Applying a gender lens to health policy in India

In India’s Karnataka state, girls and women face many barriers stemming from their low social status that are exacerbated by poverty and caste. Researchers with the Indian Institute of Management in Bangalore are exploring how power dynamics within households and communities affect women’s health outcomes. Using a gender framework to explore social norms is essential, says research leader Gita Sen.

“Why (would) a woman living with chronic pelvic inflammatory disease or severe back pain never go near a doctor? Is it because she has been socialized to believe that is the norm? Or when she finally does go to the health system she is treated so badly she never goes again?  Gender analysis lays these dynamics bare.”

The project features a series of studies of the underlying causes of maternal illness and death, where routine patterns of deprivation and abuse are often hidden. For example, a review of verbal autopsies – interviews conducted following  a death – suggested that oversights and bias may be masking the true causes of women’s deaths. While nearly two-thirds of pregnant women in Karnataka suffer from nutrition-related anemia – which increases pregnancy risks – such common underlying conditions were not recorded. And with verbal autopsies normally conducted by a single medical officer – often one involved in the patient’s treatment – health worker errors or failure to take action in emergency situations were underreported.

The team is working backwards from data on maternal deaths to identify the prevalence of violence and its consequences. And given the rates of undernourishment, teen pregnancy, anemia, and domestic abuse in the area, action research in 15 villages is testing interventions designed to help health workers address these potential risk factors much earlier than usual.

To ensure evidence informs health policy and practice, researchers are also working with state officials to improve maternal health services. They are creating village-level support groups and district-level advocacy for safe motherhood, and building overall awareness on maternal rights and safety. Lessons from these interventions are also being shared at the community, state, national, and international levels through existing platforms, including the Fostering Knowledge-Implementation Links Project, an effort commissioned by the Karnataka state government to strengthen the evidence base for public health.

Learn more about IDRC-supported research on maternal health