Af Lærke Levine, projekt- og formidlingspraktikant
29/09/2023
Dansk version længere nede
Since March 2022, Action Child Aid and Living Farms have worked to support the health and wellbeing of young women in rural Odisha through the project “Agents of Change – For empowerment and health.” Through a series of 19 Participatory Learning and Action (PLA) sessions, adolescent girls learn about and discuss topics such as the malnutrition cycle, personal and menstrual hygiene, child marriage, available government services for adolescents, and gender discrimination. The goal, here, is threefold: to improve the overall health of these adolescent women, to empower them to take action in their lives, and to convince local NGOs and state authorities to continue this work by adopting the PLA method.
Women from one of these groups, called “Kasturba Kishori Dala,” have previously been successful in receiving iron and folic acid supplements, as well as subsidised sanitary napkins through ongoing engagement with local authorities. More recently, we have received a second success story, where after attending PLA meetings and frequent discussions on government services, adolescent women from this same group have realised the importance of Village Health Nutrition Days as a platform for adolescent girls and have asked that a special VHND be held for them.
What is a VHND?
Village Health Nutrition Days are a government initiative and are typically held in villages at local ‘Anganwadi centres’ once each month – fostering connection between local healthcare professionals and the communities they serve. These sessions provide a space in which villagers can freely interact with healthcare personnel, as well as obtain access to basic healthcare services, learn about preventative care and available government services, and learn where to seek healthcare when needed1. VHNDs provide information and counselling in a number of areas, including sanitation, maternal and child health, communicable and chronic disease prevention, nutrition, and family planning. These events place special emphasis on healthcare for women and children and hold communication activities regarding child marriage and violence against women, among other topics.
Why a special VHND?
Though VHNDs are supposed to be held monthly, many villages do not organise them. Those that do often do not advertise them to young women, leading many to think that VHNDs are irrelevant for them – if they are even aware that they are being held. Furthermore, it can be difficult for some to join as the events are often held during work and school hours. Adolescent women and girls, who are often unable to join VHNDs for this reason, therefore miss out on the valuable information and services available to them. Additionally, many of the girls have mentioned that they understood VHNDs as events only for women and small children. This has since changed, due in part to the PLA sessions on available services for adolescents, though primarily because of the initiative taken by the women of Kasturba Kishori Dala.
What has changed?
After participating in 10 PLA sessions with Living Farms, this group of young women learned about the importance of participation in VHND and decided to implement a plan to have a special VHND held on a holiday so that they could join. This began with a visit to the local municipality office, where the women spoke to their local representative about their wishes. From here, they were directed to meet with the medical officer responsible for their district. Following a written application and two meetings, the women were assured that a special VHND would be organised for all of the villages in the district. Now, groups of adolescent girls and women from other villages have been inspired to do the same – to make use of the services available to them. In the words of our partner Living Farms, “now [these women] are unstoppable.”
Dansk version af artiklen
Adgang til lokale services: en succeshistorie fra ACEH
Siden marts 2022 har Aktion Børnehjælp og Living Farms samarbejdet om at støtte unge kvinders sundhed og velfærd i landsbyerne i Odisha gennem projektet “Unge Kvinder – Fælles Handling.” Gennem 19 PLA-sessioner (Participatory Learning and Action) lærer unge piger om og diskuterer emner som underernæring, personlig hygiejne og menstruationshygiejne, børneægteskaber, tilgængelige offentlige ordninger for unge og kønsdiskrimination. Målet er trefoldigt: at forbedre disse unge kvinders generelle sundhed, at give dem mulighed for at handle i deres liv og at overbevise lokale NGO’er og statslige myndigheder om at fortsætte dette arbejde ved at indføre PLA-metoden.
Kvinder fra en af disse grupper, kaldet “Kasturba Kishori Dala”, har tidligere haft succes med at få tildelt jern- og folinsyretilskud samt subsidierede menstruationsbind gennem løbende samarbejde med de lokale myndigheder. For nylig har vi modtaget en anden succeshistorie, hvor unge kvinder fra den samme gruppe på baggrund af deltagelse i PLA-møder og hyppige diskussioner om offentlige tilbud har indset vigtigheden af Village Health Nutrition Days (VHND)som en platform for unge piger og har bedt om, at der bliver afholdt en særlig VHND for dem.
Hvad er en VHND?
Village Health Nutrition Days er et regeringsinitiativ, der typisk afholdes i landsbyer på lokale ‘Anganwadi-centre’ en gang om måneden, og som styrker forbindelsen mellem det lokale sundhedspersonale og de landsbyer, de arbejder for. Her kan landsbyboerne tale frit med sundhedspersonalet og få adgang til basale sundhedsydelser, lære om forebyggende pleje og tilgængelige offentlige tilbud og få at vide, hvor de kan søge lægehjælp, når de har brug for det. VHND’er tilbyder information og rådgivning inden for en række områder, herunder sanitet, mødres og børns sundhed, forebyggelse af smitsomme og kroniske sygdomme, ernæring og familieplanlægning. Disse arrangementer lægger særlig vægt på kvinders og børns sundhed og har kommunikationsaktiviteter om bl.a. børneægteskaber og vold mod kvinder.
Hvorfor en særlig VHND?
Selvom det er meningen, at VHND’er afholdes hver måned, er der mange landsbyer, der ikke får dem afholdt. Dem der gør, informerer ofte ikke unge kvinder om dem, hvilket får mange til at tro, at VHND’er er irrelevant for dem – hvis de overhovedet er klar over, at de bliver afholdt. Desuden kan det være svært for nogle at deltage, da arrangementerne ofte finder sted i arbejds- og skoletiden. Unge kvinder og piger, der ofte ikke kan deltage i VHND’er af denne grund, går derfor glip af vigtige information og services, der er tilgængelige for dem. Derudover har mange af pigerne nævnt, at de opfattede VHND’er som arrangementer kun for kvinder og børn. Dette har siden ændret sig, til dels på grund af PLA-sessionerne om tilgængelige tjenester for unge, men primært på grund af det initiativ, der blev påtaget af de unge kvinder i Kasturba Kishori Dala.
Hvad har ændret sig?
Efter at have deltaget i 10 PLA-sessioner med Living Farms blev denne gruppe unge kvinder klar over, hvor vigtigt det er at deltage i VHND, og derfor besluttede de, at implementere en plan om at afholde en særlig VHND på en helligdag, så de kunne deltage. Det begyndte med et besøg på det lokale kommunekontor, hvor kvinderne talte med deres lokale repræsentant om deres ønsker. Herfra blev de henvist til at mødes med den distriktsansvarlige ‘medical officer’. Efter en skriftlig ansøgning og to møder fik kvinderne bekræftet, at der ville blive arrangeret en særlig VHND for alle landsbyerne i distriktet. Nu er grupper af unge piger og kvinder fra andre landsbyer blevet inspireret til at gøre det samme – at gøre brug af de services, der er tilgængelige for dem. Med vores partner Living Farms’ ord: “Nu er [disse kvinder] ustoppelige.”