Gender dynamics affecting maternal health services and care

• Maternal health interventions have been successful in increasing access to and utilization of maternal health services, however, failure to address underlying gender dynamics limits the sustainability of benefits generated.
• Gender power relations can be understood by how power is constituted and negotiated to: access to resources, division of labour, social norms, and decision-making, the intersection of which was found to affect maternal healthcare access and utilization.
• In order to address gendered inequities affecting women’s lack of maternal health care access and utilization, interventions are needed that challenge unequal gender roles and relations that perpetuate inequities in maternal health access and utilization.

Research has shown that gender inequities have a negative effect on maternal health and maternal healthcare access and utilization in multiple ways. On the demand side, gender divisions of labour, lack of access to and control over resources (e.g. finances, information, transport, supplies), gender norms, limited autonomy, and lack of decision-making power limit women’s ability to access maternal health care services. On the supply side, societal patterns of gender discrimination are often reflected within maternal health service delivery. For example, the lack of ‘women-centred’ services, such as family planning or abortion, maternal health services being treated as ‘women-only’ spaces, and the mistreatment of women and men by health providers are all manifestations of gender discrimination. In addition, the intersection of gender with other social stratifiers, such as age, race, class, ethnicity, geography, (dis)ability and sexuality compounds the effect of gender inequities on maternal health and health care for vulnerable and marginalized women, such as poor women in rural areas. Finally, men affect women’s access to prenatal care and women’s obstetric outcomes in their roles as partners, neighbours, community leaders, and health providers due to their control over household resources and decision-making. However, progress towards engaging men in maternal and child health has been slow, despite their key decision-making roles in maternal and newborn care-seeking behaviour and family planning.

Integrating gender into maternal and child health interventions has been found to positively affect intervention outcomes. A review of gender-integrated interventions in reproductive and maternal-child health, for example, found that while the effects of integrating gender into interventions were mixed, overall the studies suggested that addressing social and structural factors within maternal and child health interventions, such as gender norms and inequalities, is beneficial for effective intervention outcomes. In particular, out of 23 interventions, those which incorporated empowerment approaches, for example, by "empower[ing] women to take actions to address health issues, […] empower[ing] adolescents and their families and chang[ing] community norms around child marriage", had the strongest evidence in support of integrating gender into maternal and child health interventions.

While maternal health interventions have been successful in increasing access to and utilization of maternal health services, failure to address underlying gender dynamics limits the sustainability of benefits generated. More needs to be done if the root causes of barriers to maternal health access and utilization are to be effectively addressed. The community discussions reveal important gender dynamics affecting maternal health access and utilization. These have laid the foundation for future interventions to address gendered power relations within intervention design, implementation, and evaluation. Gender aware interventions, particularly those which are gender transformative, are needed if access to and use of maternal health care is to be improved in the long-term.

Nutrition Education

 Nutrition education is a critical component of public health initiatives, especially in regions like Odisha where malnutrition remains a challenge. Here are some key aspects of nutrition education that can be implemented in Odisha:

1. Community-Based Programs: Engaging local communities through workshops and interactive sessions to educate them about the importance of nutrition and healthy eating practices.

2. School Curriculum: Integrating nutrition education into the school curriculum to teach children about balanced diets, the importance of various nutrients, and healthy eating habits from a young age.

3. Training Health Workers: Providing training to health workers and Anganwadi workers on nutrition so they can effectively communicate this information to the communities they serve.

4. Mass Media Campaigns: Utilizing television, radio, and social media to spread awareness about nutrition and address common myths and misconceptions.

5. Collaboration with Local Organizations: Partnering with local NGOs and government programs that focus on nutrition to create a more cohesive and widespread education effort.

6. Monitoring and Evaluation: Establishing systems to monitor the impact of nutrition education programs and make data-driven decisions to improve them.

Addressing the high prevalence of anaemia in Odisha

 Addressing the high prevalence of anaemia in Odisha requires a multi-faceted approach that involves both government initiatives and community engagement. Here are some strategies that can be effective:

1. Supplementation Programs: Strengthening iron and folic acid supplementation among targeted groups, especially women of reproductive age, adolescents, and pregnant women, is crucial¹².

2. Testing and Treatment: Regular testing for haemoglobin levels to identify anaemic cases early and providing appropriate treatment is essential¹².

3. Capacity Building: Training service providers, such as frontline health workers (ASHAs, ANMs), to effectively manage anaemia cases and promote iron supplement use³.

4. Behavior Change Communication: Implementing social behavior change communication through information, education, and communication activities to address misconceptions and encourage healthy practices¹².

5. Nutrition Education: Educating the population about the importance of a balanced diet rich in iron, such as green leafy vegetables, legumes, nuts, and seeds.

6. Addressing Root Causes: Tackling the underlying causes of anaemia, including malnutrition, parasitic infections, and poor sanitation.

7. Programs like Amlan: The Odisha government has launched the ‘Amlan’ program, which encompasses many of these interventions to reduce anaemia across the state¹².

For more detailed strategies and interventions, you can refer to the research article on BMC Public Health and news articles from Times of India and OrissaPOST that discuss the efforts being made to combat anaemia in Odisha. These resources provide insights into the multi-level strategies being implemented to address this public health challenge.

Gender stereotypes and its impact on health

Gender stereotypes, which are oversimplified and generalized beliefs about how members of a certain gender should behave or what traits they should have, can have significant effects on health. Here are some ways in which gender stereotypes can impact health:

• Mental Health: Gender stereotypes can lead to psychological stress and mental health issues. For example, men may feel pressured to suppress emotions, leading to increased stress and potential mental health problems. Women may face stereotypes that limit their perceived capabilities, leading to lower self-esteem and confidence.
• Behavioral Health: Stereotypes can influence health behaviors, such as discouraging men from seeking help for health issues or encouraging risky behaviors to conform to ‘masculine’ ideals.
• Healthcare Access: Stereotypes can affect the quality of healthcare individuals receive. For instance, healthcare providers may have biases based on gender stereotypes that impact their treatment decisions.
• Occupational Health: Gender stereotypes can influence job opportunities and work environments, potentially leading to occupational stress and related health issues.
• Social Determinants of Health: Stereotypes contribute to social determinants of health by shaping societal structures and norms that can lead to unequal access to resources, education, and power, all of which are critical for health.

Combating these stereotypes involves raising awareness, promoting gender equality, and encouraging inclusive behaviors that allow individuals to express themselves freely without the constraints of traditional gender roles. For more detailed information, you can refer to resources provided by health organizations such as the World Health Organization and articles like those found on Verywell Health, which offer comprehensive insights into the development and effects of gender stereotypes on health.