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SEWA's Community Health Programmes

SEWA's Community Health Programmes

The Self Employed Women's Association (SEWA) is a women's trade union that was started in Gujarat in 1972 by Smt. Elaben Bhatt, with the aim of organising women in the informal sector. SEWA represents the convergence of three movements: the labour movement, the women's movement and the cooperative movement. Based on the philosophy of Gandhiji, SEWA's goal is to achieve full employment and self-reliance for all its members.

SEWA defines 'full employment' as employment that provides work security, income security, food security and social security. 'Self-reliance' refers to economic self–sufficiency and equitable roles in the decision-making process. These goals are achieved through a strategy of "struggle and development". The struggle is against the many constraints imposed on women by society and the economy, and the development activities are aimed to strengthen women's collective bargaining power and provide them with sustainable new alternatives. .

Genesis of SEWA Bharat:

SEWA's experience in Gujarat provided encouragement to women in other states as well, with sister organizations being set up in a total of nine states till date. Together, these sister organizations constitute SEWA Bharat, the All-India Federation of Self Employed Women's Associations. SEWA's mandate is to highlight the issues of women working in the informal sector, and to strengthen the capacity of the different organizations that serve them. SEWA Bharat is a membership-based organization.

Mission Statement:

SEWA is committed to strengthening the informal economy by highlighting their issues at the national level and building its member organizations' capacity to empower them.

The nine states where SEWA organizations are spread across are
Rajasthan,
Gujarat,
Kerala,
Madhya Pradesh,
Delhi,
Uttrakhand,
Uttar Pradesh,
Bihar
West Bengal.

They account for over 1.34 million women members engaged in numerous activities like home-based work, street vending and hawking, manual labour, service providers and small producers.

Activities undertaken by SEWA Bharat:

  • Organizing and Capacity Building:

    Organizing women to increase their bargaining power, and building their capacity to achieve the same.
  • Micro-finance:

    Helping women to increase their capital at the household levels by providing them the necessary financial tools like continuous savings, micro-credit etc.
  • Skill Development and Employment Generation:

    Improving income-generation and market opportunities for women workers and conducting skill enhancement programs for adolescent girls.
  • Social security:

    Increasing access of women workers to social protection entitlements, including health, insurance, child care and pensions.
  • Advocacy and Networking:

    Making the concerns and problems ofwomen workersvisible through organised advocacy and campaigning,leading to increased recognition of their rights and entitlements by organizing campaigns and linking them to various media sources.

Background:

Belonging to the lowest socio-economic bracket, and living and working in high risk environments that lack water and sanitation SEWA members and their families are often in poor health and have short expected life span. The high cost of health care often prevents them from seeking treatment resulting in worsening health status. Poor health results in lost wages and health care expenditures and lead to indebtedness, loss of assets and further poverty. Unfortunately, while many excellent policies offer free or subsidized treatment or benefits for impoverished families, the implementation of these schemes is poor. Therefore, women seek care at private institutions leading to high health expenditure and debt, further impoverishing their families. SEWA Bharat seeks to tackle this issue through its integrated approach. First, it provideeconomic security opportunity to their members by linking them to its livelihood and microfinance programs, andsecondly, it capacity within the communitytowards providing health and social security.

SEWA's Approach:

SEWA's believes in strengthening existing services, rather than establishing a system parallel to that of the government. At the same time, SEWA works to ensure that health services reach members, their families and communities.

Local community health workers are the cornerstone of SEWA's health program. Known as sathis, SEWA health workers serve the entire community, and work to organize SEWA members in their villages and neighbourhoods. They are educators, service providers and advocates.

Objective:

The objectives of SEWA's health programme are as follows:

  • To build the community's capacity to demand their sexual and reproductive rights within a broader framework of the rights to health and social security
  • To work with partners to bridge the gap in government services and increase the availability subsidized or free sexual, reproductive and other health services and advocating for availability, accessibility and quality of public services.

Key Components of SEWA Health Programmes:

1. Jagruti or awareness meetings

The basis of the health program is awareness meetings. Community health workers provide health awareness through community meetings and cover a range of topics. These meetings are instrumental in understanding the key issues facing that particular village or community and are a gateway into the health programs other activities such as referral to services, linkages with schemes and programs and advocacy.

2. Increasing access to quality services: Referrals and health camps

SEWA works extensively with government officials at community, panchayat, block and district level as well as service providers in the area, including doctors, counsellors, and laboratory staff. Service providers are requested to provide services in the community or patients are referred to known qualified providers. Public providers are also invited to train SEWA teams and communities. Where there is a service gap SEWA has two approaches: one is accompanying patients to the relevant provider, and two, if there is great demand for a service or a whole community or issue is neglected, is organising health camps at the community level.

This is an international initiative that aims to inspire, mobilize and unite young people in an effort to push back the spread of HIV and AIDS. The use of popular culture, particularly dance engages young people and creates an experience which is personal, interactive and emotional. The concept follows the steps of inspire, educate, activate and celebrate.

The concept is owned by a Dutch based organization called Dance4life that reaches more than 30 countries worldwide.

In India, Restless Development has partnered with the organization in programme implementation and is the National Concept Owner of the programme.

The Project is implemented by Restless Development in 4 states, which includes Bihar, Orissa, Jharkhand and Tamil Nadu.

Youth Resource Centre

We have signed the prestigious MoU with Rajiv Gandhi National Institute of Youth Development, Ministry of Youth Affairs and Sports, Government of India as the pioneering youth led agency to pilot the implementation of 8 Youth Resource Centres in 4 states of India as part of the Indian National Youth Policy.

The Youth resource centre will be an information hub with a library, computers, a corner for peer advice and murals and paintings drawn by young people themselves on the areas of health, livelihoods and youth participation in governance.

The youth resource centre will be run by young people from the community and will serve as a model for youth engagement as outlined in the National Youth Policy (draft 2003).

Facilitator for Youth Livelihoods

Based on our continued research on livelihoods, Restless Development will serve as a facilitating agent feeding into the entrepreneurship training programmes of other like-minded players. We will source young people from the communities, provide them with soft skills, help them in choosing their career paths and link them to appropriate service providers for livelihood options - skills training, career development, employment and developing entrepreneurship.

3. Linkages with government schemes and programs

The government has provided schemes and programs for certain target groups such as schemes for girls' education, for bidi workers, RSBY insurance for BPL families, etc. Some of these schemes would help address the social determinants of health while other directly address health needs of communities. Working in collaboration with other program teams, health workers help women learn about these schemes, fill out and process forms and access these entitlements.

Some of the schemes that SEWA actively works on are:

  • Janani Suraksha Yojana (JSY Maternity benefit for institutional delivery)
  • Minority schemes
  • National Rural Employment Guarantee Act
  • RSBY- insurance for BPL families
  • Indira Avas Yojana
  • Ladli: Education of the girl child
  • Old age and widow pension
  • Worker schemes: ex. Bidi cards and entitlements,
  • Death benefits
  • Disability certification and benefits
  • Birth, death and BPL certificates

4. Water, Drainage, Sanitation and Health

Members often bring up the issue of water, sanitation and drainage. These key determinants of health are critical for community health; however, changes to the drainage, water or sanitation system represent a systemic challenge for communities with build-up structures. However some basic strategies can be followed to address these basic needs:

  • Behavioural change communication regarding hand washing, community cleanliness, use of different types of toilets and waste disposal.
  • Awareness of different waste disposal strategies.
  • Community cleaning and garbage disposal.
    • ◦ Advocating with government for regular paid cleaning and disposal structures.
    • ◦ Organising and pooling in community funds for community cleaning drives.
  • National Rural Employment Guarantee Act
  • RSBY- insurance for BPL families
  • Indira Avas Yojana
  • Ladli: Education of the girl child
  • Old age and widow pension
  • Worker schemes: ex. Bidi cards and entitlements,
  • Death benefits
  • Disability certification and benefits
  • Birth, death and BPL certificates