Worldwide, it is estimated that there are more than 60 million non-institutional births each year with the vast majority being attended by traditional birth attendants (TBA) (Madhivana, P., Kumar, B.N., Adamson, P., & Krupp, K.,2010). With almost 60% of births occurring at home, India faces a variety of challenges in providing high quality maternal child healthcare (Madhivana, P., Kumar, B.N., Adamson, P., & Krupp, K.,2010). These challenges are all related to societies education and TBA’s that have been delivering children for decades. TBA’s also known as Ashas oversee 1,000 people in Indian villages. These women overall have an eight-grade education or no education. Their training is based on what they learned from their mothers and pass ancestors through cultural experiences. In these zones of India there is a lack of education when it comes to health care, therefore Ashas have no adequate training or the technics necessary to circumvent the high incidents of HIV and maternal mortality.
In the lecture Dr. Purnima Madhivanan created a space where students had the opportunity to explore and understand neonatal health care and how important is to research the different villages in India, to help and control traditional births attendance practice. Regrettably, because of social economic status (SES) or lack of transportation most of the families in the villages have low or no access to health services and rely on TBA’s and mobile clinics. For this reason, villages still use this kind of services, saving them time and money to keep raising their children and take care of their families. When it comes to physical health, because of the lack of resources and education, many women are not treated for HIV/AIDS or STD’s, and newborns are in danger contracting these diseases. In studies this high incident of diseases contraction is also correlated to TBA’s not using the training and materials provided by the government. Dr. Madhivanan, show the students how surgical instruments are not sterilized or use for their purpose at the time of labor. Villages are caught in ancient methods that is not allowing society grow and provide improved professional services. This is also related to not having the government support and the qualify people to service these mothers and their children. India excels in the health services they provide, especially when it comes to specialties in the country, but on the other hand fails to deliver these services to those in need.
Understanding India’s health system is vital when it comes to mothers and child health. By knowing the information provided by Dr. Madhivanan in her presentation, we can understand in more detail how the system works in rural areas where low SES is present. On the other hand, if we compare villages health system to health care provided to transgenders we can say that beside not having the resources to have the best health services, there is also a stigma among this minority population. Although these communities have existed for ages within Indian society, hijras have been stigmatized and marginalized to a large extent ( Kalra, G. & Shah, N., 2013). Because of been marginalized, hijras find difficult to access health services, especially when it comes to their sex change. Both MtF transgender persons and health care providers reported a near lack of free gender transition services in public hospitals. There is only one medical-college–attached public hospital in Chennai has a free SRS program (limited to removal of male genitalia and creation of vagina) (Singh, Y., Aher, A., Shaikh, S., Mehta, S., Robertson, J., & Chakrapani, V.,2014). Because of research we can acknowledge that the transgender community have the same and even more complications when searching for health resources because of society rejection and the stigma attached to their gender.
In conclusion India’s health system still needs more organization when it comes to providing services for all communities. Even though the system is design for many people to obtain free health care, many rural areas and minority populations have no access to the services. Health care is lacking the ability to understand how difficult is for villages to find health providers and minority populations to be accepted in clinics and hospitals. This shows that culture is still evolving, but not enough to understand the necessities of others that are not recognize by society as men are. Right now, not only India needs education when it comes to different topics related to public health, prevention and treatment of diseases, by doing research we all can provide the information necessary to help communities and make more advance decisions when it comes to health care.
Kalra, G., & Shah, N. (2013). The cultural, psychiatric, and sexuality aspects of hijras in India. International Journal of Transgenderism, 14(4), 171-181.
Madhivanan, P., Kumar, B. N., Adamson, P., & Krupp, K. (2010). Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India. BMC Public Health, 10(1), 570.
Singh, Y., Aher, A., Shaikh, S., Mehta, S., Robertson, J., & Chakrapani, V. (2014). Gender transition services for Hijras and other male-to-female transgender people in India: availability and barriers to access and use. International Journal of Transgenderism, 15(1), 1-15.