Voicing Aspirations to be Heard

Abstract: Quality of maternal healthcare is one of the many pervasive public health challenges facing India. Maternal healthcare is defined as a fundamental human right and a crucial development issue by the UN, with direct links to the progress towards achieving the Sustainable Development Goals, especially reducing poverty (SDG1), ensuring healthy lives (SDG3) and achieving gender equality (SDG5). Whereas healthcare provision has traditionally been governed by a needs-based assessment approach founded on health resource utilisation data, social accountability is increasingly recognised and adopted by healthcare service providers as an approach that centres the perceptions and priorities of the recipient. There are many studies on the social accountability approach to maternal healthcare, but there is little current research on the link between aspirations and accountability in the context of low-resource maternal healthcare provision. Through the insights offered by social theorists including Bourdieu, Sen and Appadurai, this thesis examines a case study of the Hamara Swasthya Hamari Awaz campaign and the communications process it used to strengthen poor, rural Indian women’s voices and enable aspirations for better maternal healthcare. One semi-structured, in-depth interview and two secondary source interviews with campaign organisers, as well as 15 media texts and 121 social posts provided data about the campaign. The analysis revealed that the campaign used a social accountability approach, complemented by an operationalisation of the capacity to aspire approach, to: create a dialogue and information exchange with poor, rural Indian women; to amplify their voices about their priorities; and to support them to develop a capacity to aspire for, and realise that aspiration for, better maternal healthcare. By demonstrating the connection between the present and the future for these women, HSHA helped to form a platform for dialogue with traditional power-holders, leading to a sustainable aspiration-building framework for women’s empowerment on maternal health issues at the local, national and international levels.