The 28th Foreign Correspondent Report

How Vigilant Women Health Workers Are Saving Lives
Swapna MAJUMDAR (India)
It was late at night when Sadhna Kumari heard that the pregnant 16-year-old
daughter-in-law of her neighbor had given birth at home. Being a government
accredited social health worker working in Belsand block in Sitamarhi district in
the Indian state of Bihar, she rushed to their house. Unfortunately, the child, weak
and born prematurely, did not survive. In Sitamarhi, 106 children die for every
1000 live births, according to government statistics.
Although she was deeply saddened by their loss, Sadhna took the opportunity
to convince the mother-in-law that she would not insist on another grandchild
until her young daughter-in-law had recovered physically and mentally. In fact,
Sadhna extracted a promise that they would wait for at least three years before
the next baby. By that time, not only would Pinky, her daughter-in-law, turn 19
and be better prepared for motherhood, but it would also reduce risks of infantmortality would also be reduced.
Over the next three years, Sadhna kept a vigil on the family. She also provided
reproductive and sexual health information as well as contraceptive pills so that
Pinky could plan her family and delay motherhood. In January this year, Sadhna’s
hard work bore fruit when Pinky gave birth to a healthy girl at a local primary
health centre.
Although women health workers are making a difference in this block, they
face many obstacles. One of their biggest challenges is the community’s practice ofmarrying their daughters young. While girls enrolled in Bohramal middle school
in Belsand, Sitamarhi outnumber boys, these numbers don’t tell the real story. By
the time girls reach Class 8, their absence becomes conspicuous due to the highprevalence of early marriage.
Sitamarhi, which shares its geographical borders with Nepal on one side, isamong the more sensitive districts in Bihar. Not only is it known for its high ratesof migration, but also for its vulnerability to cross-border and inter-state
trafficking. The district with the highest HIV prevalence rate in the state,
Sitamarhi is plagued by a high incidence of early marriage, thus exacerbating thevulnerability of adolescents.
According to the teachers of the school, all the girls who had passed out of Class
8 were married off by their parents. Early marriage was a big challenge, said
Vinita Kumari, a middle school teacher. Kumari, who has been teaching Classes
6-8 for the last five years, stated that the marriage of girls was not consideredwrong as it was part of the culture in the village. Consequently, most of them did
not continue studies.

The 28th Foreign Correspondent Report

Gulaichi Kumari, a 14-year-old student of Class 8 at Bohramal middle school
was married off even before she could take the Class 8 examinations. Her friendand class mate, 16-year-old Pinky Kumari, was married off a month after she hadcompleted the Class 8 examinations. Neither of these girls was sure that theywould be able to study further although they wanted to. Only if their husbands
and parents-in-law allowed them, could they continue their education.
But Anuradha didn’t even make it to Class 8. She was pulled out of school while
she was a student of Class 7. Anuradha had
no say in her marriage and had to drop outof school.
Official statistics indicate that the school
dropout rate is as high as 66 per cent among
marginalised groups, especially adolescentgirls. The National Family Health Survey(2015-2016) revealed that, in Sitamarhi,
50.5 per cent of women aged between 20 and
24 got married before reaching 18 years ofage, and 11.7 per cent of women aged
between 15 and 19 were already mothers or
pregnant at the time of the survey.

Forced to drop out of school

When early marriage is coupled with the lack of sexual and reproductive healthinformation, girls are unable to escape the vicious circle of having too many
children too quickly. The likelihood of girls aged between 10 and 14 dying inpregnancy and childbirth is five times more than that of women aged between 20
and 24. An estimated 6,000 adolescent mothers die every year in India. Further,children born to teenage mothers are much more likely to die in infancy than thoseborn to mothers above the age of 20.
In such circumstances, it is women health workers like Sadhna who are helping
to change people’s mindsets and making the difference between life and death.