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Reproductive health in Delhi’s slums

Family planning & contraception use of people living in slums

Studies show that fewer than half of women in India’s slums use any form of contraception.

Reproductive health in Delhi’s slums

Sterilization is the preferred method for about a fourth; pills, IUDs, and condoms are used less commonly and discontinued more often by women in the slums.

At the same time, according to WHO (2012), one in every four couples in developing countries is affected by infertility, where the overall burden of infertility is over three times higher than in developed countries.

Reproductive health in Delhi’s slums

Healthy sexual behavior

The prevalence of  sexually transmitted infections (STIs), or venereal diseases (VD), is around 40% in India. Women in slums who are not using contraception are at especially high risk. Treatment and management of Reproductive Tract Infections (RTIs) is important to prevent spread and complications, including cancer and infertility.

Menstrual health

Menstruation is a natural fact of life and a monthly occurrence for the 1.8 billion girls, and women, of reproductive age. Yet millions of menstruators across the world are denied the right to manage their monthly menstrual cycle in a dignified, healthy way. Gender inequality, discriminatory social norms, cultural taboos, poverty, and lack of basic services often cause females’ menstrual and hygiene needs to go unmet. Adolescent girls may face stigma, harassment, and social exclusion during menstruation. All of this has far-reaching negative impacts on the lives of those who menstruate restricting their mobility, freedom, and choices; affecting attendance and participation in school and community life; compromising their safety; and causing stress and anxiety. 

Asha’s interventions for people in Delhi’s slums

  • Trains Community Health Volunteers (CHVs) on reproductive health topics with sessions on the life cycle; safe motherhood; contraception and infertility; STIs/RTIs; HIV/AIDS; uterine prolapse; cancers of the uterus, cervix, and breast; menstrual irregularities; and menopause.All pregnant women in Asha-supported slums receive basic laboratory investigations; 
  • Conducts a behavioral change program among men and women in the slum community to help them attain the highest standard of sexual and reproductive health. Sensitive to the community’s reproductive health problems, Asha supports women in continuing their pregnancies, does not have facilities for pregnancy termination, and opposes prenatal sex determination, which in India is used primarily with the goal of aborting a female pregnancy.99% of deliveries take place either in hospitals or by trained birth attendants;
  • Educates couples (ages 18 to 45 years) through a noncoercive and motivational approach in how to use temporary methods of contraception, and distributes condoms so as to encourage small families. CHVs accompany couples to hospitals when they choose sterilization, and refer infertile couples for treatment;
  • Uses IEC (Information Education Communication) material to educate regarding treatment and management of HIV/AIDS, Reproductive Tract Infections (RTIs) including Sexually Transmitted Diseases (STDs), and tuberculosis. Once screened by trained staff or volunteers, patients are treated by the doctor, supported by laboratory facilities at the Asha Polyclinic. Staff encourage HIV testing at nearby facilities for expectant mothers, for children who remain malnourished and fail to thrive despite intervention, and for patients with multi-drug-resistant tuberculosis despite prolonged treatment.
  • Provides gynecological and infertility medical workups and treatments, and refer women with infertility to other health institutions;
  • Focuses on safe and effective menstrual hygiene management. Women and adolescent girls are provided access to clean absorbents and sanitary pads for safe and hygienic management of menstruation.
Reproductive health

Rajjo’s story

Rajjo lives in the Dr. Ambedkar Basti slum colony of R.K. Puram with her husband of 12 years. Two years after their marriage, Rajjo had her first child. Unfortunately, the child died within three months. After a gap of one year, Rajjo conceived again and gave birth to a healthy boy in a hospital under Asha supervision. The couple then consulted the Asha Polyclinic doctor for family planning. The doctor advised them on the advantages and disadvantages of all contraceptive methods. Rajjo chose to take the Depo Provera (DP) injection every three months. After 3 years, the couple wanted to have another child, Rajjo stopped taking the DP injection and became pregnant. 

She has again started the DP injection on advice from the Asha team as she does not wish to have more children. Asha’s Family Planning Services counsels thousands of such couples across the slums to plan their families by using both temporary and permanent methods.

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Asha’s Mission is to work with the urban poor to bring about long-term and sustainable transformation to their quality of life.

Asha India - children on the slum streets