Sunday December 17, 2017

Dreary state of Maternal Health Care in Jharkhand

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By Prachi Salve

New Delhi: This week, as Prime Minister Narendra Modi announced – quoting the World Health Organisation (WHO) – that India was free of maternal and neo-natal tetanus, the state of maternal health in the eastern state of Jharkhand indicates the long road still ahead in the country’s dark spots.

Women_at_farmers_rally,_Bhopal,_India,_Nov_2005
Modi was speaking at the just-concluded 24-nation Call to Action Summit, which discussed how to end preventable maternal and infant deaths, particularly in high-risk areas globally, including Jharkhand.

Since its birth in March 2000, Jharkhand has seen its maternal mortality ratio (MMR), or maternal deaths per 100,000 live births, improve from 261 in 2007-09 to 219 in 2011-12 due to improved access to healthcare.

But this is 41 points higher than the national MMR average of 178 in 2011-12, worse than Myanmar and Nepal and about the same as Laos and Papua and New Guinea, according to WHO data.

Jharkhand is a part of a group of eight poor states, called the empowered action group (EAG), which includes Bihar, Chhattisgarh, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh. The EAG was formed by the central government following the 2001 Census to contain the population explosion in these states.

The real maternal and infant-health problems in Jharkhand are revealed when we compare the state’s health indicators with other EAG states, such as Chhattisgarh and Bihar.

Jharkhand does not fare well on any of the nine key indicators including government schemes, such as the Janani Suraksha Yojana (Mothers’ Protection Programme).

The JSY is fully sponsored by the central government and provides cash incentives, including out-of-pocket expenditure incurred by pregnant women: Rs 1,400 for rural women and Rs 1,000 for urban women.

Jharkhand has the lowest ante-natal care coverage with only 60 percentof women receiving such facilities. Compare that to Bihar with 85.4 percent and Chhattisgarh with 91.8 percent.

Mothers who opted for institutional deliveries in Jharkhand were also low at 23.6 percent, compared to 39.5 percent and 29.2 percent in Bihar and Chhattisgarh, respectively. The women who do use state-run health institutions receive poor quality care.

Seen from the view of those who provide healthcare, they work at substandard facilities and there are too few of them.

The gulf between targets and reality in India’s dark areas

At the Call To Action Summit, Prime Minister Modi talked about how India had achieved 75 percent institutional deliveries nationwide, a significant factor in improving maternal and infant healthcare.

But as Video Volunteers’ ground reports reveal, absolute numbers are not enough: The quality of healthcare is an important draw for women in remote, rural areas. If infrastructure is crumbling, centres lack medical staff and patients must pay out of their pockets-apart from being treated badly-they are unlikely to use institutions.

The idea behind the JSY is to encourage women to deliver babies at health facilities by making these services free and available, especially in rural areas.

Of Jharkhand’s 24 districts, there is a significant urban bias among the bottom five districts, based on maternal-health indicators.

In general, mothers in urban areas received better maternal care in Jharkhand, including facilities under JSY, emphasising the point that poor facilities attract fewer women.

(IANS/IndiaSpend)

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Women can Boost their Working Memory with Hormone Therapy

Benefits of oestrogen therapy in women.

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oestrogen therapy can increase working memory under stress
oestrogen therapy can increase working memory under stress. wikimedia commons

New York, Nov 5: Undergoing a type of hormone replacement therapy — used for menopausal treatment — may help protect as well as improve working memory for some women as they age, according to a new study.

Hormone replacement therapy uses female hormones – oestrogen and progesterone – to treat common symptoms of menopause and ageing.

The findings showed that women taking oestrogen-only therapy had lower levels of the stress hormone cortisol and performed better on tests of “working memory” following exposure to stress compared to women taking a placebo.

“Our study suggests that oestrogen treatment after menopause protects the memory that is needed for short-term cognitive tasks from the effects of stress,” said lead author Alexandra Ycaza Herrera, a researcher at the University of Southern California – Davis.

To measure the effect of oestrogen therapy on working memory under stress, the team recruited 42 women with an average age of 66.

Half of the postmenopausal women had been on estradiol — a type of oestrogen therapy — for approximately five years, while the others had received a placebo.

The researchers, in the paper published in the Journal of Clinical Endocrinology and Metabolism, collected saliva to measure the women’s levels of cortisol, oestrogen, and progesterone.

They also ran a test of working memory called a “sentence span task”, in which the women were each given a series and then asked whether each sentence made sense. They also were asked to recall the last word of each one.

While women receiving oestrogen therapy had a smaller increase in cortisol and showed no decrease in working memory function, even after being exposed to stressful situation, those taking the placebo experienced a spike in cortisol levels as well as demonstrated a decrease in working memory function.

Previous studies have pointed to potential health risks — the Ahigher risk of breast cancer, heart disease, stroke and blood clots — of the treatment.

Thus, Herrera noted that “hormone replacement therapy may not be right for every woman, but women need to be able to have the conversation with their doctors”.(IANS)

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Drop-dead (to become) Gorgeous? How Social Media Corrupts our Definition of Body Image

Researchers believe that social media platforms like Twitter, Facebook and Instagram are even more harmful than stipulated websites in support of anorexia due to the increased accessibility and wider target audience of as these mediums.

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Anorexia is not photogenic. Instagram

New Delhi, November 1, 2017 : I have grown up as a conscious kid; hours spent looking at pictures of strangers with perfectly toned bodies have been like an everyday ritual, carried out religiously, day after day. But thankfully, my fascination for the ‘ideal’ body that ruled the internet never materialized and it was not long before I became happy in my own skin.

Years later, I look at my 12 year old sister, who wishes to consume only watermelon juice because that’s what her favorite blogger does too, to maintain her fit body. She is my teenage sister’s ‘#fitspo’, she proudly announces.

Just a young teenager, where is she getting all this information from, you’d wonder.

The answers is; everywhere!

We are all chasing unrealistic expectations when it comes to our body image, courtesy the enormous content we consume over different social media.

Social media has completely radicalized the way we see body image- ourselves and other people, and transformed the way we interact with the larger society.

If analyzed duly,
aren’t we all seeking validation
on the internet at the
expense of a ‘like’?

You can never be sure which side you will be on – messages on social media can spread self-hatred, animosity, encouragement, joy and a myriad of other emotions. It is like this that movements have created not just ripples but waves on the social media; some positive while others more damaging than we are prepared to handle.

People are constantly being bombarded with pictures of the body image that is ‘goals’, the ‘ideal’ body; photos and videos of people dieting and exercise have become a part of mainstream generation, so much so that the hashtag fitspo is one of the most used hashtag of the present times.

This increased proliferation of the ‘ideal’ body image often has people comparing themselves to images of strangers and people online, hoping to be more like them.

We are at a phase of life when
images of strangers’ bodies and lifestyles not only affect but govern our lives-
in ways that may be far beyond
our expectations.

According to a study published in October, it was revealed that an increasing number of people are celebrating extreme thinness on various social media accounts. The research, carried out by researchers at University of Exeter, shed light on the hundreds of users, especially women, who were praising anorexic bodies on Twitter and Instagram under the umbrella term ‘thinspiration’.

The Research

Researchers analyzed 734 images that were posted on Twitter, Instagram and We Heart It with indicative hashtags- #thinspiration, #bonespiration and #fitspiration.

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An anorexic model. Pixabay

 

The images that came under the scanner were selfies taken by girls, boasting about their withered bodies by highlighting their protruding collar bones, spine, rib cage and hip bones.

It was revealed that an alarming amount of content online is dedicated to glorifying such shrunken bodies, plagued by eating disorders.

Shockingly, the researchers found that every shared image was complimented alongside proud captions boasting about the calories they had consumed that day, or how they ‘totally rock a thigh gap’.

 

 

The Instagram Effect

I remember being in school when the entire ruckus about a thigh-gap gained momentum. After almost 5 years, I am a 22 year-old adult now, and the world continues to rave about the thigh-gap.

Different eating orders, even umbrella terms like “Pro-Ana” and “Pro-Mia” that were essentially aimed at promoting anorexia and bulimia as an ideal lifestyle choice, are not new. However, the only difference is the dangerously new breeding platform that social media has provided to these hazardous body image campaigns.

Researchers are convinced that social media platforms like Twitter, Facebook and Instagram are even more harmful than stipulated websites in support of anorexia due to the increased accessibility and wider target audience of as these mediums.

Not very surprisingly, the Bonespiration movement has now become rampant – easily accessible with hashtags like needtobethin, thinspiration, fitspo, etc, pro-eating disorder and a specifically shrunken body image content drive this campaign on almost all social media platforms.

According to Claire Mysko, spokesperson for the National Eating Disorders Association, “Thinspiration is content that promotes weight loss but often in a way that actively glorifies eating disordered behavior and thoughts.”

#Thinspo and #Fitspo And Eating Disorders

#Thinspo :  The thinspiration or the thinspo movement has an enormous presence with almost all bloggers and models using it as a hashtag in their posts. Although thinspo does not categorically promote eating disorders, it is dominated by images of unrealistically (and dangerously) thin women (and sometimes men), who portray themselves as the ideal body image; an inspiration for people to lose enormous amounts of weight.

#Fitspo : The fitspiration, or fitspo hashtag initially emerged as a counter movement to thinspo by promoting healthy eating and working out culture but it is popularly believed that the movement makes use of equally unrealistic and hence dangerous imagery.

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Fitspo can loosely translate to being obsessed with healthy eating and working out. Pixabay

These extreme behaviors foster unhealthy expectations in the minds of individuals who then begin to seek impossible results from their diets and exercise plans to look like the ‘ideal’ bodies that rule the internet.

Various researches are known to have noted that constant exposure to such content psychologically affects users.

According to another study published in January by researchers at University of Adelaide (Australia), it was found that women posting ‘fitspiration’ posts on Instagram are at a greater risk of suffering from eating disorders.

Additionally, anorexia nervosa reports nearly 10 per cent mortality rate, thus being the most dangerous psychological disorder. People who do not die from anorexia can still suffer health effects like loss of bone mass, damage to heart, and withered immune system.

In 2012, Instagram had banned the use of five hashtags “thinspiration”, “imugly”,  “anorexia”, “proana”, and “thighgap”.

However, that did little to no help as propagators of these body image hashtag trends look for alternate spellings or combinations of words that are close to the original and can convey similar meanings. You would be surprised to know that despite the ban, there continue to be more than 1,44,000 posts tagged #bonespo on Instagram to date.

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Notice the variations in spelling, following the ban of the hashtag thinspiration. Instagram

Is There No End?

Social media has garnered a lot of criticism for such gregarious body image content that propagates unhealthy behaviors and attitudes, because of which some social media sites have updated their guidelines and instructed users to strictly not post content promoting self-harm in any manner, doing which can lead to dismissal of their accounts. However, how practical is it to monitor the billions of posts that are shared on a daily basis?

While several hashtags like #pro-ana or #pro-mia have been banned by social media vigilantes, several users continue to post #thinspiration content with new hashtags that haven’t been recognized by the social media police.

Certainly, this has emerged as an online epidemic, now beyond the realm and control of social media.

Approach to Recovery

Every coin as a flip side.

Social media platforms also combine pro-recovery groups that make use of hashtags that people seeking a way out search for.

“It is like an intervention”.

– Claire Mysko,
                     director of programs,
the National Eating Disorder Association (NEDA), USA

Individuals seeking recovery from an unhealthy lifestyle or anorexia can connect with people who have been affected by similar notions of an unhealthy body image and eating disorders and receive comments of encouragement from all over the world – the warmth and the support are literally like getting a virtual hug.

Instagram has also now installed a filter that offers support every time a user searcher for similar dangerous words like anorexia.

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Support filter on Instagram. Instagram

~  NewsGram supports all things healthy.  

We urge you to go online and have a look yourself at all the ‘thinspiration’ posts. They tend to glamorize anorexia and promote frail models and starvation, ignoring their health and well being.

Anorexia is not photogenic.

Anorexia is not glamorous. Not from the outside, definitely not from the inside.

 

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India’s pink army: Bringing healthcare to doorsteps of deprived

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In a country where quality healthcare remains a privilege of the rich and influential, a silent army of women, clad in pink sarees, work tirelessly and selflessly to make basic healthcare facilities accessible to those who live on the margins of the growing Indian economy, particularly in the country’s vast rural hinterland.

Barely getting time to sleep as calls for help keep coming round the clock, this pink army — as they are popularly known — is the backbone of the primary healthcare in India’s 600,000 villages, providing a connect between the community and the inadequate public health system. These are the trained female community health activists — called Accredited Social Health Activists (ASHA) — under the National Rural Health Mission (NRHM) of the Indian government.

Instrumental in bringing down the infant mortality rate from over 50 deaths per 1,000 live births in 2005 (when ASHA was launched) to 34 deaths in 2016, these women provide information to people in rural areas about health, sanitation and nutrition; conduct ante-natal and post-natal checkups; assist women during their deliveries, deliver polio vaccines and conduct health surveys.

With many of them mothers themselves, they often take along their children to the clinics at unearthly hours because they can’t leave them behind at home.

Clad in the trademark pink saree, her work uniform, state health worker Godavari Anil Rathore, 23, a resident of Kalaburgi, Karnataka, about 623 km north of state capital Bengaluru, is one of the youngest employed as an ASHA.

“When I was a kid, I remember how my aunt had a baby and lost it just within two months. The baby had contracted malaria after she was born, and my aunt couldn’t bear the pain,” Rathore told IANS.

“It’s an unimaginable pain not to be able to save your own baby, which is one of the reasons why I decided I should help women,” she said.

Rathore has helped over 100 women in her district in delivering healthy babies over the last three years that she has been working as an ASHA.

“It makes me extremely happy looking at women living in the remotest parts of the country with not much money to focus on their health giving birth to healthy children.

“Even though it means that we work an average of 12 hours each day, taking health surveys, carrying out polio drives, assisting pregnant women from the district I live in — right from medical checkups during pregnancy, to the delivery, then getting the baby all the vaccinations, and in the end receiving only about Rs 1,500 for a month.”

Rathore said that every woman she works with “becomes family to me, even if they need me at 3 a. m., I’m there.”

For many Indian villages where hospitals aren’t accessible easily, 860,000 ASHAs across the country (according to the Ministry of Health and Family Welfare, 2014) are the only ray of hope in providing medical assistance to thousands of people, and have been working extensively on eliminating polio and malnutrition among infants.

Making sacrifices every day to build a healthier society, these women find it hard to even make ends meet, earning a paltry sum for their services. Over 15,000 ASHAs from Karnataka staged a protest last month at Freedom Park in the heart of the city for a better remuneration from the state so that they could live with dignity.

Rathore, like many other ASHAs, barely sleeps, as calls for help keep coming in from pregnant women round the clock, after a long day of delivering polio vaccines or conducting health surveys. Many a time, she can’t leave her two-year-old girl, Lakshmi, behind at home and takes her along.

“Sometimes, I feel I’m raising my child within clinics with my husband not being at home all the time. But I am glad she’s growing up learning to be empathetic, knowing that as humans we must be able to help one another without any hesitation,” said Rathore with a smile.

ASHAs take pride that they’ve managed to get their communities talking about health and hygiene.

“We are overwhelmed to see people in villages pay attention to sanitation and building their toilets and purifying their water, which they earlier didn’t care much for. These are very important when we talk about health,” Rathore explained.

With every right to quit their difficult job, the women say they continue on because the power to be a part of the birth of a healthy life is unparalleled.

Geetha B, 31, from Ballari district, has been an ASHA for nine years now. A mother of two boys, she takes the responsibility of overseeing the health needs of over 1,500 people in Hariginadone village in Ballari district seriously.

“My vision is always towards making the village a better place. I would have assisted at least 300 women in these nine years in their pregnancies and now I see the kids going to school within the village, children I would have helped while growing up to be healthy. It fills me with happiness each time.”

“Pregnancy comes with a hope for every family. Our job satisfaction comes from seeing their dreams come true, in helping India’s next generation grow up healthy.”

A mother of five children, 35-year-old Nagomi K. from Raichur district, about 400 km to the north of Bengaluru, has seen ASHAs help in transforming the villages in the district over the past 12 years that they have been working.

“In many villages, the women are blamed if something happens to the baby. They have to live with guilt that it was their fault that the baby was born prematurely,” Nagomi told IANS.

With their constant visits to the villagers’ homes for checkups, men also tend to learn from them about their wives’ health, which doesn’t happen in healthcare centres, where the men are just asked to wait in the waiting rooms, she said.

“Even though many don’t recognise the work we do, we are trying to act as bridges involving both man and a woman when it comes to a pregnancy, and having villagers lead better lives in general with better health.”

“A lot of times I assist women who cannot even afford a strip of medicine. That’s when I give them whatever money I have so that the health of the community is never compromised,” Nagomi said.

As Karnataka State ASHA Workers’ Association Secretary D. Nagalakshmi puts it, “These women are the lifelines for our country in letting those who cannot access medical help get every kind of support. They must be credited with raising a majority of India’s next generation.”

Each of the 37,000 ASHAs in Karnataka are working despite severe hardships and have some moving stories to tell, but they don’t hesitate to make any sacrifice in building a healthier country, she said.

India ranks 131 among 188 countries on the Human Development Index (HDI) 2016 released by the United Nations Development Programme (UNDP). India was placed behind countries like Gabon (109), Egypt (111), Indonesia (113), South Africa (119) and Iraq (121) among others. The government is working towards improving this rating by creating competition between states to perform better on key social indicators like infant mortality rate, maternal mortality rate and life expectancy.

(This feature is part of a special series that seeks to bring unique and extraordinary stories of ordinary people, groups and communities from across a diverse, plural and inclusive India and has been made possible by a collaboration between IANS and the Frank Islam Foundation. (IANS) Bhavana Akella can be contacted at bhavana.a@ians.in) By Bhavana Akella