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Consultant to Tata Trusts shares her vision for the future of women’s and children’s health in India
Shalini Rudra’s work with The India Nutrition Initiative (TINI) looks to inform nutritional policymaking through the use of large-scale data analysis. Rudra explains the reasoning behind the data-driven initiative is “[to] make it so that it is an effective intervention and it also turns out to be an efficient one so that we meet targets as they have been described.”
The initiative is closely linked with the National Nutrition Mission (NNM), a project launched in 2017 by the Indian government to tackle the problems of under-nutrition, low birth weight and stunting in Indian children.
Rudra is one of more than 50 participants from around the world who convened at Schloss Leopoldskron to participate in the program Healthy Children, Healthy Weight, part of Salzburg Global’s long-standing multi-year series, Health and Health Care Innovation.
It was the data-driven aspect which guided her into focusing on women’s and children’s health. Rudra said, “I was writing a project in which me and my guiding supervisor, we looked at expenditure on hospitalization at the household level and found that most of the female-headed households have actually proportionately less expenditure than otherwise.”
She added, “Women compulsorily get inducted to health systems through pregnancies.” Rudra believes childbirth and pregnancies may be the only reason many Indian women attend hospitals. “We have this idea that the health of women is always secondary to others, to children, to male [children], to male earning member of the family.”
“We have found that… women suffer from simple things such as a urinary tract infection, and they do not seek care for almost all their lives, and it is something that can get treated with… one course of antibiotics.”
She has observed how this culture in women’s health can directly affect the health of children. She said, “So it’s cyclical, and then these women who do not take care of their own bodies actually deliver children who have very bad health behavior, but also might not be doing very well physiologically.”
This even links back to malnutrition in children. Rudra said, “Anemia in women…is almost 50% at the moment, which is a really big thing. So this anemia gets carried to the unborn child, and then when the child is born with anemia, the children [are] also not treated as well as they should be, and we know that undernutrition is resulting from very bad dietary diversity, very difficult breastfeeding.”
The solution? Changing the culture in women’s health would mean starting from a young age. Rudra said, “Schools should have regular visits of physicians, or if not physicians then at least nurses. We know the age band where women generally achieve puberty and begin their periods. So that is when [it] should be highly focused and covered.”
“It should start from school at one end, and it builds at the other. And also the schools become responsible for children in a larger way because they are sowing the seeds of habit development. So when you have behavior change - you want to enable behavior change - you start where the responsibility lies the most. So stakes are very high for schools because they want to encourage good habits in children.”
The program Healthy Children, Healthy Weight was part of Salzburg Global's multi-year series Health and Health Care Innovation. This program was held in partnership with the Robert Wood Johnson Foundation.