According to the National Family Health Survey (NFHS), about 10 million girls are married each year before the age of 18 worldwide, and one-third of them live in India.
While almost all states in the country have registered a decline in the percentage of underage brides, Bihar heads the list of number of child marriages in the country. The latest available survey found 69.9 percent of women aged 20-24 are married or are in union before 18 years in Bihar, and almost one in five are married or in union before 15 years. Of these, about 56 percent are in rural areas. Nearly 76 percent of the girls have no education.
The statistics come to life in a grimy back lane in the heart of the Patna city where Anju, a visibly undernourished woman, surrounded by three equally scrawny children and a toddler perched carelessly on her hip, looks out of a small room she calls home. Her husband is a rickshaw puller. When asked about her age, Anju timidly replies - twenty! The plethora of examples that the Kadam Kuan locality of Salimpora Ahra in Patna, Bihar has to share is merely a glimpse of the grim reality as one heads towards the Dargah Road in Sultanganj region, where several cases surface and most families comprise numerous children and pale mothers.
A resident of the slum region of Dargah Road, Najma Tabassum, in her early thirties, is a mother of five. She was married off in 1996, soon after she appeared for her high school examination. Today, despite her education, she plays virtually no role in decision making in the family- not even for things regarding her own life.
"The responsibility of taking care of children, cooking food and maintaining the household lies on my shoulders but decisions regarding how many children, to educate them or not, what to cook, what to buy and what to wear- these lie with my husband, who sells shoes in the local market," said Najma. The task of bringing up five children has made Najma completely ignore her health. At the age of thirty, she already looks as tired and lethargic as a fifty year old woman.
A girl married before the age of eighteen and forced to produce children without a gap of two years, is likely to impart her poor health to the children. All the children along with the young mother suffer their entire life; especially the girl child, who grows up undernourished, is forced into early marriage and continues the vicious cycle of vulnerability.
The statistics represent lives of several voiceless Najmas and Anjus whose health is compromised and worse, pay the price with shorter lives. At about 300 maternal deaths per 1 lakh births, Bihar has the fourth-highest Maternal Mortality Rate (MMR) in India and one of the highest MMRs in the world. Considering the minimal role that they play in family planning, is it only the women who are required to be educated?
Worldwide, educating women is considered to be one of the most important factors towards bringing a change in the current scenario. Empowering them to take decisions regarding their own marriage, family planning, health and life at large, can be facilitated through education.
One cannot, however, turn a blind eye to the facts and cultural mores that require no surveys or statistics to throw up some uncomfortable realities : the role men play in a woman's life in a society as patriarchal as India's. It has always been "the man" who has decided whether it will be a condom, oral pill or a DMPA injection - or nothing at all. And this has not been addressed, let alone changed, by any of the government schemes thus far.
Last year, the Bihar government launched its most ambitious programme by signing an agreement with Jhpiego, a US body and a pioneer in the field of providing health care services and developing human capacity worldwide. Under the agreement, Jhpiego provided technical assistance to the Bihar government in the area of postpartum family planning (PPFP) and Pre-service education (PSE) for nursing and midwifery cadre in the state.
Recently, Union Health Minister Ghulam Nabi Azad rolled out the "door-to-door contraceptive" programme across all districts of the country wherein contraceptives - oral pills and condoms - will be available to all families in rural India at their doorstep. The pilot scheme launched in 233 districts of seventeen states became a thriving success in a year, helping women get access to emergency contraceptives and oral pills right at their doorstep.
Under the programme, Accredited Social Health Activists (ASHAs) were supplied contraceptives for free. ASHAs then went from door to door selling them at Re 1 for a pack of three condoms, Re 1 for a cycle of oral contraceptive pills and Rs 2 for one tablet of an emergency contraceptive - the earning being their commission. Bihar was one of the seventeen states.
The government is trying its best, at least on paper, to take measures that will eventually contribute towards the health of women and children in our country and also regulate the constantly growing population. Where, then are we lacking? Why is it that despite several initiatives taken by both state and central governments, we are unable to create awareness on issues, which directly or indirectly affect women's health?
The answer perhaps lies in changing the mindsets. Educating women is certainly the need of the hour, but this alone would not change the current scenario. The discrimination happens regardless of whether a woman is educated or not. Men must participate equally in the empowerment of women. A healthy woman creates a healthy society. Good health is her right, not an indulgence afforded her by some enlightened individuals.
The Charkha Development Communication Network feels that perhaps it is time the women stood up to be counted, shouldering the responsibility of an equitable society at par with their male counterparts. By Kamala Kumari (ANI)