A Quest to Ensure the Fundamental Right to a Healthy and Empowered Life

An Interview with Meher Rehman, Senior International Advocacy Associate

We recently welcomed Meher Rehman back to the PAI office with great excitement and cheer. In the discussion below, we took a few moments to learn more about Meher’s new advocacy position, the QUEST initiative, and what motivates her dedication to family planning programs.

First, tell us who you are and what QUEST is.

My name is Meher Rehman. I am a Senior International Advocacy Associate responsible for managing QUEST: Quality Upheld Every Service Every Time. QUEST is a PAI initiative supported by the Packard Foundation and created to strengthen the abilities of advocates in five countries (The Democratic Republic of Congo, Ethiopia, India, Myanmar and Pakistan) to assess and monitor the quality of family planning programs. Our goal is to understand quality in reproductive health programs and use what is learned to support changes in policies and health systems, correcting imbalances, and replicating conditions that drive quality.

Why is an initiative like QUEST necessary?

In the last few years there has been a renewed interest in the reproductive health community as well as among funders and governments to address women’s unmet need for family planning. However, a significant amount of focus has remained on understanding the client-provider relationship and assessing quality from that perspective but there has been a lesser reflection on the larger environmental and systemic determinants of quality and rights in family planning. In this backdrop, an initiative like QUEST that uses a quality and rights approach is an important one to not just recognize quality, but also understand ‘HOW’ it happens and what drives or hinders the quality of reproductive health services.

What was your first encounter with issues of quality?

In 2003, I was working with women-led groups in the state of Rajasthan in India, helping them with good governance and strengthening their capacities to participate in the political sphere more effectively. The women were predominantly agricultural laborers and construction workers who had been diligently running micro-credit programs and leading a range of community development initiatives in their respective villages. One day, as we were waiting to start one of our monthly trainings, we learned that Kamli Devi, one of our very active group members had had a medical emergency and had been rushed to the hospital, almost 15 kilometers away from her village. I learned that Kamli who was about 21 years old was expecting her fourth child. She had faced several complications in her previous pregnancy as well as in this one.

Kamli passed away after excessive blood loss; her baby could not be saved either. I was heartbroken. It was too disturbing to think of the three children Kamli had left behind and more importantly, the fact that a young life had just been taken in a matter of minutes. As a team, we grieved the loss of a potential young leader who would have certainly led the outcomes we were jointly working towards.

For me, Kamli’s untimely death raised several questions about the state of health in India and how ordinary women in the rural hinterlands fit into that huge system.

What pressed most on my mind was what exactly had failed Kamli Devi? Was it the inadequacy of our public health system? Was it the conservative nature of the society that led her to marry at the age of 14 when she should have been at school? Or was it the government which seemed so oblivious to the concerns and challenges of women—or was it all of these?

Coming from an urban middle-class family in New Delhi, I had always taken my rights and health for granted until that moment when I was confronted with the disconcerting reality of a woman who probably never knew she had any rights.

What has changed for you since then?

Five years after my experience in Rajasthan I came to PAI as an Atlas Corps Fellow. The opportunity opened up innumerable avenues for me to learn about a woman’s right to achieve her potential by having access to contraception. It was then that I clearly understood the critical links between family planning and prevention of unintended and complicated pregnancies, unsafe abortions, and maternal and infant deaths, and its intersectionality with HIV/AIDS, sexual health and gender.

Throughout it all, I have thought of Kamli. And so it made perfect sense for me to return to PAI this year. QUEST has been an important reminder that high-quality care is the right of every woman. If I was to put myself in Kamli’s place, I would interpret quality to include my right to get readily-available, safe, cost-effective and respectful reproductive health care. That said, guaranteeing a woman her right to access quality reproductive health at the most primary level is not that simple. It is impacted by several other factors like a country’s laws, regulatory frameworks, standards and protocols, and its socio-cultural fabric. This is what QUEST attempts to study and what has helped me to begin to understand the complexities behind Kamli’s case.

As I think of the possibilities that QUEST presents, it instills a huge sense of hope and confidence in me that this strategic work could ultimately impact the lives of millions of women like Kamli, who are still waiting to fulfill their fundamental right to live a healthy and empowered life.