Last night, after arriving in Delhi, we were given the amazing opportunity to have dinner with Nandita Chopra, the NIH Representative in India. Ms. Chopra shared her story of working for NIH for the past decade and how she eventually made her way to India. It was extremely interesting to hear her side of working for a government organization and how she paved her career path through NIH to do something more fulfilling. With all that we are experiencing within both the private and public sectors of public health in India, it was refreshing to hear the personal side of working for a government organization.
Today we visited the India branch of Population Services International (PSI) and were introduced to their Women’s Health Initiative to reduce maternal and infant mortality in India. The program discussed involved providing IUD education and services to impoverished women throughout Delhi as well as medical abortion kits. The two objectives of this specific program were to increase the percentage of women with IUDs by 1% as well as provide 300,000 medical abortion kits via PSI trained pharmacists. Personally, the PSI presentation was one of the more interesting presentations and was very relevant for what we are learning in the public health program at GW. I was able to approach the subject objectively and critique specific aspects of PSI’s program.
There are significant cultural differences between Indian and American women and their ability to choose their own forms of birth control and family planning mechanisms. Men are the dominating forces within the family, which lead Indian women to have less control over their bodies and how many children they want. IUDs allow for women to choose not to have children without daily contraceptive use or the permanence of sterilization. PSI takes a door-to-door approach and sends out IPCs to meet with women on an individual level. They explain the concepts of family planning, how IUDs work, as well as the side effects of IUDs. Women that are interested in the idea give their contact information in order for IPCs to follow up and provide assistance. We were able to see the actual spreadsheet of women visited and the extensive record keeping of the IPCs when the group set out in the field locations… it also showed the large amount of young women that already have multiple children.
We visited one of the community health clinics where women come to receive medical services ranging from standard check-ups to childbirth. The doctor sat down with us in her office (which acted as a patient room as well) and went over the issues women face in regard to family planning and women’s health. It was fascinating to see firsthand the medical facilities and services available. Visiting the clinic really provided insight into the barriers faced by women in India as well as the huge cultural differences in women’s health.
The other aspect of the program involves training pharmacists how to properly explain and distribute PSI branded medical abortion kits. The fact that these medical abortion kits can be taken up to 2 months into a pregnancy without the assistance of a doctor didn’t settle well with me. I absolutely believe they should be available and provided by trained pharmacists but the lack of follow up after the abortion kit is distributed concerned me. The potential for emotional and mental health issues is extremely present and not addressed in this program. I would add some form of tracking aspect for the women receiving medical abortion kits and follow up as they do with the IUDs.
PSI is doing fantastic work within their Women’s Health Initiative through education and providing access to affordable modes of contraception that are not otherwise available to this population of women. It was a great opportunity to experience a public health initiative in the works and feel comfortable providing feedback for the program.
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