For decades, India’s most populous state, Uttar Pradesh has been performing poorly on many socio-economic fronts. Leading amongst these are exceptionally high maternal and infant mortality rates. Often, pregnancy and child birth are accompanied by several avoidable complications and risks like disease, infection and even death. In the face of all this, and to combat such problems, CARE is implementing a project to help pregnant women in rural Uttar Pradesh gain access to information, resources and support groups. The project works on individual, household and community levels to promote practices which improve maternal and newborn wellbeing.
In many cases, the resistance to healthier practices can be attributed to numerous archaic and entrenched social beliefs held by the communities. These include the strong preference for a male child, which results in relatively less care for the female child. Another is the belief that heavy work during pregnancy ensures a smooth delivery. There are poor community practices during child birth and pregnancy and the key decision maker in such matters is not the woman, but the mother-in-law and husband. Women seldom have control over reproductive decisions and are unable to say “no”. A negative perception of government service providers and rampant class-based geographic and social exclusion, fuel the problem further.
An assessment of the above reasons made it clear that in order to promote safe and healthy practices among the pregnant women, it was supremely important to involve their family and gain their trust and support as well. To propel this holistic approach, the husbands of the pregnant women were invited to attend the routine “Women’s Meeting” held in a village in Barabanki district of Uttar Pradesh.
The meeting was a first of its kind, and saw the participation of 4 young couples, some pregnant women (without their spouses), an Accredited Social Health Activist (ASHA), Anganwadi Workers (AWW), an Auxiliary Nurse Midwife (ANM) and some elders. The agenda was simple. It aimed to educate the group in a fun-filled and informal manner. Knowledge about the importance of iron tablets, and regular prenatal checkups was dispensed, followed by an interesting activity specifically for the couples. Several items, some crucial for child birth preparedness and others unnecessary, were placed in front of each couple and they had to select the ones that they would need for the birth of their child. I noticed that only the men made these selections and they ended up collecting some unneeded (and even harmful) things that were traditionally considered useful. The benefit of each necessary item was explained by the CARE staff present and when the activity was repeated, the men were able to make the correct selections.
Another game was played, one that a husband and wife usually play right after their marriage. A ring is hidden in a bowl of coloured water and the couple has to compete with one another to find it. While in that scenario, it is believed to playfully determine who will have more control in the marriage, in the meeting, it helped steer the discussion toward promoting equal decision making powers within the household. The participants enjoyed this, and it served as a good ice breaker. The men admitted that though they were unaware about the minute, yet crucial details related to pregnancy and child birth, they were grateful for an opportunity to learn about them. The presence of ASHAs, AWW and the ANM during the meeting helped in reinforcing that men should also seek counseling with the service provider during checkups.
I was impressed by the ease and confidence with which some sensitive topics were broached by the local CARE staff, and was pleased when the level of comfort was reciprocated by the young couples. The day’s activities were undoubtedly a learning experience for all. In the end, I was left with the realisation that though it would be years till substantial, measurable change would occur, thanks to Join My Village the seeds of change had been sowed in the minds of the young men and women who were present that day.