in Rajasthan, recognises their crucial role in holding panchayats accountable in ensuring rural women get access to quality maternal health services.
Availability and access to affordable reproductive health facilities and right to body autonomy (which includes deciding whether or not to reproduce and when) are critical for the overall well-being of women. In India, reproductive rights (of which the aforementioned are essential components) have been implicitly protected by Article 21 (right to life), Article 14 (right to live without discrimination), and Article 15 (right to equal access to law) of the Indian Constitution as well as through various entitlement schemes of the Central and state governments. However, a majority of women still do not have the power to exercise these rights. It is anganwadi and ASHA workers, collectively called frontline health workers (FLWs), who ensure proper implementation of the various health ‘yojanas’ and ‘karyakrams’, capacitating and enabling rural women to realize and exercise their reproductive rights.
MCHN day at anganwadi in Banswara[/caption] Beyond reproductive rights in general and maternal health care in particular, these workers play an equally vital role in rural health governance. Their contribution ranges from upgrading health infrastructure through constant feedback, monitoring improvement in quality of services offered and influencing societal norms and behaviour. With the elected representatives of gram panchayats spending a disproportionate amount of time towards infrastructure development and construction works (roads, bridges, sewage system, sanitation facilities), it is FLWs who maintain constant pressure on the local machinery to listen to the issues raised by pregnant and lactating women. These workers, being trained, capacitated as well as connected to the State level administration, act as catalysts in the process of communities demanding their rights.
VHNWSC meeting in Govindgarh[/caption] Recognizing this role, PRIA’s Apna Swasthya, Apni Pehel project has involved them as primary stakeholders since the inception of the project in mobilization efforts and ensuring accountability from public health services to communities. FLWs are collectively and individually mobilizing pregnant and lactating mothers who do not come for regular check-ups on immunization day. They were at the forefront in the process of mobilization for the recently held Gram Sabha (on 15 August 2018). Through regular engagement and constructive monitoring, FLWs have been transformed into a resource group, which in turn is taking forward the process of bringing people and governance together. They are now the link between communities and village/block level functionaries for transfer of information as well as facilitating meetings. They are becoming instrumental in breaking the silos within which departments and schemes such as National Health Mission (NHM) and Integrated Child Development Services (ICDS) function. Ripples of such integration are visible in Govindgarh (Jaipur district), where FLWs have used the meetings of the Village Health, Nutrition, Water and Sanitation Committee (VHNWSC), of which they are members, for discussing and resolving issues related to maternal and child health care and nutrition. As an effective convergence point, FLWs strengthen local governance. It is about time that they are supported as an integrated nationwide platform of workers who enhance demand of health rights by women (releasing them from the cycle of unwanted and repeated pregnancies, stifled capabilities and inability to exercise reproductive rights) and ensure accountable delivery of health services.
PRIA’s MobiliseHER team traveled to Bangalore during the week of June, 10 – 14, 2024. The aim of the visit was to gain relevant insights into the civil society ecosystem in Bangalore and meet different organisations to understand the city through a lens of gender and inclusive mobility.
Working at PRIA, often leads us to various cities across the country. Each trip is an opportunity to witness firsthand the challenges and triumphs of different communities.
Mr. Yedukrishnan V has recently joined PRIA after gaining valuable experience in the development sector. Drawing from his journey in the social sector and personal encounters in Kerala, he emphasises the importance of participatory governance and research in empowering marginalised communities.'
