Tag: maternity

THE INFLUENCE OF GENDER ROLES ON HEALTH SECTOR INCLUDING REPRODUCTIVE RIGHTS

                                                                          (Photo: Singularity Hub)

  Men form one-third of a typical medical school’s population; Rest of the seats are all occupied by women. The pay gap in the healthcare sector is 25% higher than any other sector. Most women agree to work at low wages because of the financial crises they face. Gender inequality is leading to a shortage of healthcare workers in the sector. Women in India face “extensive gender discrimination” in access to healthcare. Gender inequality is leading to a shortage of healthcare workers in the sector because obviously only one-third of the seats were taken by men. 

Under the National Health Mission, the government has launched several schemes. The most important program launched by the government is Rashtriya Arogya Nidhi which provides financial assistance to the patients that are below poverty line and are suffering from life-threatening diseases.  Rashtriya Swasthya Bima Yojana is a government-run health insurance program for the Indian poor. It aims to provide health insurance coverage to the unrecognized sector workers belonging to the below poverty line.  National AIDS Control Organization was set up so that every person living with HIV has access to quality care and is treated with dignity.  Anganwadi Workers and the ASHA workers are the grassroots level functionaries under the umbrella ICDS Scheme and the National Health Mission respectively.  Both these functionaries being closely connected with the rural and urban poor families, play a pivotal role in addressing their nutrition and health related problems/issues.

How the Government has failed them ?

·        Do not have regular salaries, partly because their work is supposed to be voluntary and part-time.

·        Even though the Code on Social Security, 2020 aims to include formal and informal sectors under a social safety net, it excludes several categories of workers, including ASHA and Anganwadi workers. The Code on Wages, too, has left this constituency out of its coverage, depriving employees of a fixed minimum wage.

·        “As per Modi government’s definition, Anganwadi and ASHA workers are not ‘workers’ but only ‘volunteers’, who do not receive any ‘wage’ but only an ‘honorarium’! So the principle of minimum wage would not apply to these scheme workers.”

Also a gender issue

·  Limited space for career progression is linked to low institutional recognition, demotivation, and curtailed opportunities for growth. ASHAs face sexual harassment by other health workers and community members, linked to their mobility and public profile. ASHAs have worked to further women’s interests, particularly in Chhattisgarh state where Mitanins(the name for ASHAs there) have mobilized protests against alcoholism, supported women’s collectives and taken action against gender based violence. ASHAs have begun taking action to mobilize their peers to reduce gender based violence. ASHAs have reported an increased sense of empowerment and personal growth, in part through their belief in the social value of their work.

     Gender as a social determinant of health

  •     The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.
  •          The SDH have an important influence on health inequities – the unfair and avoidable differences in health status seen within and between countries. In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.
  •        The following list provides examples of the social determinants of health, which can influence health equity in positive and negative ways:

              1.Income and social protection

              2. Education

              3.Unemployment and Job security

  •      Research shows that the social determinants can be more important than health care or lifestyle choices in influencing health. For example, numerous studies suggest that SDH account for between 30-55% of health outcomes. In addition, estimates show that the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector.
  •     Addressing SDH appropriately is fundamental for improving health and reducing longstanding inequities in health, which requires action by all sectors and civil .
  •      Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.”
  •      In addition to the more material attributes of “place, ” the patterns of social engagement and sense of security and well-being are also affected by where people live. Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services and, environments free of life-threatening toxins.
     Reproductive rights in India
     Reproductive Rights are rights of individual to decide freely and responsibly the number, spacing and timing of children. It is individual’s right to decide whether to reproduce and have reproductive health. The Supreme Court of India and several state high courts have recognized the importance of reproductive rights and have observed that the denial of reproductive rights is violation of women’s fundamental and human rights.
     Courts have been at the forefront of expanding, protecting, and promoting reproductive rights. court through its various judgements from time to time has promoted and protected the reproductive rights of women. for instance, Puttaswamy judgment, Suchita Srivastava V. Chandigarh Administration, Navtej Singh Johar V. UOI. 
     
     Role of socio-physical environment in health care
     Social determinants of health are the conditions in the environment where people sustain, i.e. they born, live, learn etc., which affects the health, functioning and quality of life outcomes and risks. Health starts from our localities, our homes, schools, communities where it is also examined by our access to social and economic opportunities. So, social determinants of health are designed to identity ways to create social and physical environment that promote good health.

 




Kangaroo Care: A Bonding Experience With Advantages

Parenthood is a huge responsibility. Parents strive to have a good bonding with their children. Do you know that bonding opportunities start right off with the birth of the child? And with other scientific advantages. This bonding experience is scientifically termed as Kangaroo Care. So what does it exactly involve? Let’s see

Introduction

Kangaroo mother care, also known as skin to skin contact, is a treatment used by the medical workers in the cases of preterm underweight babies. Though it also has an integral part in the newborn care routine, it is of special significance for taking care of the premature low weight baby. The skin to skin contact primarily reduces the chances of the baby contracting hypothermia, while under neonatal intensive care. Apart from that, it helps to regulate and stabilize the baby’s cardiovascular and respiratory parameters, lowers the chances of contracting infections from the surrounding and also have a steady weight gain. 

Deriving similarities with the specific marsupials, who carry their younger ones around in a pouch, this medical phenomenon thrived in the 1970s, when there was a shortage of neonatal care services and equipment for premature low weight babies. Also, there were trends of high infant mortality rates and large number of infection cases. Originally started for the full term babies, this technique soon gained prominence in premature care techniques.

Requirements and Objectives

The preterm babies who weigh less than 1500 grams and can breathe without any external support are the primary cases requiring KMC. Babies under monitoring or some other specialized medical care are not eligible to get KMC initially. For premature low weight babies, a weight increase rate of  15-20g/kg/day is considered to be ideal.

Under KMC, some parameters like temperature and heart rate are checked regularly. Also, monitoring for any symptoms of apnea, diarrhea, yellow skin, convulsions are done.

Kangaroo care has a primary objective, that is to establish bonding with parents and/or family members. The physiological and psychological connect provided by this technique is very effective. Ideally, the contact must be from immediately after the birth and cleaning of the baby, till the first feeding . The baby would be wearing only a diaper and hat, and are placed over the parents chest for direct skin to skin contact. Apart from warmth, this also provides various simulations, essential for baby’s growth, like the vestibular stimulation from parent’s breathing and chest movements, auditory stimulation for parent’s voice and so on. The baby needs to be held in the fetal position for optimum contact. Usually the mother is the one to provide Kangaroo Care, as she also happens to have to feed the baby. But the father can too provide it. In some cases, even the family members also do it. The babies tend to develop attachment with the caregivers. A ground point is that the process should be as long as possible, and should be least disruptive. Normally, it is recommended for healthy babies for upto 3 months and for premature babies upto 6 months.

Advantages

Kangaroo Care has been associated with higher levels of parental confidence. Parents, who have done KC are more likely to be sure of themselves while handling the baby. It also decreases the anxiety levels in both the parents and in the child. Infact, it is recommended that babies should be held close to the skin during any medical procedure after their birth, as holding the babies close to skin reduces their pain. Kangaroo Care also provides a chance to the fathers to establish a very good bonding with the baby. This helps the baby recognize the father’s voice and also stabilize various physiological parameters. These children tend to have better sleep trends and cry less. They also tend to have better cognitive growth and in general, a better rate of growth and development in the long run. Another advantage is the smooth feeding process. Skin to skin contact stimulates the breast feeding response in the babies and hence, it becomes easy and less stressful for the mother to feed the baby. Apart from that, it is observed that the mothers who have participated in KMC tend to produce larger quantities of milk for a longer period of time. For the medical institutions too, KMC is an advantageous opportunity. With lower requirements for neonatal care units and expensive equipment, it also provides ample opportunity to educate the first time parents about some basics. And then, there is the advantage of reduced hospital stay.

With all these advantages, Kangaroo Care is here to stay!

https://en.wikipedia.org/wiki/Kangaroo_care

Paternity Benefit Bill: The Gender We Talk About, The Benefit We Don’t

Amidst all the expectations around the male gender since his birth, there is secretly an expectation which every spouse hopes for. Time has developed since the only job of the male co-partner remained until the “sperm fertilised the egg”. The couples grow in love as they call themselves ‘pregnant’ and not just the technical one. The change in the ideologies was very well understood by the law presenters of the country. The idea to give chances to the father to be able to be completely devote to the upbringing of his junior. The benefits to be able to not lose work, not to miss deadlines but to be able to absorb the presence of a new member in the family.

‘Paternity Benefit Bill’ made rounds in the corner of the Parliament in 2017 with a view to benefit the fathers to oblige to their parental duties. It stated to give all workers, including men in the unorganised and private sector, to be benefitted with a paternity leave of fifteen days which could be extended up to three months.

The bill introduced stated for the employees to receive payment at the same rate as the average daily wage or even so, on a minimum rate of wage as revised. The same could be availed from an organisation if he had already served not less than eighty days in the last twelve months immediately preceding the delivery date of the child. However, the clauses require fathers with only less than two surviving children to opt for the same.

The gender benefits do not end here as the bill further stated to introduce proper guidelines in order to provide benefits to every man. A crucial affair that the bill brought was the Parental Scheme Benefit Fund. Under this, the government would create a fund specifically for purposes of paternity benefits where employers irrespective of genders would contribute. It was to meet the costs which would be induced through the availing of the particular benefit and the loss of work. Not to forget to mention on how the bill boldly announces that on death of the man during the following tenure, the nominee has rights of receiving payments till the end of it.

The beauty of the bill is not restricted to the birth fathers. The Bill allows the adoptive father of a child below three months of age or the legal husband of a mother in the cause, to be given the same benefits.

The objective of the bill is to ensure to the mother gets constant support in the process. It is not only through looking after the child together but when the father gets time with the child, the mother gets a chance to resume her work. Usually during the commissioning period, the mother develops a distant connection with her work until her child grows to handle himself. Such an act of love unfortunately also throws the woman out of the race of the market. Her positions degrade after she resumes and the restoration is more often than not, impossible. The option of choosing between the newborn and the profession is unjust and the bill certainly helps the attain the goal.

Through the bill, the perception of gender roles gets on hold. It creates an aura of gender equality at home. The shifts of looking after the child when divided among the two parents can lead to none of them having major deviations from their works to only allow the emotions of seeing their child grow into a form of their own reflection.  

Despite the benefits kept in front, a lot of issues persisted to not allow the bill to go further. The Maternity Benefit Act shifts the entire financial burden on the employers and through an introduction of system which would allow funds, the work place might discourage the driving force of the other objectives of women employment. Furthermore, the Paternity Bill necessitates to be extended to all sectors whereas the Maternity Act has only limited applications. It creates inequality, not only with the Maternity Benefit Act but also with the fact that the objective of the Paternity Bill is not merely paternal benefits but also equal opportunities to both the genders.

However, this creation of inequality is amendable.There can be similar benefits to both the parents and if it requires anything urgently, it is the mindset to evolve that both of it can co-exist.