Vivek Bellampalli, a sexual health expert based out of Pune talks about the gaps in the system and explains, “Women should feel safe to approach healthcare workers. We need to focus on problems women face.”
“I don’t do any work that I can be proud of,” says Seema*, a sex worker from the Indo-Bhutan border town of Jaigaon in West Bengal. Seema was married when she was 16, and at 26, she has three children aged four, seven and 10. She also suffered from a miscarriage after her second pregnancy and frequently suffers from itching and other vaginal infections.
Vulnerable women like her are the ones who are in most need of reproductive care and awareness about sexually transmitted diseases, but there’s a minor glitch in the delivery system — one that can mean life and death for women like Seema. “The ASHA workers in our village don’t talk to us. They look down upon us, which is the reason why we hesitate to approach them,” she says.
The lack of attention to this crucial issue has resulted in a decline in the use of contraceptives across several states, according to the result of the latest National Family and Health Survey (NFHS-4) for 14 states. Experts say while we have fought STDs like HIV/AIDS on war footing, being lax about access to contraceptives and awareness could have serious repercussions.
ASHA or an Accredited Social Health Activist is present in every village in rural India and most often these women are responsible for delivering basic healthcare to the end users. Belonging to the same communities that they serve, they may carry certain biases with them.
Vivek Bellampalli, a sexual health expert based out of Pune talks about the gaps in the system and explains, “Women should feel safe to approach healthcare workers. We need to focus on problems women face.”
There are additional problems. “The reach of the ASHA workers tends to be limited to married women. Widows, separated women and even men tend to get left out as most ASHA workers are women. There is a lot of misinformation about the availability of contraceptives and their uses,” points out Kalpana Apte, secretary general of Family Planning Association of India (FPAI).
Anitha*, an ASHA worker in Jaigaon admits that there are several obstacles.“We look for excuses to go and interact with sex works but they don’t always open up to us. Many women have HIV here and we first talk about contraceptives and then approach the subject of condoms with them,” she explains. “We also have to take care not to offend them or they will not talk to us,” she adds.
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