Women still Deal with Socio-Cultural Notions Regarding their Health; say Experts

Women, primarily those living in a metropolitan city like Mumbai, might seek nutrition advice from Neha, Ranglani, however, as Neha Ranglani, a Mumbai-based nutritionist and health coach, states, “Food comes last; first, it is important to understand their socio-cultural background.”

According to data from the World Health Organization, India has a maternal mortality rate of 174 deaths per 100,000 live births, which is significantly higher compared to other countries. This year, World Health Day focuses on the theme ‘maternal and newborn health’ – an area in which India lacks substantial discussion.

But why are discussions lagging, especially among women? According to Neha Ranglani, women are conditioned to see themselves as “nurturers” and “givers”. “Women fear that if they prioritise their health, their families will be neglected,” says Ranglani, 37, adding that with almost every female client of hers, she has to “break their regular patterns” (hinting that the pattern does not include prioritising one's health first) and understand their behaviour and backgrounds.

As Ranglani points out, there are women who say they cannot eat at 7 p.m. if their husbands come home at 9 p.m., highlighting the issues that women face, which often become hindrances to their health. “I once had an elderly lady tell me that even if she wakes up at 5 a.m., she cannot eat before 10 a.m. until she has worshipped God. There are a lot of social barriers attached to each woman,” Ranglani says.

Considering that “change” is the only way forward, Neha Ranglani’s consultations begin with clients filling out a form, where one of the most important questions is: “How ready are you to change?” “Women who are aware seek advice through YouTube and Instagram, which is not ideal,” says Ranglani, who is also going to talk about the similar issues at the ‘It’s A Girl Thing’ event in Mumbai the upcoming weekend. “Such events are important because the more rounds of conversation, the better the chances of raising awareness,” she adds.

Why is it deeply rooted?

The World Health Organization states that around 50 million women in India suffer from reproductive health problems, a number higher than the total population of some island nations like Luxembourg, Iceland, or Malta. While the health infrastructure plays a pivotal role, it is the social conditioning that holds women back, says Dr. Sarita Subramaniam. “It starts when girls are raised in environments where they have little agency in life, and it continues to grow,” says the 56-year-old.

From women in urban settings to underprivileged homemakers in both urban and rural areas, what unites them is the social mores that prevent them from prioritising their health. Dr. Subramaniam, the founder of the Earth Brigade Foundation, who recently distributed sanitary napkins to tribal menstruators in Matheran, a hill station near Mumbai, shares her observation: “Underprivileged women believe that they do not need or ‘deserve’ sanitary napkins because they don't step outside the home. Instead, they provide them to their daughters who are attending school.”

Before this, Dr. Subramaniam and her team had conducted a similar drive among the tribals living in Aarey Colony in Mumbai. She says, “There, I observed that the family’s monthly budget did not have any space for sanitary napkins or health-related products.”

She, who plans to conduct the same drive at Kanha National Park in June, explains that the sanitary napkins are distributed to the women guides, who, in turn, take them to their respective villages for further distribution. However, at a time when Indian society is moving towards menstrual cups, Dr. Subramaniam has similar plans. “There is another level of taboo that has to be overcome to implement it for women.”

Talking to Local Samosa, Dr. Subramaniam opines that the government and non-governmental agencies need to come together to move beyond the current awareness programmes and schemes to put women at the “forefront of their own health.” “We talk about ‘Beti Bachao, Beti Padhao,’ but what do we do for the dropouts whose primary reason is their health?” she asks in a scathing attack. Noting the lack of programmes that should start at the school level to make girls aware of the importance of their health, she mentions that the hesitance among women won’t go away unless an environment of equality is fostered.

Currently, anaemia affects around 50% of women of reproductive age in India, leading to complications during pregnancy and childbirth. Ayurveda practitioner Dr. Smita Naram, Co-Founder of Ayushakti, believes that women fail to prioritise their health due to deep-rooted social and systemic issues. With 60% of her patients being women, she views financial constraints as a major barrier to accessing services, forcing many to neglect their well-being.

Commenting on the reasons for this situation in India, Dr. Naram says, “Education plays a role, as it affects the understanding of health issues. Systemic gender discrimination also limits access to healthcare. Early marriage and childbirth in some regions can worsen health outcomes, and there is still so much stigma around discussing reproductive and mental health, preventing women from getting the help they need.” If nothing else, she laments, “Many women are just plain exhausted from juggling work and home, leading to sleep deprivation and increased health risks.”

Are the solutions achievable?

In a country already dealing with a lot of social stigma, as mentioned by the experts above, it might be challenging to tackle the problems and reach effective solutions. As per Dr. Naram, the country needs health education programmes specifically for women, focusing on practical knowledge about nutrition, hygiene, and preventive care. “Providing economic support can make healthcare more accessible, especially for those facing financial challenges, by organising free health camps, distributing sanitary napkins, and assisting them in understanding reproductive health, among other initiatives,” she adds.

However, Dr. Naram highlights the role of men in this process as a major contributor to the solutions. “It’s also incredibly important to involve men by encouraging them to share responsibilities at home so that women have more time for themselves,” she says.

As a matter of fact, India already deals with a crippled health infrastructure, which was recently put to the test during the COVID-19-induced pandemic. Beyond the infrastructure, budget allocation dedicated to these areas, schemes, and benefits, it is the shackles of the social structure that stand in the way of women accessing the healthcare they need and deserve — a necessity that might never be achieved unless these shackles are broken.