These past few weeks have been crazy! So much has been going on with my internship that I’ve been unable to keep up with the blog. I’ve had a variety of experiences ranging from immersing myself in the rural regions of Meghalaya, attending glamorous conferences, strolling the wealthy streets of Bandra, Mumbai, hiking in Sohra, etc. In the last few weeks, I have grown as a researcher and a person. I’ve witnessed the struggles of those who are poor in India, I’ve observed the cultural and economic differences across states, and have often thought about what the future of health systems strengthening looks like. At times, I’m extremely optimistic about the trajectory of development in India and then there are moments where I see infrastructure is sub-optimal, health facilities are nowhere to be found, etc. and I’m left with a sense of frustration and disappointment. I’m rambling, but quite honestly, I don’t have a coherent conclusion about what the development path in India will converge towards in the health sector.
For now, I’ll concentrate on my experiences with field work in Meghalaya. My project focuses on examining the quality of maternal care at institutions. For the purpose of my project, I decided to specifically look at the user experience of women who delivered at institutions. User experience can be broken down into two components: respect and customer service (Kruk et al., 2018) I attempted to gauge these components by traveling to two villages in Meghalaya that had a high number of institutional deliveries (absolute number not percentage). These two villages were in Ri Bhoi district which was surprising considering the fact that this district had low institutional delivery overall.
With the help of four eager interns from the Indian Institute of Public Health-Shillong, I led the field visit across these two villages. We started our trip at 7 a.m. in the pouring rain. My plan for the day consisted of conducting individual interviews with mothers who have delivered at institutions as well as focus group discussions with relevant stakeholders like ASHAs, Anganwadi, workers, village headmen, and other members who would be likely to refer women to institutional delivery. Before I could conduct any of these interviews of FGDs, I had to obtain the consent of the village headman. The interns and the block manager would help with Khasi translations of the project scope. It was exciting to see some of the concepts from my ethics class last semester come into play. Throughout the day, we walked through villages going from house to house to talk to women who have recently delivered. It was a memorable experience.
Throughout the day, I realized that surveying individuals is a much harder task than I anticipated. While I was improvising ways to retrieve more information from participants, I realized that the power dynamic at hand was hard to overcome. Women felt pressured to report positive experiences. I came away with a strong understanding of what limitations exist when collecting data on a topic like user experience. The field visit was a great opportunity for me to practice the skills I developed at school and to witness how theory can fall apart in real-life situations.
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