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Paper short abstract:

Lived realities of women in Uganda who experience either delayed healthcare access or constructive exclusion from public healthcare access. The dangers associated with the couple-centric approach to accessing maternal health services.

Paper long abstract:

Some women experience poor maternal health due to the absence of male partner involvement in their pregnancy journeys. To minimise this, the World Health Organization and existing research have encouraged a couple-centric approach to accessing maternal health services. This position has been backed with a proclamation of the various benefits that male involvement brings to the woman during and post the pregnancy journey however the resultant problems remain overlooked. Based on the author’s fieldwork findings in Uganda, the paper offers an insight into the lived experiences of women that lack male partners during their maternal healthcare visits and the problems they face in the process. The paper begins with a discussion of the justification of male partner involvement in maternal healthcare and this is followed with the implications this has on women that lack male partner support and/or presence. The paper explains the strategies used by women that lack male partner support and/or presence. It concludes that the blanket requirement of women to bring male partners are antenatal visits reinforces the multiple disadvantages on them and disenfranchises such women from seeking and accessing maternal healthcare services in public hospitals.

Key words: maternal health, male partner involvement, lived experiences of women, strategies, multiple disadvantages

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Paper short abstract:

This study investigates the causal link between menstrual health and hygiene (MHH) and mental health among women in Nepal. Using an instrumental variable approach with the 2022 Nepal Demographic Health Survey, I find that improved MHH significantly reduces the likelihood of anxiety and depression.

Paper long abstract:

The "polycrisis"—an interconnected web of global challenges, including economic instability, conflict, and public health emergencies—poses a significant threat to gender equality and well-being, particularly impacting the health of women, girls, and trans/non-binary individuals. This study investigates the causal effect of improved MHH practices on the likelihood of experiencing anxiety and depression among women aged 15-49 in Nepal. To address endogeneity concerns, I employ an instrumental variable approach, leveraging the perceived barrier of distance to the nearest health facility as an exogenous source of variation in MHH access. Using data from the 2022 Nepal Demographic Health Survey, I find that women with better MHH practices experience a 32.3 percentage point (pp) reduction in the likelihood of experiencing anxiety and a 33.5 pp reduction in the likelihood of experiencing depression. These effects are robust to a battery of sensitivity checks. Notably, the impact is more pronounced for women from disadvantaged backgrounds, highlighting the intersectional nature of MHH and mental health inequities. This study contributes to the limited causal evidence on the MHH-mental health link and underscores the urgent need for comprehensive MHH interventions as a crucial component of promoting health equity in the era of the polycrisis.

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This paper aim explores the traditional health related practices of Malayali tribes, India and reflect upon how government initiatives can assist or restrict these traditional health practices and thereby recommend ways to integrate traditional and modern healthcare systems.

Paper long abstract:

The Malayali tribes, like many indigenous communities, often have their own culturally rooted health practices that differ from mainstream healthcare interventions. Understanding and navigating this intersection requires a nuanced approach that respects the cultural heritage and traditional knowledge of the Malayali tribes while also integrating modern healthcare strategies promoted by government schemes. Challenges may arise due to differences in beliefs, practices, and language barriers between traditional healers and healthcare providers. Additionally, there may be skepticism or resistance to government interventions perceived as foreign or culturally insensitive. However, there are also opportunities for synergy and collaboration. Government schemes can leverage the trust and influence of traditional healers within the community to promote maternal and child health practices aligned with modern medical standards.

Furthermore, incorporating traditional practices that are safe and effective into government schemes can enhance their acceptability and accessibility among the Malayali tribes. Effective navigation of the intersection of traditional health practices and government schemes requires a collaborative and culturally sensitive approach that respects the autonomy and wisdom of the Malayali tribes while also promoting the well-being of mothers and infants through evidence-based healthcare interventions. This study shed light on the intersection between tradition and modernity, as well as the influence of external factors such as government policies and healthcare initiatives. By amplifying the voices of Jawadhu mothers, this study seeks to inform culturally sensitive approaches to maternal and child healthcare that respect and integrate traditional knowledge while addressing contemporary challenges and needs.

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Paper short abstract:

This study examines disparities in maternal healthcare access and outcomes between tribal and non-tribal populations in India, identifying contributing factors. It highlights global challenges in maternal healthcare access, particularly for vulnerable populations, an issue concerning SDGs 3 and 10.

Paper long abstract:

Maternal health remains a global priority, yet significant disparities persist, particularly among marginalised populations. In India, maternal health among tribal women, a historically disadvantaged group with distinct socio-economic characteristics and cultural beliefs, remains a pressing public health concern. Tribal communities often face systemic barriers to accessing maternal healthcare services. In response, initiatives like the Janani Suraksha Yojana aim to reduce maternal and infant mortality by improving access to skilled care during pregnancy and childbirth, with a focus on marginalised groups. However, inequities in access persist across socio-economic groups. Using data from the National Family Health Survey (NFHS-5), a large-scale, nationally representative sample, this study investigates the disparities in maternal healthcare utilisation and outcomes between tribal and non-tribal populations. It examines whether significant differences persist and identifies the factors contributing to these disparities. Logistic regression analyses reveal that tribal women are more likely to receive four or more antenatal care visits but less likely to opt for institutional deliveries compared to their non-tribal counterparts. Despite lower institutional delivery rates, tribal populations exhibit a lower likelihood of infant deaths than the non-tribal population. Decomposition analysis further reveals that factors such as wealth status, parity, and distance to healthcare facilities play a significant role in contributing to these disparities. These findings highlight a complex interplay of social, cultural, and systemic factors that influence maternal healthcare access.

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Paper short abstract:

Ethnographic account on Afghan refugee women in Delhi, highlighting their resilience in tackling health barriers, period poverty, and food insecurity through community networks and NGOs. to discuss global health inequities, marginalised voices, and explore actionable, intersectional strategies.

Paper long abstract:

The health polycrisis has intensified existing inequalities for marginalized communities, particularly for women, girls, and trans/non-binary individuals in precarious settings. Afghan refugee women in Delhi occupy a unique position at the nexus of intersecting vulnerabilities—legal precariousness, economic insecurity, gender-based violence (GBV), and barriers to accessing healthcare. Drawing from my ethnographic research, this paper examines how Afghan refugee women resist and adapt to the compounded challenges posed by the polycrisis. Through narratives of lived experiences, I highlight how these women navigate structural inequalities by mobilizing community-based networks, employing indigenous health practices, and engaging with non-governmental organizations (NGOs).

Despite systemic exclusions, Afghan refugee women demonstrate resilience by reshaping health-seeking behaviors, cultivating social solidarity, and asserting agency within patriarchal and resource-constrained environments. However, such resistance often comes at a personal cost, further entrenching inequalities like increased reproductive health challenges, period poverty, and unsafe coping mechanisms, including early hysterectomies. By situating their struggles within broader crises like climate change, economic instability, and global displacement patterns, this paper underscores the importance of intersectional frameworks in understanding the impact of the polycrisis on gendered health outcomes. It calls for inclusive, multi-scalar interventions that center the voices and agency of marginalized women in addressing these overlapping crises.

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Paper short abstract:

The polycrisis has deepened health inequities, particularly among marginalized women and tribal communities. Saksham's Sashakt AAA model empowers FLWs, fostering community-driven solutions that improve maternal and child health outcomes through participatory, gender-sensitive approaches.

Paper long abstract:

The polycrisis—characterized by climate change, pandemics, economic instability, and sociopolitical conflicts—has exacerbated health inequities, particularly for marginalized women and tribal communities in regions like Assam, Chhattisgarh, and Odisha. These areas face systemic neglect, limited access to healthcare, and socio-cultural barriers that hinder progress in maternal and child health.

The Saksham project's Sashakt AAA model offers a community-driven, gender sensitive solution to these challenges. By empowering frontline health workers (FLWs) such as ASHAs, ANMs, and ASHA Supervisors, the model strengthens grassroots healthcare systems. Participatory methodologies like Living Labs (5Ds), Visioning exercises and Leadership and Supportive Supervision enhance FLWs’ capacity to co-create locally relevant solutions, ensuring better health outcomes for marginalized populations.

Key interventions in the three states have demonstrated success: in Assam, the MAAdol campaign bridged documentation gaps for Wage Compensation Scheme, benefiting over 5,000 tea garden workers; in Chhattisgarh, improved FLW coordination through agenda driven sector level cluster meetings resulted in a 185% increase in high-risk pregnancy identification; and in Odisha, community advocacy through joint home visits reduced home deliveries by 70% in Kashipur block. These initiatives underscore the power of community-led approaches in transforming health behaviors.

To build resilient and equitable health systems, the Saksham approach advocates for expanded intersectional training for FLWs, strengthening community platforms like VHSNCs and GKSs, integrating climate resilience into health planning, and fostering cross-sectoral partnerships. These strategies align with India’s health and equity goals, supporting SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality) through inclusive, gender-responsive health systems.

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Paper short abstract:

We examine intersection between two pertinent issues that pose significant threats to health and well-being of women: intimate partner violence and anaemia. We analyze causal association between them and provide evidence of anaemia leading to IPV using a nationally representative dataset from India.

Paper long abstract:

The grappling dual burden of anaemia and exposure to intimate partner violence (IPV) among married women in India reflects a significant policy crisis in achieving the SDGs. While a thin branch of literature examines the plausibility of the channel where spousal violence may trigger risk of anaemia in women through cumulative levels of deprivations and psychosocial stress, this paper estimates the non-trivial channel where prevalence of anaemia may increase exposure to IPV. Anaemia is associated with reduced physical work capacity, quality of life, loss of productivity, and income-earning capacity. It is also linked with women’s reduced ability to manage multiple responsibilities efficiently like childcare, elderly in-laws’ care, daily household tasks like cooking and cleaning etc., instigating the partner to indulge in violence. Moreover, sexual dysfunction due to anaemia can further exacerbate the risk of violence. Using the latest round of nationally representative datasets, we provide robust evidence of anaemia leading to IPV. The potential endogeneity concern is addressed through an instrumental variable approach. We use exogenous variation in district-level prevalence of anaemia, and age of the women during first birth as instruments for anaemia. Our findings reveal that anaemia has a significant impact on some form of IPV. Moreover, the effect is higher for physical violence. The results are robust to alternative estimation techniques and additional factors. Furthermore, the heterogeneity analysis indicates a higher impact of anaemia on IPV in rural areas and among socio-economically underprivileged groups indicating the intersection of poor health, domestic violence, and socioeconomic disadvantage among women.

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Paper short abstract:

This research examines how climate-induced adversities exacerbate menstrual health inequities in flood-prone Bihar. By identifying gaps in disaster policies and advocating for gender-sensitive interventions, it fosters discussions on integrating menstrual justice into climate resilience frameworks.

Paper long abstract:

Menstrual Health and Hygiene (MHH) remains a neglected aspect of disaster response, despite its critical role in gendered health equity. Climate-induced adversities, such as recurrent flooding, exacerbate existing socio-economic inequalities and disrupt access to clean water, sanitation, and menstrual products. This study explores how menstrual health is impacted by extreme weather events in the flood-prone Muzaffarpur district of Bihar, which has deeply entrenched caste, class, religion and gender disparities.

Using qualitative methods, the research draws on semi-structured and in-depth interviews with menstruating individuals from diverse socio-economic backgrounds. Findings reveal that resource scarcity during floods—coupled with social stigma and displacement—severely limits access to menstrual products, privacy, and sanitation facilities. The study highlights critical gaps in disaster relief policies, where MHH remains an overlooked issue despite its implications for public health, gender equality, and human rights. Participants’ narratives reflect that the invisibility of MHH in climate and disaster policies underscores broader socio-political neglect towards reproductive health needs.

This study calls for integrating MHH into disaster response frameworks, advocating for gender-sensitive policies that recognize menstrual hygiene as a fundamental right. Using a menstrual justice framework, the study emphasizes the need for intersectional approaches that address the compounded vulnerabilities faced by menstruating individuals, particularly in resource-limited settings. By positioning MHH within broader discourses of public health, climate justice, and gender equity, this study contributes to rethinking care and health in crisis settings.

Keywords: Menstrual Health and Hygiene, Climate Adversities, Gender Inequality, Disaster Response, Menstrual Justice

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Paper short abstract:

This research seeks to understand how the intersection of socio-cultural, economic and physical factors affects the capacities of adolescent girls to manage menstruation, within resource-poor communities in Uganda. It utilises a feminist phenomenological framework, to privilege participant voices.

Paper long abstract:

The lived experience of menstruation differs across contexts. In resource-poor communities, the intersection of socio-cultural, economic and physical factors affects the capacities of adolescent girls to manage menstruation. In Uganda, the patriarchal construction of menstruation as “something that you have to hide” creates pressure on adolescent girls to conceal their menses, leading to menstrual stigma. Previous research has neglected menstrual stigma as a qualitative measure of menstrual experience. Instead, school absenteeism and WASH have remained focal points of analysis within studies across resource-poor contexts. Additionally, human rights-based frameworks have further contributed to marginalising diverse experiences of menstruation.

This research aims to understand how issues of menstrual health management (MHM) exacerbate the embodied experiences of menstrual stigma for adolescent girls living in resource-poor communities around Kampala, Uganda. The research also addresses how community-based approaches are supporting girls to navigate menstruation-related challenges, through the case study of Kids Club Kampala (KCK). Utilising a feminist phenomenological framework, this study thematically analyses qualitative data on the menstrual experiences of adolescent girls in two slum communities and one non-slum community, inclusive of girls both in and out of school. The results suggest that communication taboos, gendered expectations of womanhood, and the economic and physical environment exacerbate menstrual stigma. The study finds that KCK is contributing to protecting vulnerable girls from gender-based harms solicited by menarche, in addition to sanitary pad provision. The study concludes that more attention needs to be drawn to menstrual stigma as a catalyst in exacerbating challenges to MHM, and vice versa.