The Maharashtra government recently included a penis mold in its family planning counseling kits to make demonstrations more “effective”. But Accredited Social Health Activists (ASHAs) – women responsible for raising awareness of family sexual health and fertility in rural areas – are meeting resistance from community members because of the graphic models.
“Through the tools, ASHAs can also demonstrate the process of wearing condoms,” said Dr. Archana Patil, Chief Health Services Officer. Until now, women used images in brochures and brochures. This is the first time that practical tools – such as a replica of a womb and a mold of a phallus – have been included.
The motivation for the decision is obvious: experts believe that the hands-on representation will increase awareness and make the demonstration more effective. A visual demonstration of how to use condoms or detailed anatomy can be said to be instructive and may even encourage people to use condoms. But any family planning intervention takes place in a socio-cultural context; in this case, the context is filled with social taboos around sex and reproductive health.
ASHAs, as the frontline rural health workers in India, are primarily responsible for maintaining community contacts, distributing contraception and counseling couples on family planning. Family planning remains the most immediate community-based intervention to reduce pregnancy-related mortality in India, experts say Remark. Their fluency and training in the use of sexual material then becomes the focus of the conversation.
Notably, there are ideological and systemic barriers to this implementation. On the one hand, there remains a widespread stigma around sex education or talking about sex of any kind; the specter of a rubber penis used to talk about family planning then undermines cultural characteristics.
“Before, we advised couples with photos. But now, as soon as you break the mold, family members, especially men, get offended because of the stigma. They claim that we are shameless and that we corrupt their women”, an ASHA from Nashik Told the Indian Express.
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Next, some experts also note that ASHAs may not be fully trained to deliver sex education or family planning awareness using these tools. Their own discomfort, coupled with the insults and harassment they face from members of the community, can make the whole endeavor futile.
“Most ASHAs have studied up to class X and are not qualified to properly impart sex education with the tools,” said Raju Desale, Maharashtra Rajy Aarogy Khate ASHA V Gat Pravartak Sanghtana. “Any inappropriate discussion can still confuse couples and insult men’s virility.”
In addition, ASHAs faced discrimination and harassment – because of their gender and their self-employed status. “ASHAs are structurally vulnerable to bullying because they are perceived to be of lower status – they are women, at the bottom of the hierarchical health system, often not wealthy, not formally employed by the health facility, and are not salaried workers”, mentioned public health advocate Anant Bhan. This pattern of exclusion was reinforced during the pandemic – when several women reported experiencing violence and were excluded from their communities for their connection to Covid19. Undoubtedly, having to use models of sex equipment for local rural outreach can mean greater hardship for women.
The question is not whether visual models of reproductive organs make family planning plans more effective; but how can these channels of instruction be integrated seamlessly into intervention programs. The answer lies somewhere between responding to ASHA reluctance and structurally dismantling stereotypes around sex and reproduction.