From facing a to bearing the women continue to be disproportionately affected by the COVID-19 pandemic. Their exodus from the workforce has also affected their professional and financial goals. Research by the Public Health Foundation of India has shown that financial insecurity plays a key factor in hindering women’s access to adequate healthcare. The rampage of the pandemic has only accelerated these challenges to the already precarious Indian healthcare and nutrition security.
Doctors observed a significant rise in the number of pregnant women testing positive during the second wave of COVID-19. A study by the Centre for Disease Control revealed that changes in pregnancy such as increased heart rate and oxygen consumption and decreased lung capacity make pregnant women more vulnerable to the virus. Apart from coronavirus infections, health programs established by the government to support women during pregnancies have also taken a hit during the pandemic.
Adverse impact on nutritional indicators
Dr Sylvia Karpagam, a public health doctor and researcher shares how the Mathru Poorna scheme in Karnataka — launched to meet the nutritional needs of pregnant and lactating women in rural areas — has been interrupted. Under this scheme, the women would be provided with one meal a day for 20 days in a month which would meet 40-45% of their daily calorie, protein and calcium requirement. Iron Folic Acid (IFA) tablets would also be administered and gestational weight monitoring would be conducted for pregnant women. “Usually it's the ASHA workers who provide these iron and folic acid tablets, but the whole program has been disrupted now because they are occupied with COVID-related work,” says Karpagam.
The government-mandated lockdowns and restrictions have further affected the supply of food materials, resulting in widespread food insecurity in a population that is already battling increased unemployment rates. “Ever since the outbreak of coronavirus, rations have been erratic and the Integrated Child Development Services (ICDS), midday meals, pensions have all shut down,” Karpagam says.
She notes that nutrition programs like the midday meal scheme have deprived several children of their right to food since the onset of the pandemic. “Midday meals are a legal mandate, but now it has stopped,” she says. She shares that a public interest litigation (PIL) was filed to which the Karnataka High Court responded by ordering the midday meals to be resumed. “But if you go to the rural areas, it’s clear tokenism, people are given half a glass of rice and half a glass of dal,” she remarks. This further exacerbates the already large inequalities in food security.
Chaos-riddled public health crisis
There has been an increased hesitancy among women in rural areas to visit hospitals for their regular check-ups amid the pandemic, observes Dr Mahima Bakshi, a woman and child wellness expert. With limited healthcare centres in rural areas that are already overwhelmed by the tsunami of COVID-19 cases, pregnant women fear exposing themselves to the virus during their visits. “The monitoring of high-risk pregnancies or routine scans are also not happening because public transport is shut down and additional health workers have not been brought in to meet the added needs during the pandemic,” Karpagam adds.
Bakshi too, points out possible disruptions in the availing of aid under the Pradhan Mantri Matru Vandana Yojana. Under this scheme, a cash incentive of Rs 5,000 would be provided directly to the account of pregnant women and lactating mothers for the first living child of the family, and disbursed in three installments. But, a pregnant woman first needs to register her pregnancy at the nearest Anganwadi center along with required documents to avail this benefit. However, across states, Anganwadis have mostly been closed due to lockdowns, thereby keeping women from receiving urgent financial assistance.
“They are also supposed to get money as part of the Janani Suraksha Scheme but that’s not happening because the whole health system has been swamped by COVID-19 cases,” Karpagam notes. This safe motherhood intervention is focused on states like Uttar Pradesh and Bihar that have a low institutional delivery rate. Under this, cash assistance is disbursed to the mother to meet the cost of delivery at health institutions. “People aren’t even able to go for routine deliveries or even in the cases of complicated deliveries,” she says.
“We were already in a huge crisis and I think the pandemic is going to blow it out of proportion,” remarks Karpagam. She says that the response in a situation like this has not been adequate to bridge the glaring gaps in essential health and nutrition services that have only widened during the COVID-19 pandemic.
(Edited by Amrita Ghosh)