Institute for Development Studies conducts digital storytelling workshops in Shillong; participants gain technological skills while telling stories of poverty, unplanned pregnancies, and poor quality healthcare.
For Many Living in Urban Slums, Family Planning Means Sterilization
The need for family planning education in India became headline news when the deaths of 16 women at a sterilization camp in Bilaspur, India were reported. In November 2014, 83 women received tubectomies at one sterilization camp within six hours. The surgeons used the same equipment in every case – including syringes and gloves.
With an unreliable supply of other, temporary contraceptives, tubectomy (i.e., the surgical removal of fallopian tubes) is the most common form of family planning in much of India. Female sterilization accounted for roughly 85% of family planning expenditures for the 2013-14 budget year, other family planning activities (i.e., transportation, equipment, and staff expenses) accounted for 13% of the budget, and only 1.45% of the budget was spent on spacing methods.
Given a shortage of trained surgeons, sterilization camps are especially popular, as many procedures can be scheduled in one day. Physicians are assessed and incented based on the number of procedures performed rather than patient outcomes or the quality of care provided.
The doctors are not the only ones incented to sterilize. Women living in low-income, urban settings face many challenges when it comes to sexual and reproductive health. In India – as in the rest of the world – unplanned children can lead to financial hardship.
Women are offered a stipend equal to one month’s wages (i.e., about USD $22 for day laborers). This stipend allows them time to heal without bearing an economic burden.
Although women may wish to prevent pregnancy because they cannot afford to support children, without reproductive health education pregnancy can be difficult to avoid.
Positive Change Comes from Digital Sharing
The Institute for Development Studies, an international, non-profit organization based at the University of Sussex, UK, is leading a four-year collaborative research program called Influencing Policies to Support the Empowerment of Women and Girls.
One aspect of the project involves using digital storytelling to influence policy makers.
One of the great things about stories is their power to bring perspective and change no only to audiences, but to the storytellers themselves.
Digital Storytelling for Public Health Advocacy: Stories of Unplanned Pregnancies, Alcohol, and Abuse
Researchers from the Institute of Development Studies held a digital storytelling workshop for women of the slums of Shillong, a city within the state of Meghalaya in northeast India. Although the women had never used tablets or animation software, they produced their own 3-5 minute digital stories using iPads in a four-day workshop.
The personal stories discuss the difficulties these women face in accessing sexual health services, their significant financial hardships, and the poor quality and accessibility of healthcare. Their stories also speak to the effects of alcoholism – their spouses', not their own – and abuse.
One key theme throughout these stories is the taboo of family planning. When the women in the stories refer to family planning, they do not mean discussing how many children they would like to have with their spouse or physician. They don’t mean choosing between condoms, oral pills, or other temporary birth control methods. They mean sterilization.
The women describe their struggles obtaining quality reproductive healthcare. Their main information source about reproductive health appears to be their peers, and they face judgment from their elder family members if they seek advice.
Digital storytelling uses computer-based tools to tell personal stories. It combines voice narratives, video, still-frame imagery and music. Digital storytellers can maintain their anonymity, while telling moving and intimate stories.
In addition to their use for advocacy and policy decision-making, digital stories can build resilience as women own and share their stories. Creators also build technology skills by using tablet computers and software.
Research shows that engaging women in reflection and giving them a platform through which to share their experiences in a non-threatening environment can lead to positive growth and health enhancement.
Source: Harini Calamur (Flickr: CC)
As with many digital public health initiatives, there are significant limitations to this project. Efforts must be taken to maintain the confidentiality of participants. Additionally, follow-up counseling may be needed as mental health issues, or feelings of guilt and helplessness may arise after such intense workshops.