Investigating Health Justice Indicators and Advocating Institutional Interventions: Ground Zero Reproductive and Child Health Assessment in District Bahraich-Uttar Pradesh in India

Abstract

India is a society of patriarchal order¹ and hegemonic masculinity that rules the contours of human relationships within and outside the family. The reproductive deliberations and child health priorities are considered the forte of womenfolk contrary to the global norms of equality² justice³ and constitutional mandate⁴ of gender parity. Gender is not a property; it is a performance but an accomplishment performed by a person. Social situations provide occasions to deliver gender identity. But, unfortunately, the world of reproductive rights and child health is not a comfort zone for women in India. Women bear all reproductive procedure risk, particularly at the stage of advanced maternal age⁵ and do not have any stakes in the reproductive decisions, and spousal intervention in such a decision must be regarded as an aberration, particularly in rural India. The male-controlled sociocultural space⁶ considers reproductive rights and reproductive hygiene as a dirty dark secret.

The reproductive rights of women are under more threat now than ever before. The international organizations such as UNFPA⁷ and the WHO⁸ have been at the forefront in defending the reproductive rights of women since 1995. It was at the Beijing Conference⁹ in 1995 on a theme called ‘women’s rights as human rights.’ In this context, the UN and WHO focused on a wide range of women matters such as access to family planning services, sex education, menopause, and the reduction of obstetric fistula, the relationship between reproductive rights and health, and economic status. Therefore, the reproductive rights of women are advanced in the context of the right to freedom from discrimination and the socioeconomic status of women. Reproductive control is a fundamental requirement, and it is a human right for every woman. Such a right has a direct connection with the health of a woman but societal structures created by the religious norms dictate such a right contrary to the legitimate aspirations of womenfolk’s motherhood. Further, state intervention and administrative apathy¹⁰ are driven by private profit and have abated the lawful reproductive and child health claims of the women. But, unfortunately, global population trends are likely to mount significant pressure on resources and institutions.

Moreover, in the cycle of reproductive rights, women are pitted against women in vertically and horizontally fragmented traditional social milieu. Women’s rights of access to abortion and contraception remain a distant dream in India. However, India has started to extend– although gradually–women’s access to abortion, whereas the US continues to crack down on abortion. The amendment carried out in the Medical Termination of Pregnancy Act, 1971 (MTP) in 2018, has made the MTP Act, 2018¹¹ liberal, and it promotes gender-sensitive health policies and allows women to go for an abortion at up to 24 weeks. MTP also replaces the term “married women” with “all women” in the contraceptive failure clause. But, the policy appears to be useful in theory, but the reality is quite different for women, especially rural women, as most abortions are carried out by unauthorized, and medically novice professionals as unsafe abortions worldwide cause every year 4.7% to 13.2% of all maternal deaths¹², and it is a big problem in India.

Therefore, women’s sexual and reproductive rights are under constant threat¹³, driven by religion and the right-wing interpretation of sexual choices.¹⁴ Hence, reproductive and child health has always been the most neglected area of health and medical consciousness in India. The sociocultural barriers have been guiding and dictating the extent of enjoyment of the reproductive and child health rights in India since time immemorial. Reproductive rights of women are not luxuries but responsibilities that have been envisioned as a subcategory of human rights. Thus, womenfolk have a fundamental human right to decide freely and conscientiously the number and the gap among their children. Further, the problems regarding the reproductive rights of women are strongly challenged, notwithstanding the socioeconomic level of the population, culture, or religion. Therefore, In India, women and child health are destined to suffer in silence and embarrassment.