The impact of the COVID19 pandemic was hard on women in India. Only 11% of girls across the country had access to smartphones, said Poonam Muttreja, Executive Director, Population Foundation of India.
In an interview to DataBaaz, Poonam Muttreja talked about the impact of the pandemic on women, the difficulties they faced. Their health, education, and mental health also suffered.
Muttreja said women were unable to take case of essential health services like family planning and unplanned pregnancies. "Which means India is going to have 26 million couples going through a pregnancy, without planning for it," she said.
One of the other major issues faced by women amidst the lockdown were rising cases of domestic violence. Women had no way to escape and were virtually locked in with their perpetrator.
Muttreja said, "Often, women go to their parents' house, or friends house, or neighbourhood something but in this situation they were captured in captivity with their perpetrators."
Edited excerpts of the interview below.
A broader question first, we are now eight months into COVID 19 and also into some form of lockdown or the other. This has had a tremendous impact on homes, particularly on women both in rural as well as in urban India. What have you taken away?
You know first of all, all the essential services that women use much more because of their reproductive, sexual and other aspects of their biology have got completely neglected. So, the demand for family planning services has gone down. Women are scared to go to health facilities but the facilities are also not providing help to women on let us say contraception. Which means India is going to have 26 million couples are going to go through a pregnancy, without planning for it.
Second, women you know are the ones responsible for a child's health-immunisation for instance. Immunisation rates went down by close to 25%. Women and girls, the burden of work in the households whether urban or rural increased dramatically. This is because husbands, parents, inlaws, children were at home and women had to fetch more food, more fuel, more water for the family.
Third, violence against women and girls increased because women were locked in the house with the perpetrators of violence. And a lot of the frustration, I am afraid that men have, came out on both the women and the young girls. They were the victims, they could not go anywhere to report given the lockdown and they could not even move out to deflect the situation. Often, women go to their parents' house, or friends house, or neighbourhood something but in this situation they were captured in captivity with their perpetrators.
Fifth, girls because they began to do a lot more work at home, they are the ones who got the least even when there was education online, it was the girls who suffered more because the order of priority of even using smartphones, leave alone connectivity to Internet is father, then son, then mother, then daughter. So girls had very little access, only 11% of the girls across the country had any access at all. We did some studies and found that 80% of the girls, young girls we interviewed in Bihar needed support. They said they experienced tremendous anxiety throughout the lockdown.
Young girls are worried about two things that always happen when there are pandemics or disasters -- which is girls drop out of schools and there is early and forced marriage. There is also reports of slavery, selling young girls for the flesh trade and so on. So the story for girls is all this existed even before, family planning is a challenge, reproductive health, maternal health, immunisation is a challenge. So all these silent factors got exacerbated/exasperated. It got much worse for women and girls than men.
And finally cooking, cooking under resource constraints, where people have lost their jobs, where there is insecurity about the jobs, the burden falls on the women to feed, always women eat the last and the least. And here it was even meagre eating. So I would like to say that not only did their biological factors fail them, but in terms of mental well being, in terms of physical well being, their sexual and reproductive right which is access to family planning. And finally access to abortion.
In India, there are 60 million abortions every year. And there were no abortions options available. And the private sector also failed the women because many women, even the poor, we know that almost 65%of the expenditure are in the private sector. The private sector almost closed down in the small towns and villages. So, the situation for women in the pandemic requires serious attention and we need a post-COVID response that looks at women and girls. Also, we need to put in mechanisms in place-what do women do, when they experience violence even under normal circumstances. But let our post-COVID response at least be a serious response to women and girls realities.
Now, you talked about the girl child, for example, losing out of school, the ability to go to school, or early college or pushed into marriage. This is one kind of problem, the biological, reproductive issues you talked about is another kind, the mental health is the third kind, violence that they face at the hands of the spouses and other family members is the fourth kind. How will you prioritise them? Though I fully understand and acknowledge that each of them is critical and deserves a proper response. Is there a way to prioritise or distribute the responses in a manner that is more efficient and effective?
I would like to say that we prioritise health first. Because we are already in the pandemic, which makes them more vulnerable. So, pregnant women are more vulnerable, we do not know the impact on children. So we have to create special facilities. Just like, let us say, Max has COVID facility hospital and non-Covid facility hospital. So we need to separate the services--we need Covid facilities and non-Covid facilities even in the rural areas.
We need to strengthen our public health system. You know countries that have done well, either developed or developing, or emerging economies are the ones that had strong public health systems. Even the most developed countries, as you know, that did not have strong public health systems did not do well on Covid. Our public health system was already in the ICU, we need to lift it up.
We need to strengthen our public health system, and we need the response to women because of their biological and special needs greater attention, to ensure that family planning services are available not just in public health facilities.
We should have a partnership. This is one place where I encourage partnership for the responsibility and the role of the private sector. Second I would like to say that, you know within our existing infrastructure. For instance, education, schools close down, but what stopped?
One of the things that I forgot to mention is that 60% of the girls cannot afford sanitary pads, they get free sanitary pads in schools. Now the schools closed, but what stopped the school system, the education system, from distributing them at their home or using ASHA or A&M, the Anganwadi worker. We have 3.3 million frontline health workers who could have been used well, who could have been paid well and to give these services. We could have had the distribution of not just contraceptives but also the distribution of sanitary pads for the girls across to their homes or ration shops. We have too many infrastructures for distribution, fortunately, in our country that could have been put to good use.
Finally, I think this digital divide that we have where people in the rural areas and poor kids have a much bigger divide in terms of educational attainment, it has been a wasted year. It has been a year of anxiety for people.
Why cannot we have facilities where at social distance we have children coming to school, especially in those districts where there has never been COVID. So many tribal areas, we have had not a single case of COVID. The most backward areas actually have the least COVID. Why could we not have put the district. I am all for the DMs. We should put the District Magistrate in charge.
They have a more important role to play than the PM at the district level. So they could have taken a call--where is it that we can provide what facilities. Where there is no COVID could we experiment with schools? Ten children going, even once a week would be great for their mental health. Extraordinary times require extraordinary solutions. Young kids, even one day a week going to school would really keep their mental well being in a better situation.
This is time for innovation and NGOs are doing huge innovations across the country. Instead of the government dumping them after they did the relief, and making laws which are going to make them more dysfunctional, this is the time for the government to take advantage and use the NGO sector's commitment, innovation to work across the country.
Let me pick up one more point. You spoke about the challenge faced within homes. There were two points that made and one was quite interesting. First was violence, the second was access to a phone or a mobile phone and therefore to information, entertainment, and so on. So how do you feel that these are very daunting challenges could be addressed from a policy framework, and maybe as you said the solution lies more in a disaggregated approach or a decentralised approach rather than a federal structure where you kind of push everything down?
You know everyone may not have a phone. While I do want to see the digital divide narrowing, everyone in India except the homeless have television, we have the Government's own channel Doordarshan where the quality has quite improved today. Gone are the days when we were growing up, and we saw those very boring programmes. I am quite impressed with the kind of things that are happening on Doordarshan. There are great anchors and all kinds of things are happening. So why could we not do the education of children. You choose Monday for class 2, Tuesday for class 3 and do some education which cuts across 3 years and 4 years. There are methodologies and so on. So television was a missed opportunity in terms of digital.
Then, why cannot we also use the cell phone for messaging on behaviour change and health education including on ending violence? You know, people do need to be reminded, I am sorry but again, I am not anti-men, but the way we have brought up our men is so bad that we need to help now to be less violent, be less patriarchal and they have the phone. So can we not send messaging, good messages, convincing and powerful.
India is home to the best film industry. The film industry came out in a big way to do fundraisers, and concerts and so on. Why could we not use this opportunity for messaging...they were all free. Our experience with some of the celebrities was they gave us more time in the lockdown than at any other time. So we could have used them to make short films with good messaging.
This was again, people are sitting at home, there are thousands of filmmakers. Forget the Bollywood industry. We were doing it in our own small way -- PFI is a small NGO. We made 700 short films and programmes for the MyGov website and for states across India. We who are not producers of great...production houses, why could we not ask, I mean if the Government can bully, but in this case request different channels to do their own programmes. People were tired of just hearing these experts. Great experts we have, health scientists, we needed people messaging, people to talk about these issues on effective ways to have compassion, kindness, as a treatment for COVID lockdown.
And you believe that approach will work to some extent. It is not going to solve the whole problem...but it can help?
It will not solve the whole problem, let me give you an example. 'Entertainment education' is the new mantra for changing social norms and behaviour across the world. Soul City in South Africa, for 20 years has had a programme which helped educate people. There was a perception in South Africa that half the young population will be wiped out because of risky sexual behaviour and HIV AIDS as a result. This sort of entertainment-education, we all take inspiration from Soul City for this type of programming. In 20 years, sexual behaviour is the most difficult behaviour to change, and they changed it.
In Brazil, the fertility rates came down from 6 per woman to 3 per woman in five years through entertainment education in favelas (low income settlements in Brazil).
In India we had this programme called Hum Rahi, Ashok Kumar did 25 years ago, and PFI did something called Mein Kuch Bhi Kar Sakti Hoon, directed by Feroz Abbas Khan.
When we evaluated it, we did not believe the impact. 8%, for instance, women said they plucked the courage after seeing 52 episodes, to negotiate contraceptives with husbands. And normally in India, in average patriarchal conservative household, which is most households, the women do not dare to discuss family planning and contraception with their husbands. After 20% men and women, after seeing 56 of our episodes, said it was not right to beat their partners or get beaten by their spouses. Now, this is huge. We had to get an international evaluator to India, to evaluate whether our evaluation was right. The impact was tremendous, believe me.
You know during COVID time, our feedback on our own behaviour change communication was that the impact was much bigger because the people were anxious, people wanted well being, and they were watching more TV than they normally did.
I am going to add one more thing. What has happened is that the power of communication--people have access to information. They know how the better half lives, so people are more ready for a change. It is not that we are making good programmes and that is the only reason people are changing. We have to bring out the aspirations of the people which have already changed. So we have to play with the aspirations to create a bigger change and that potential exists today more than ever.
As you look ahead, how do you see us coming together on this. I mean if gender is a critical area, and it is for IndiaSpend as well, it is one of the four areas that we focus on, how do you see us as a country coming together, or converging on bringing more awareness, and therefore an improvement in gender equality, gender lifestyle, and gender empowerment from a workforce point of view?
One is we have to invest more in behaviour change communication. And we have to understand the science and art and run with it. You know it is cost-effective when you do it at scale.
Number two, we have to understand that violence which is a huge problem, is not just a mental health issue, it has too many negative externalities and consequences. Violence must become a public health issue. It is not a public health issue now, today a doctor looks away when he realizes that a woman is being beaten even when he or she examines them. A child is sexually abused, a doctor looks away. And the public health system because violence is not a part of it. Both sexual and other forms of domestic violence should be part of the public health system.
Third, as I said, I have read some great articles that India Spend has done on budgets and we need to invest more money on public health. If pandemic has taught us one big lesson which is to strengthen your public health system and spend more money. We have to invest more in our public health system not just in terms of finances but in human resources and a very good management approach. We cannot have governance failures and now we realise that it is a life and death issue not just for the poor but the richer too.
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