Jagrutha Mahila Sanghatan (JMS) is a rural Dalit women agricultural laborers’s collective in the district of Raichur, Karnataka. The leadership is entirely of Dalit (Indigenous) women. The campaign is wholly led by women.
Health rights issue has been particularly marginalized in the social movements’ domain and health issues continue to remain within the techno- bureaucratic stranglehold of experts, researchers and the like. Health NGOs which have been in the forefront of policy making have been gate-keeping this issue and infanticising communities on the pretext that “communities do not understand the larger political issues of health care policy”. The campaign led by JMS women is counter-narrative against the NGOised, apolitical practices and processes of NGOised approach to health rights while simultaneously striving to hold the governments of the day accountable. JMS work and practice in the context of the present Campaign therefore provides insights for health activism in general and for community led practices in health rights realization in particular.
The JMS campaign provided an insight into what goes into the making of a marginalized women-led health rights initiative. Their capacity was built through workshops, discussions, and other participatory processes. A pictorial tool developed not only helped them understand their entitlements, but also allowed them to lead the communities with the power of knowledge, and their collective power allowed them take the feedback and demand to the policy spaces. The maternal health rights campaign that was woven around the processes of this community based evidence for maternal health rights of Dalit women, focused primarily on two key dimensions: one, empowered community leadership and two, claiming and accessing spaces of policies for community feed back and improvement of the overall health system.
The advocacy processes and capturing policy spaces:
- Primary Health Centres: The five public health dialogues at the PHCs brought them face to face with the medical officers heading PHCs and key health providers.
- District Convention: The district convention that was organized in the mode of a open – public hearing, at one of the block headquarters (Manvi) had quite distinct features. Two of the state legislators (elected representatives) heard them for over three hours. The district health officer (DHO), the highest health authority of the district too was present to hear the feedback of health services, the gaps, violations experienced by women (such as not providing medicines, undue prescriptions to private medical stores, absenteeism of the health staff), abuse, neglect and discrimination experienced by women etc.
- Face to face dialogue with Block health authorities: The Taluka Health Officer (THO) is the block health authorities below the DHO. In both the talukas (Manvi and Sindhanur), the JMS women leaders had a detailed and point-to-point discussion on the memorandum of demands that they submitted which included improvement of services in the PHCs.
- Press conference: JMS leaders, though are neo-literates, along with other allied social organisations in the district, held a press conference to brief the media on the state of the maternal health services in the district of Raichur. This was effective in reaching the community voice far and wide, in the local Kannada media (both print and visual) as well as in the English leading daily newspapers.
Such events and access to policy spaces has in turn been responsible for putting pressure on the lower level health functionaries at the PHC and village levels. This was seen in palpable changes in PHCs and women’s increased access to maternal health care services. The District Health officer also issued an official government circular (memo) to all the PHCs on directions to meet JMS demands.