JAGRUTHA MAHILA SANGHATANE (JMS) in Raichur district is a Dalit Women’s Collective of over 2000 women, led by Dalit women’s leadership from the communities. JMS now has sanghatan in 25 Gram Panchayats spread across 4 of 7 talukas of the district. Initiated in 1999 as a community led organisation, it has focused on health and healthcare as one of the key intersecting themes, among others. The engagement with Sub-centres and PHCs began in 2002, with a perspective of claiming spaces for Dalit women by regularising and legtimising their entry in PHCs, which was a space they shuddered to enter, then. In the series of community monitoring and citizen rights campaigns that JMS has pursued over the years, human right to health and right to primary health care, has been one of the prominent campaigns of JMS.
Since 2017, JMS has focused on right to maternal health care services, as the declining public health services are experienced by pregnant and nursing women, especially Dalit women, as very painful and indignifying experiences. In 2017, with interviews with 234 women very intensive campaign began to press for primary health care services using the evidence on maternal health care. In September – October 2018, again, JMS undertook a survey of 362 nursing women in 43 villages coming under the jurisdiction of 8 PHCs.
The campaign started with interviews by the community women leaders themselves and community meetings were part of such discussion. The report card is compiled in a pictorial format and pie charts with colour codes. The report of the survey and a general entitlement discussion is now being held in each of the 43 villages. The community level discussions converge in a public hearing in each PHC. Such a process has been completed in two PHCs – i.e. Paparao Camp PHC of Sindhanur Taluka and Byagwat PHC of Manvi Taluka. The process will now continue in the other 6 PHCS.
JMS has been doing this campaign with varied degree of intensity for several years now. Since 2017, there has been an intensified campaign. There are several changes one could see – increased ANC coverage, increased responsiveness to women in the community from the health care providers etc. Among the troubling factors two things stand out: informal referrals (directing women) to private hospitals for various reasons. Secondly, unchanged status of women’s HB. The average HB level of 362 women is at 9.3, only 8% women were at 11 (i.e. 28 women). Most of the women had HB below 8.
The struggle continues to revive primary health care and to engage health care providers in a productive – supporting, cajoling and at times confronting – dialogue.
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