“Community involvement must for better sexual health information”
Gender-based constraints, for both married and unmarried youth in India, influence sexual behaviour and attitudes, and restrict knowledge and access to reproductive and sexual health services. However, it is possible to address these constraints by involving the community, according to the findings of a survey carried out by the International Centre for Research on Women (ICRW) and its five partners.
Gender inequality affects young women’s access to information and services regardless of whether they are married or not. Young married women, most of whom are sexually active and many ready for childbearing, need access to reproductive health information and services. Yet, they typically are at the bottom of the social hierarchy and depend on family elders for that access. Many young married women forego health services because of social taboos surrounding reproductive and sexual health.
In rural Tamil Nadu, 53 per cent of married women (16-22 years) reported symptoms of reproductive tract infections (RTIs), but two-thirds of them did not seek treatment, largely because of perceived stigma and embarrassment, the survey said.
Limited access
The social taboo is even more pronounced for young unmarried women. Unmarried adolescent girls are denied access to information and are expected to remain silent about these issues. Consequently, unmarried women have limited access to information and services, even though they may be vulnerable to sexual harassment.
Gender norms inhibit boys and men as well. Young men are not aware of or are ashamed to acknowledge or seek information about sexual or reproductive health issues. In rural Tamil Nadu, men who have sexually transmitted infections (STIs) are often associated with having “a wrong relationship,” a common term for extramarital sex or sex with a commercial sex worker. As such, men seek STI treatment when symptoms become severe.
The survey further suggests that norms that label maternal care as “a woman’s affair” also limit husbands’ participation in care for their wives. In Ahmednagar, Maharashtra, only half the men who said husbands should accompany their wives for antenatal and post-natal care actually did so. The proportion fell to one-third for delivery care.
More cost-effective
According to the survey, community mobilisation approaches in these studies were more effective in achieving the outcomes and more cost-effective than other approaches.
The ICRW partners for the intervention research between 1996-2006 were Christian Medical College at Vellore, Foundation for Research in Health Systems, KEM Hospital Research Centre, Institute of Health Management and Swaasthya.
