By Dr. Aarti Sahasranaman, Vice President – Interventions, ICTPH
As the primary caregivers within a family, and as members of the formal and informal health sector workforce, women play a pivotal role in providing healthcare. It is therefore somewhat paradoxical that health systems have tended to overlook the health needs of women. There are two broad issues with the provisioning of appropriate health services to women. First, there is the issue of accessibility of healthcare to women. In this case, accessibility is a reflection of not just physical proximity of health centres, but also factors such as cost, education, awareness, and cultural and social norms that act as barriers to women receiving healthcare. The second issue is the absence of comprehensive healthcare services to women. Consequently, even when services are available, their scope is very limited. For example, the Indian government’s National Health Policy, National Population Policy, and National Nutrition Policy all relate to women’s health only in terms of maternal and infant mortality rates, and nutritional supplementation of infants and pregnant women. As a result of this focus on the reproductive role of women, services such as antenatal care are much more likely to be in place at the primary care level than others, such as, say, cervical cancer screening and care. While this focus on maternal health is important to meet the Millennium Development Goals of reducing maternal and infant mortality, there are other pressing women’s health issues where opportunities to make a difference have been missed. Therefore, in order to effectively design programmes that are responsive to the health needs of women, it is imperative that health systems provide comprehensive and accessible care to women.
The ICTPH approach to health care provision is broad-based wherein a wide variety of services (both preventive and curative), including diagnostic tests, are provided to rural populations (Johar, 2010). The women’s health programme will incorporate both the preventive and curative aspects of health care. While the eventual goal is to have a comprehensive health package for women of all age and developmental groups, it will initially focus on reproductive tract health. Since the reproductive health of women has important repercussions for women and their families, this aspect of women’s health was chosen. In its current version, the women’s health package will screen all non-pregnant women aged 30 and above for cervical cancer using the visual inspection tests, VIA and VILI. Cervical screening will especially be encouraged for women who are asymptomatic. Additionally, symptomatic women will also be treated for reproductive tract infections (RTIs) such as candidiasis, trichomoniasis, vaginosis, chlamydia, gonorrhoea, syphilis, and chancroid. Treatment and management of these RTIs will follow guidelines laid down by the World Health Organization (WHO), and adapted by National AIDS Control Organization (NACO). Future iterations of the women’s health package will include nutritional supplementation aimed at different target groups such as adolescents, unmarried women, and pregnant women.
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