Urban Poor Women Research Articles

Assessment of knowledge, and practices of urban women towards folic acid fortified maize meal in Zimbabwe

Neural tube defects (NTDs) are the second most common birth defects in humans and are associated with high rates of neonatal mortality, morbidity, disability, psychological and economic costs. Roughly 200,000 neonates are born with NTDs in low- and middle-income countries. To reduce the risks associated with NTDs, pregnant women are recommended to supplement their diets with folate tablets or to consume foods fortified with folic acid. Despite the introduction of a mandatory fortification program of maize meal with folic acid, in Zimbabwe, there is a paucity of literature about the perceptions of individuals towards fortified foods, as well as the storage and processing practices of fortified maize meal. This study aimed to assess the knowledge, as well as, storage and processing practices of folic acid-fortified maize meal in urban poor women. Data on knowledge and practices on fortified maize was gathered using a structured questionnaire from 630 women of childbearing age from low-income suburbs in Kwekwe town, Zimbabwe. The results showed that a paltry 26.3% of the respondents knew about folic acid, 22.5% knew about the effects of folic acid deficiency, 13.8% knew foodstuffs containing folic acid, 4% knew about food fortification and 35.6% had bought and used folic acid fortified maize meal before. Availability and accessibility were the main drivers to purchasing fortified maize meal (90%). There was no significant relationship (p < 0.05) between age and folic acid knowledge as well as between level of education and folic acid knowledge. Furthermore, the result indicates that the households were engaged in poor storage practices of the folic acid fortified maize meal. There was a significant relationship between the level of education and knowledge about food fortification. In conclusion, urban women's knowledge regarding folic acid and fortified maize meal is very low in Zimbabwe and households also store the folic acid fortified maize meal under conditions that speed deterioration of the folic acid. Folic acid awareness campaigns are recommended for people to benefit from the government of Zimbabwe's fortification programme. Key words: Neural tube defects, maize, folate, deficiency, fortification, women

Health-seeking behaviour during times of illness among urban poor women: a cross-sectional study

BackgroundUrban poor women face dual challenges regarding gender inequalities and urban poverty, which make them more likely to have health problems and affect their health-seeking behaviour. This study aimed to determine the prevalence of health-seeking behaviour during times of illness and predictors of sought care among urban poor women in Kuala Lumpur, Malaysia.MethodsThis cross-sectional study was performed among 340 randomly selected women residents from April to May 2023. Data was collected using a validated and reliable self-administered questionnaire and analysed using SPSS version 28.0 software. The dependent variable in this study was health-seeking behaviour during times of illness, while the independent variables were sociodemographic characteristics, socioeconomic characteristics, medical conditions, women’s autonomy in decision-making, social support, perceived stigma, and attitude towards health. Multiple logistic regression was used to identify the predictors of sought care during times of illness.ResultsStudy response rate was 100%, where 72.4% sought care during times of illness. Being non-Malay (AOR = 4.33, 95% CI: 1.847, 10.161), having healthcare coverage (AOR = 2.60, 95% CI: 1.466, 4.612), rating their health as good (AOR = 1.87, 95% CI: 1.119, 3.118), and having pre-existing chronic diseases (AOR = 1.92, 95% CI: 1.130, 3.271) were identified as predictors of sought care during times of illness.ConclusionThe present study showed that health-seeking behaviour during times of illness among the participants was appropriate. Health promotion and education, with a focus on educating and raising awareness about the importance of seeking timely healthcare, are crucial to improving health-seeking behaviour among urban poor women. Collaboration with relevant stakeholders is needed to develop comprehensive strategies to improve access to healthcare facilities for these women.

A Study on Mobile Phone Technology Adoption & Usage Among Urban Poor Women in Resettlement Sites

Digital transformation and the use of interconnected digital technologies have opened up new opportunities across the world and hold promises for enhanced productivity and development for all. However, research from around the globe has proven that urban poor women are less likely to be digitally active, limiting the realization of its benefits. This study provides an insight into the mobile phone technology experiences of urban poor women at the resettlement site Perumbakkam in Chennai, India. A purposively selected group of women from the resettlement site participated in a workshop that focused on the usage of mobile technology. Post-workshop, the shared experiences of these marginalized women have provided insight into the interactions between gender and communication technology at resettlement sites. The researchers discovered that there was a growing awareness and recognition among the women about how technology could benefit their lives. They expressed eagerness to learn more about utilizing the new technology, particularly for economic improvement. However, structural barriers, particularly patriarchal gender norms, have thus far hindered women from fully harnessing the potential of mobile technology.

Intra-urban Differences in Maternal Health Care Service Utilization in Nepal: Results from 2016 Nepal DHS

After restructure of local bodies in Nepal, some rural settings before 2015 fall under urban set tings. It is advantageous to understand the situation of maternal health care utilization among poor and non-poor in the new urban structure. Officially, one-fifth of the total population is poor in the country. The objective of this study is to explore the differentials in utilization of all the care designed during the course of reproduction from the notice of pregnancy to postnatal care within two days of delivery among urban poor and non-poor in Nepal. Differentials and roles in utilization of all care, utilization of full maternal health care service for the healthy pregnancy and childbirth are explored among the two economic groups living in urban setting of Nepal. This study has utilized Nepal demographic and health survey 2016 women’s data file. The data used for the analysis came from the 2016 Nepal Demographic and Health Survey (NDHS). This survey is nationally representative population-based household surveys that collected information on fertility, family planning, maternal and child health etc among other data. Details about the survey designs and sampling procedures of this survey are explained in publicly available final report. Using wealth index used as a proxy for household economic status, the lowest wealth quintile is taken as poor and the remaining as non-poor. Result shows that nearly 10 percentage point differences have been observed in utilizing recommended months of antenatal care visits as well as full antenatal care among poor and non-poor. Such differences remained three times more extensive in receiving de livery care from skilled birth attendants and the postnatal care within two days of delivery among those groups. Even, urban poor women are less likely to receive all components of maternal health care. Results of logistic regression confirm the lower chance of receiving full maternal health care by urban poor. The study concludes that urban setting, as local body of Nepal, needs to address the urban poor especially in utilization of maternal health care in protecting and saving health of mother and the newborn.

‘The Girls are Alright’: Beauty work and neoliberal regimes of responsibility among young women in Urban India

This article addresses the complex ways in which poor urban women’s educational and training needs are embedded in official discourses of capacity creation and are constructed in opposition to their community and kinship networks, an aspect that is very often overlooked when such programmes are designed. It argues that this oversight is not a coincidence, as neoliberal policies and discourses of empowerment construct young women as ‘subjects of capacity’. Where they are addressed directly, young women are framed as the single, autonomous subjects of liberalism who, once enabled, overcome ‘traditional’ kin and community attachments. Based on the ethnographic study of vocational training for beauticians provided by an Indian NGO, the article argues that such interventions are geared towards ‘community development’ and therefore reference broader social landscapes, but that the participants in training see themselves and the process as part of, rather than as opposed to, kin and community obligations. While education and training are more often than not conceived as stand-alone projects offering young women a way into employment and the labour market, the article foregrounds the class-based limits of such workist approaches and the entanglements between body work, caste/class, and histories of feminized poverty. It demonstrates how young women from lower-caste and lower-class backgrounds see opportunities in the beauty industry mainly as supporting their roles as responsible daughters, future wives and daughters-in-law realized within the complex economies of marginal urban communities. They are also acutely aware that while the actual work of the beautician allows some access to the world of ‘professional’ modern and classed notions of femininity and, arguably, a more dignified workplace than in domestic service, the pitfalls of an industry built on gendered, racialized and classist inclusions and hierarchies are noted too. Critiquing the mainstream feminist focus on access to the labour market, the article argues that young women are fully aware of their own precarious relationship with ideals of neoliberal constructs of autonomous subjectivities promoted by the state and its agents.

Urban nutrition situation in the slums of three cities in Asia during the COVID-19 pandemic.

Urban-poor households are disproportionately food insecure. The Status and Determinants of Food Insecurity and Undernutrition in Poor Urban Settings (SDFU)cross-sectional surveys were conducted in 2020-2021 to assess the impacts of COVID-19on food security and diet quality among urban poor women of reproductive age (WRA)and children under 5 (CU5)in Jakarta, Quezon City, and Yangon. Data, collected on food insecurity and child and maternal diet quality using Computer Assisted Telephone Interviewing (CATI),were compared with prepandemic surveys. Prevalence for food insecurity and diet quality indicators were computed. Eight in 10 households in all three cities reported reduced incomes, with 6 in 10 worried about food the previous year. Over 10% of households in all cities substituted nutrient-dense (ND)foods with cheaper alternatives; yet less than 50% of children 6-59 months ate sugar-sweetened beverages or sweet and savoury snacks. Compared with baseline, women's minimum dietary diversity (MDD)in the three cities was significantly lower (up to 30% lower in Yangon and Jakarta), while the prevalence of children (6-23 months) meeting MDD was lower by 17.4%-42.5% in all cities. MDD was attained by >40% of children (24-59 months) in Yangon and Jakarta but only 12.6% in Quezon City. To improve food security and diet quality, multi-sectoral interventions are needed, including distributing ND foods and cash assistance to vulnerable households with CU5 and WRA and delivering targeted nutrition training to encourage appropriate complementary feeding practices and purchasing and consumption of ND foods.

Social networks, empowerment, and wellbeing among Syrian refugee and Jordanian women: Implications for development and social inclusion

In response to large-scale refugee crises, frameworks for development assistance have promoted women’s empowerment, wellbeing, and social inclusion. A productive research agenda lies in analyzing social networks: it is unknown how women structure their social ties within refugee and host communities, and whether social networks matter for their sense of empowerment and wellbeing. In 2022, we surveyed Syrian refugee (n = 106) and Jordanian (n = 109) women from poor households across five neighborhoods in Amman. We implemented a standard network survey instrument (PERSNET) to assess network structure and composition. We tested associations with six measures (PE, MRS, MTL, Cantril, PWB, MSPSS) of psychological empowerment and wellbeing. We then conducted participatory network mapping (Net-Map) to assess local meanings of empowerment and visually map the pathways between social actors, community-based work, and psychological outcomes. Survey data show that networks were highly homogeneous, smaller for Syrians than Jordanians (p = 0.0001), and smaller for women in very poor households (p < 0.0001). As network size increased, so did levels of psychological empowerment (p = 0.02), motivation to lead (p = 0.007) and perceived social support (p = 0.001). Notably, as networks became increasingly kin-based, empowerment levels decreased (p = 0.003). Networks were more diverse for community volunteers, who named fewer female, married, and kin-based peers (p ≤ 0.05), and reported higher levels of resourcefulness (p = 0.01) and psychological wellbeing (p = 0.002). Qualitative data show that women, who described empowerment as “ability” and “proof of existence,” drew upon volunteering work to diversify their networks outside the home. Such evidence matters for development initiatives that build programs for women to work, learn, and socially interact. We conclude that expanding opportunities for volunteer work is one way of diversifying social networks and empowering urban poor women. Our research helps better understand how women can be supported to diversify their social ties, take community leadership roles, and respond to social change.

Maternal and newborn healthcare utilization in Kampala urban slums: perspectives of women, their spouses, and healthcare providers

BackgroundIt is assumed that the health conditions of urban women are superior to their rural counterparts. However, evidence from Asia and Africa, show that poor urban women and their families have worse access to antenatal care and facility childbirth compared to the rural women. The maternal, newborn, and child mortality rates as high as or higher than those in rural areas. In Uganda, maternal and newborn health data reflect similar trend. The aim of the study was to understand factors that influence use of maternal and newborn healthcare in two urban slums of Kampala, Uganda.MethodsA qualitative study was conducted in urban slums of Kampala, Uganda and conducted 60 in-depth interviews with women who had given birth in the 12 months prior to data collection and traditional birth attendants, 23 key informant interviews with healthcare providers, coordinator of emergency ambulances/emergency medical technicians and the Kampala Capital City Authority health team, and 15 focus group discussions with partners of women who gave birth 12 months prior to data collection and community leaders. Data were thematically coded and analyzed using NVivo version 10 software.ResultsThe main determinants that influenced access to and use of maternal and newborn health care in the slum communities included knowledge about when to seek care, decision-making power, financial ability, prior experience with the healthcare system, and the quality of care provided. Private facilities were perceived to be of higher quality, however women primarily sought care at public health facilities due to financial constraints. Reports of disrespectful treatment, neglect, and financial bribes by providers were common and linked to negative childbirth experiences. The lack of adequate infrastructure and basic medical equipment and medicine impacted patient experiences and provider ability to deliver quality care.ConclusionsDespite availability of healthcare, urban women and their families are burdened by the financial costs of health care. Disrespectful and abusive treatment at hands of healthcare providers is common translating to negative healthcare experiences for women. There is a need to invest in quality of care through financial assistance programs, infrastructure improvements, and higher standards of provider accountability are needed.

#CHOOSETOCHALLENGE: COVID-19, COMMUNITY RESEARCH, AND THE CANAANITE WOMAN

This study theologises on the Urban Poor Women and children with Academics for Reaching and Delivering on UNSDGs in the Philippines (UPWARD-UP) Project research team’s collaboration with the Alliance of Peoples’ Organisation Along the Manggahan Floodway (Alliance), Philippines. We posit that the theological process of seejudge-act, enhanced with evaluate-celebrate/ritualise, using feminist biblical characterisation in interpreting Matthew 15:21-28, serves as a spiritual resource for Christians working for the urban poor realisation of the United Nations’ Sustainable Development Goals during the COVID-19 pandemic and beyond. The Canaanite woman challenged Jesus’ identity and mission impacting onChristology and ecclesiology. This characterisation makes her a vital example and companion for the Alliance womenleaders in achieving their prioritised SDGs (1 - No Poverty; 3 - Health and Well-being [in relation with the Environment];4 - Quality Education, and 16 - Justice, Peace and Strong Institutions seen from the lens of UNSDG 5 - Gender Equality) during the pandemic and beyond.

Resistance and reproduction: urban poor women and the struggle for a socially just urban future in Manila

Women play a key role in organized urban poor resistance in Manila. While social reproduction has led to exploitation and suffering, it concomitantly situates women at the front and center of urban resistance and the re-imagination of urban futures. The turbulent everyday geographies of informal settlements which subaltern women inhabit, not only blur the tendencies to separate production from reproduction, but also provide the conditions from which urban struggles are forged. Women have risen to assert the urban poor’s right to the city and access to better services and sustainable livelihoods. Contrary to gendered perceptions of urban poor activists as being primarily male, women are instrumental in the struggle for urban social justice. Drawing from engagements with urban poor women leaders in Manila, we examine the gendered spaces of the urban struggle by foregrounding the everyday spaces that urban poor women inhabit. We explicate the spaces of interaction between social reproduction and resistance and focus on three aspects in building and nurturing the urban poor movement: (1) networking and membership expansion, (2) daytime mobilization, and (3) community building. We argue that while spaces of social reproduction are sites of oppression and suffering for many urban poor women, the proximity to these spaces enables them to become immersed in the struggles and issues that plague their communities and to collectively take action towards creating a sustainable urban future.

A Systematic Review of Water, Sanitation, and Hygiene for Urban Poor in Low- and Middle-Income Countries during the COVID-19 Pandemic through a Gendered Lens.

Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37–0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08–0.24), non-adherence to face masks was 0.27 (95% CI 0.0–0.81), and access to shared community toilets was 0.59 (95% CI 0.11–1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.

Multisectoral approaches to addressing global urban maternal and perinatal health inequities

ABSTRACT Emerging trends show declines in maternal and perinatal mortality and morbidity in urban populations might be slower than in rural areas in a variety of contexts. This is happening at a critical juncture in time when urban populations are rapidly increasing and might be partly driven by specifics of vulnerability of the urban poor in Low-income countries and High-income countries alike. Poor maternal and perinatal health outcomes are largely preventable but focusing solely on healthcare interventions misses critical opportunities to reduce ill-health. Social and environmental determinants such as poverty and the impact of climate change must be integrated into policy decisions, especially to benefit poor urban dwellers. Integrating data on the social determinants of health into policy decisions can help multisectoral stakeholders embrace a more Health-in-all-policy approach creating opportunities for better outcomes for these urban poor women and their offspring. We provide examples of two cities – Rotterdam and Kampala – to show that successful multi-sectoral approaches that can address urban maternal and perinatal inequalities should focus on interventions in which healthcare and non-healthcare determinants are integrated.

Contraceptive Use in Urban Africa: Examining Trends in Rich-Poor Gaps.

Previous studies have documented significant differences in health and reproductive health outcomes between the poor and nonpoor across various countries in sub-Saharan Africa. However, a number of these studies is dated, and the past decade has witnessed significant shifts in health and reproductive health outcomes in many African countries. Using recent data from the Demographic and Health Surveys, this paper updates and extends the literature by examining patterns in contraceptive practice among poor and nonpoor married women in urban settings in 19 African countries. First, we analyze changes in the rich-poor gaps in modern contraceptive prevalence (mCP) in urban Africa over time. We then determine the public source of the supply of modern contraceptives to the urban poor and how that supply may have changed over a 10-year period. The findings show that, in most Eastern and Southern African countries, previous gaps in mCP between the rich and poor married women have disappeared. Countries in Central and Western Africa, however, continue to have significant gaps in mCP between rich and poor women, with urban poor women experiencing only a modest improvement in mCP over the past decade. This paper contributes to our understanding about sub-regional dynamics in reproductive health outcomes in urban settings in sub-Saharan Africa.

How well are Indonesia's urban poor being provided access to quality reproductive health services?

Accommodating the needs of Indonesia’s rapidly growing urban population is essential to reaching national reproductive health goals and international commitments. As in other rapidly urbanizing low- and middle-income countries, satisfying the needs of Indonesia’s urban poor is both a high priority and a significant challenge. In this study, we assessed both how being from urban poor or near-poor households affects the quantity and quality of family planning and maternal health services received and the extent to which differentials had narrowed during the 2012–2017 period. This time interval is significant due to the introduction of a national social health insurance scheme in 2014, establishing the foundation for universal health care in the country. Data from the 2012 and 2017 Indonesian Demographic and Health Surveys were analyzed using logistic and multinomial logit regression. Poverty status was measured in terms of urban household wealth quintiles. For family planning, although urban poor and near-poor women made different method choices than non-poor women, no substantial 2017 differences in contraceptive prevalence, unmet need for family planning or informed choice were observed. However, urban poor women and to a lesser extent near-poor women systematically lagged non-poor urban women in both the quantity and quality of maternal health services received in connection with recent pregnancies. Significant maternal health service gains were observed for all urban women during the study reference period, with gains for poor and near poor urban women exceeding those for non-poor on several indicators. While the deployment of pro-poor interventions such as the national social health insurance scheme is likely to have contributed to these results, evidence suggesting that the scheme may not be influencing consumer health-seeking behaviors as had been anticipated along with continued limitations in public health sector supply-side readiness resulting in service quality issues suggest that more will have to be done.

Insecure Birth: A Qualitative Study of Everyday Violence During Pregnancy in Port au Prince, Haiti.

While the city offers economic opportunities for women in many countries, their safety and security remain vulnerable to urban violence, especially in poor areas. In Haiti, poor urban women may be subjected to multiple forms of physical, sexual, and structural violence leading to adverse birth outcomes. We explored some of the complexities of how pregnancy is experienced under the reality and threat of urban violence in Haiti. We examined data from focus group discussions with fourteen women who lived in severely disenfranchised neighborhoods in Port au Prince and who were pregnant or had recently delivered at the time of the study. We report on three recurring themes that emerged from the discussion: (a) ways in which the threat or experience of violence affected women's ability to access maternal healthcare, (b) ways in which women altered their behavior to accommodate everyday violence, and (c) the extent to which violence was embedded in women's consensual and non-consensual sexual encounters with perpetrators. We found that Haitian women considered violence, labeled ensekirite (insecurity), to be an everyday threat in their lives and that they strategized ways to access maternal health care and other services while navigating ensekirite. Pregnancy adds another layer of vulnerability that may necessitate further negotiations with the threat and presence of violence. The pervasiveness and impact of urban violence in women's daily lives needs to be better evaluated in maternal and newborn health research and programs.

Experiences of Intergenerational Caregiving among Women Belonging to the Sandwich Generation: An Example from the Philippines

ABSTRACT This study sought to understand the experiences of intergenerational caregiving among urban poor women belonging to the Sandwich Generation that is individuals who care for both their children and aging parents. Guided by Interpretative Phenomenological Analysis, we explored the experiences of eight Filipina mothers. Results revealed how societal/cultural expectations contributed to their willingness to accept the responsibility to be intergenerational caregivers, and how socioeconomic conditions influenced the existence of this care cycle. Findings point to how financial, material and policy support from government and workplaces may enable better provision of care for the parents and children of urban poor Filipino women as well as allow for self-care. Reframing traditional gender roles especially in child-rearing as well as discouraging culturally-shaped practices that engender the continuation of the care cycle through education may help in addressing the structurally enabled challenges experienced by women in the Sandwich Generation.

Determinants of Financial Inclusion of Urban Women: Evidence from Ahmedabad, India

&lt;p class="Normal1"&gt;One of the utmost active practices is to adopt an inclusive growth policy to achieve economic growth. An inclusive growth means include the excluded population into all benefits. Financial inclusion is a financial upliftment process, to help poor, slum, backward and women to come out from the poverty trap. Financial inclusion means inclusion of excluded population to access formal financial services like savings, borrowings, insurance and pension from formal financial institutions. For constructing strong financial system, it is very necessary to know first that whether sources of financial services are actually reaching to the unreached people; the awareness among people for the formal financial services i.e., financial literacy and inclusion of the excluded population by providing banking services. Among socio-economic problems in India, gender inequality is one of the major affecting problems. A noteworthy access gap has taken place between male and female regardless of significant development in broadening access to formal financial products in the country. The main objectives of this research are to examine nature and extent of accessing major financial inclusion services including Government financial inclusion programs by urban women and to analyze the determinants of financial inclusion for urban women of Ahmedabad district (having highest urban female population in Gujarat). Primary data collection method is used through semi-structured questionnaire. Probit model is constructed to analyze the financial inclusion determinants of urban women of Ahmedabad district. Considered major financial inclusion services are opening bank account, savings, borrowings and insurance. Major finding of this study is that poor urban women are being considered as less benefitted from financial inclusion services, where in-migration, financial literacy and borrowings were found to significantly influence the participation of urban women in financial inclusion programs.&lt;/p&gt;

On Intimate Reaches of US Empire: Neoliberal Imperialism and Domestic Abuse in Metro Manila

Research shows that political economy—the structural distribution of a society’s economic resources as shaped by power inequalities—is linked to the incidence of domestic abuse as well as survivors’ success in escaping abusive relationships. Yet studies often overlook the extent to which domestic abuse in the global South is embedded in neocolonial structural violence. Drawing on interviews and surveys with urban poor women in Metro Manila, I explore how structural adjustment and state violence from the 1980s to the 2000s have inextricably shaped experiences of domestic abuse. Popular discourse and some gender scholars portray economic globalization as an empowering, even liberatory force for poor women in the global South. Instead, I trace how a political economy marked by what I call “neoliberal imperialism” has fueled domestic violence, not by boosting the upward economic mobility of urban poor Filipinas but by worsening their gendered precarity. I complicate feminist scholarship that has framed increased abuse as a male backlash against heightened female mobility. Gendered material inequalities, austerity, and militarization have serially exposed women and girls to cycles of violence. These facets of a neocolonial political economy collude to reinforce low-income Filipinas’ primary responsibility for reproductive labor, trapping them in abusive relationships despite access to cash earnings. I argue that imperialist extraction not only exacerbates domestic abuse but that interpersonal gendered violence is a tool for harnessing Filipina reproductive labor to reproduce empire. I critique carceral feminist responses to abuse in a neocolonial context, considering how urban poor Filipinas’ oppositional consciousnesses gesture toward structural alternatives.

Social and economic marginalisation and sexual and reproductive health and rights of urban poor young women: a qualitative study from Vadodara, Gujarat, India

In this paper, we present the results of a qualitative study by a non-profit organisation implementing a community-based urban adolescent development programme. The study highlights the sexual and reproductive health and rights (SRHR) situation of marginalised young women in a developed state of India. Our findings, based on in-depth interviews with young women and frontline health providers, show that structural factors, such as economic and social stratifiers, gender norms and cultural beliefs, result in further marginalisation of young women. In turn, marginalisation adversely affects the realisation of SRHR through discriminatory practices around menstruation and lack of control in matters related to sexuality, contraception, pregnancy and safe abortion. Rights to the highest standards of sexual and reproductive health (SRH) care are compromised. Health system factors like providers’ attitudes and knowledge, commodity supplies, and indifference to ensuring delivery of contraceptives and other services often result in unplanned pregnancies and affect the quality of young women’s SRH care. Whatever information and support adolescents and young women get is from local community-based organisations. We conclude that structural determinants and violations of fundamental rights to education, equal opportunities and participation constitute a significant barrier to the enjoyment of SRHR by the marginalised young women in the study. Unless these are addressed, government policies and programmes to promote young people’s SRHR will not benefit young women from disadvantaged communities. Partnership and complementarity between government programmes, adolescents and health rights civil society organisations are recommended to promote rights-based, equitable adolescent and youth-friendly services to this vulnerable population.

Citizens of Scandal: Journalism, Secrecy, and the Politics of Reckoning in Mexico

Citizens of Scandal: Journalism, Secrecy, and the Politics of Reckoning in Mexico