mHealth & Gender Equality: A New Path to Better Health

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This essay is part of the series: World Health Day 2025: Healthy Beginnings, Hopeful Futures

Gender refers to the roles, behaviours, activities, and attributes that a given society at a given time considers appropriate for men and women. It dictates what is expected, allowed, and valued in each gender, creating inequalities that result in differences in rights, responsibilities, and access to resources.

Lower utilisation and poor access to healthcare in the case of women is an outcome of gender inequality. Gender norms within the household diminish women’s and girls’ agencies, limiting their access to essential resources such as healthcare, education, and nutrition. Patriarchy and intersectionality create multiple layers of generational disadvantages in India, significantly impacting maternal as well as child health. A Gender Transformative Approach (GTA) recognises these; and seeks to identify and address the impact of gender-based restrictive norms as one of the key strategies for achieving better health outcomes. In this context, it is critical that government policies also support such a change. A 2022 report by the NITI Aayog that looks at Gender Mainstreaming across Centrally Sponsored Schemes notes that the health sector performance on this front was poor. The report recognises the need to assess how various health sector schemes and policies take gender mainstreaming into consideration during design and their impact. However, none of it will be effective without gender budgeting, which is significantly lacking. An important example of gender mainstreaming is that women do not need their husband’s permission for contraception use or for medically terminating a pregnancy (within legal provisions). Another example is, making the Janani Suraksha Yojana more inclusive where adolescents; and women with any number of children can avail the benefits.

Lower utilisation and poor access to healthcare in the case of women is an outcome of gender inequality.

The present piece uses data (Table 1) from the National Family Health Survey – 5 (2019 – 2021) and the Sample Registration System’s Special Bulletin, 2022; to highlight the link between Maternal Mortality Rate (MMR) and Neo–Natal Mortality Rate (NNMR) and status of women.   It uses some key indicators that are influenced by gender, patriarchy, and intersectionality. It also presents a case about the role mHealth can play in addressing some of the key inequities. The states of Assam, Madhya Pradesh, Uttar Pradesh, and Bihar have amongst the worst MMR and NNMR in the country. Correspondingly, Bihar, for instance, has amongst the highest percentage of women aged 20 -24 years married before the age of 18 years and amongst the lowest percentage of mothers who have had at least four antenatal care (ANC) visits, women who worked in the last 12 months and were paid in cash as well as the lowest percentage of children under the age of three breastfed within one hour of birth. Maharashtra, on the other hand, with amongst the lowest MMR and NNMR; has the highest percentage of women who are literate and have used the internet; and a high percentage of mothers who have had at least four ANC visits and women having worked in the last 12 months and were paid in cash. A digital divide is evident with differences in women’s access to a mobile phone and ever having used the internet across the states. All across, they fare lower than men in these states. Karnataka, though, reveals an anomaly in terms of very high reporting of gender-based violence (GBV). However, this could be as a result of improved awareness around the issue or as a result of increase in awareness and confidence in the system. Furthermore, a causal relationship has also been established between gender equality and maternal and child mortality rates in literature.

1. Refers to women/men who completed standard 9 or higher and women/men who can read a whole sentence or part of a sentence.
2. Based on the last child born in the 3 years before the survey.
3. Spousal violence is defined as physical and/or sexual violence.

In India, a deeply rooted patriarchal system significantly contributes to the gender gap in literacy. Household duties for females, and their roles as daughters, mothers and daughters-in-law are considered more important. Their care is deprioritised; while husbands view pregnancy as a woman’s responsibility, women are ironically often excluded from decision-making. Distance from facility, lack of care-related information and transportation, overcrowding of healthcare facilities, and lack of sensitive pregnancy care; all add to the barriers in pregnant women seeking care and engaging in care practices for themselves and their children.

mHealth interventions can increase access to critical care information for women; as well as improve services by health care workers.

mHealth interventions can increase access to critical care information for women; as well as improve services by health care workers. Advancing Reduction in Mortality and Morbidity of Mothers, Children and Neonates (ARMMAN) is an Indian non-profit organisation, creating a cost-effective, tech–plus–touch approach to reduce maternal and child mortality and morbidity using a gender perspective. One of the key interventions to address gender norms is through strategically planned content amalgamated with subtle messages that address gender norms. Supportive training of front-line workers in case of high-risk pregnancies, facilitating timely referrals (thus, also preventing overcrowding in health care facilities), and sensitive maternity care are some aspects of health system interventions using technology. The training apps themselves are also made on the principle of being design-inclusive; taking into account the differential learning capacities among health workers. Scalability and sustainability are made possible through alignment with government programmes and infrastructure.

The number of smartphone users in India is estimated to reach over 1.55 billion by 2040. This presents a huge opportunity to integrate technology, health and gender in planned interventions and policies to address intergenerational gender-based disadvantages and their impact on health.

Tejal Barai Jaitly is the General Manager - Research Monitoring and Ethics at ARMMAN

• Healthcare
• India
• ARMMAN tech
• gender transformative approach
• maternal health in india
• maternal mortality rate in india
• mhealth
• newborn mortality rate in india

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