Jnana Prabodhini fights stigma to empower rural women beat anaemia

At 39, Savitha Walgude of Margasani village in Pune is already a mother of three grown children, the oldest of whom is going to college. She works 10-15 hours a day on the farm and at home. Like many rural women who have little to no access to healthcare and regular checkups—the nearest hospitals often being 8-10 km away—Walgude has struggled with severe anaemia, joint pain, and fatigue for years. 

And, like many women in the Velhe tehsil of Pune district, she now knows that these symptoms stemmed from poor haemoglobin (Hb) levels in her body. 

Like Walgude, hundreds of women in and around Velhe are aware of how low Hb affects their body, thanks to a seven-year-long blood testing campaign conducted by Jnana Prabodhini, an institution working on education, research, rural development, women empowerment and health. 

The organisation has been engaged in comprehensive rural development work in about 150 villages in and around the remote Gunjavani and Shivganga valleys in Pune. The latest addition to its grassroots work is the blood testing camps for women.

Four years ago, when Walgude got her blood tested at a Jnana Prabodhini camp, her Hb levels stood at 8 g/dL (grams per deciliter). 

The World Health Organisation considers non-pregnant women with Hb levels less than 12g/dl, and pregnant women with Hb concentration of less than 11 g/dl anaemic.

Women are susceptible to anaemia or low haemoglobin concentration due to their unique physiological needs, including menstrual blood loss, and pregnancy, which means that the burden of anaemia is disproportionately higher in women as compared to men. This is particularly true for low-and middle-income countries, where anaemia is a major cause of morbidity among women of reproductive age group, particularly adolescents.

In 2023, scholars from Banaras Hindu University, Raiganj University, Indian Health Action Trust and Population Council, New York among others, released a study analysing the change in the prevalence of anaemia among adolescent women in India from 2015 to 2021. They found that anaemia prevalence increased from 54.2% to 58.9%  over the study period. Among the 28 Indian states, 21 reported an increase in the prevalence of anaemia. 

Low haemoglobin levels in women lead to insufficient oxygen, due to which their cells cannot convert glucose into energy, leading to poor cognitive and motor development and work capacity.

“I was initially anxious to know my Hb levels because in the village it's easy to be branded as ‘ill’,” says Walgude. “But when more women got tested, the community as a whole understood these concerns better and that with timely testing, medication and better nutrition, we can overcome it,” she adds. 

Today, after years of regular checkups, medication, and diet, her Hb levels stand at 13. Walgude says she has seen an increase in her stamina and that the pain in her body is almost gone.

Walgude is among the hundreds of women who participate in the blood testing camps held by Janana Prabodhini during Navaratri every year.

Empowering women at every stage

For the last three decades, the Pune-based Janana Prabodhini Foundation has focused on providing support to rural women at critical junctures of their lives—from childhood and adolescence to adulthood.

The organisation’s work ensures that another generation of rural women does not fall prey to the perpetual cycle of poverty and disempowerment that has kept them at the bottom of social growth. 

“We have found that poor health is an aspect of disempowerment that needs urgent attention,” says Ajit Kanitkar, Secretary of Jnana Prabodhini research institution.

“The higher secondary schools are at least 5-10 km away, due to which girls drop out and are given into marriages before they can complete their education,” adds Kanitkar. 

As a result, they go on for years caretaking, child-rearing, and working for their families, without ever taking care of their health. 

Jnana Prabodhini (translating to ‘awakener of knowledge’) team organised its first blood camp for women in 2018 after the team realised that a majority of them were too malnourished—as well as exhausted from daily chores—to participate in skill development and community building programmes.

“Their symptoms pointed to low haemoglobin levels and we figured it was time to initiate a blood testing campaign,” says Suvarna Gokhale, Executive Committee Member, Jnana Prabodhini.

The organisation has been planting the idea of awareness about women’s health during large social functions and gatherings. Through years of campaigning, it has helped remove the taboo around getting a blood test, more so in a public setting, and highlighting the importance of regular blood tests.

Changing mindsets

Since 2018, the Government of India has been providing financial and technical support under the National Health Mission to reduce anaemia among six beneficiary age groups—children of  6-59 months and 5-9 years; adolescents (10-19 years), pregnant and lactating women, and women in the reproductive age group (15-49 years).

And yet, Jnana Prabodhini’s mission was a tough one due to the stigma surrounding health—especially women’s health in these rural belts. The organisation had to come up with creative ways to get the community involved in the project before they could even access the government benefits.

In the early years of the campaign, intense hemophobia (a fear of blood) and anxiety around blood sampling kept most women from participating. 

"Less than eight women from 25 villages showed up for our first camp,” says Gokhale. 

To dissipate the stigma associated with the procedure, Jnana Prabodhini decided to schedule these camps around the nine days of Navratri, amid a carnival-like atmosphere with food, games, festivity and worship.      

“We have never made it compulsory for our women to get their blood tested. Our idea however has been to present blood testing camps as one of the many activities that are planned around a festive environment,” says Gokhale. “This eases them up and encourages them to give it a shot.”

These techniques of engagement, along with awareness-building around healthcare and nutrition, led to approximately 1,300 women from across 48 villages in two blocks—Bhor and Velhe—in Pune showing up to get their blood tested during the Navratri of 2023. 

“Women who continue to shy away from blood testing, witness first-hand how those with improved haemoglobin levels are more active and upbeat in their day-to-day lives. We have reached a point where the results speak for themselves,” says Gokhale. 

What has also significantly increased awareness and participation is Jnana Prabodhini’s partnership with the ASHA (Accredited Social Healthcare Activist) workers in the region, who share long-term allyship and trust with the community, and can attend to specific challenges that each household may be facing.

One ASHA worker tells SocialStory about how she nudged the family of a woman in Velhe to take her plummeting haemoglobin levels seriously. 

“This woman was pregnant with haemoglobin levels less than seven. We brought this to the attention of her mother-in-law and warned her about the dangers of delivery in this state. This shook her and she took it upon herself to take her daughter-in-law for regular checkups and supervised her medication routine,” she says.

Another innovative way Jnana Prabodhini employs to encourage women to get their blood tested is by felicitating those whose Hb has reached the optimum level after testing and treatment.      

“During Navratri, there is a tradition to offer sarees to goddess Durga. We celebrate the women who do regular blood tests and improve their HB levels akin to the goddess herself, and gift them with sarees in front of the whole village. This increases their self-worth and also causes a ripple effect, improving their other social determinants in many ways,” says Gokhale.