Social Security and Health

The risk of illness for marginalized families is irreversible health damage, inescapable debt, and even early death. Poor working women’s health issues become neglected because of high costs, administrative barriers, overwhelming workloads, and domestic responsibilities. SEWA’s integrated health program includes both preventative and curative care to try and address women’s health problems before they escalate. SEWA Bharat aims strengthen the existing government social security program by connecting poor to government services. To facilitate this SEWA has opened its own SEWA Shakti Kendras around India.

SEWA Shakti Kendra (Empowerment Centers) (SSK)

In 2007, SEWA Delhi was appointed as the manager of a Delhi government initiative called the ‘Gender Resource Center’ in Sundernagari, a resettlement colony in northeast Delhi. The GRC project aims to bring social, economy and legal empowerment to women particularly those belonging to the underprivileged section of society. 

Adapting the GRC model, SEWA now runs its own empowerment centers called SEWA Shakti Kendra (Empowerment Centers) across 7 areas of Delhi, and across all SEWA Bharat-supported districts.

SEWA Shakti Kendras are convergence and coordination centers for SEWA in order to empower communities by strengthening members’ capacities to access entitlements – through mobilization, building awareness, initial support and hand-holding and nurturing grassroots leadership. At SSKs, community members can get information on SEWA initiatives, government departments and schemes, and application support.

Activities:

Campaigns

Achievements

  • 5,023 referrals to healthcare centers reduced financial burden on vulnerable women workers and their families in 2013
  • In 2013, 1,832 SEWA jagriti (awareness) sessions brought 26,818 people across UP, Delhi, Bihar, and West Bengal vital information on health rights, treatment, and services
  • In Delhi, The number of people visiting SEWA information desks has grown by nearly 50% since 2011, with a footfall of 18,834 people in 2013

Jagriti sessions: educating women for preventative care

SEWA believes that tragic outcomes can be avoided with preventive health awareness. Jagriti (awareness) sessions empower women with in-depth knowledge on key health issues and treatment options. Tailored sessions are designed for each local community or specific trade group to cover issues that are most relevant to them. Some major topics covered in jagriti sessions are maternal and infant healthcare, sexual health and reproductive rights, occupational health hazards, and relevant social security entitlements. Jagriti sessions are a gateway into the SEWA Bharat health program’s other activities such as referral to medical services, linkages with schemes, and health advocacy.

Referrals: increasing access to healthcare

To promote access to healthcare, overcome administrative barriers and help women reduce expenditure, SEWA health saathis directly refer women to government and private healthcare centers. Health saathis pass on the skills and experience to women members to lead others to medical centers to ensure sustainability.

Social security linkages

The government of India offers a vast number of schemes to promote social security for the marginalized, but the benefits rarely reach those in need. In SEWA Bharat project districts, local health workers help poor women learn about government schemes, fill out and process forms, and access their social security entitlements. SEWA Bharat’s integrated approach means that health workers and poor women also can connect with other program teams for legal, economic, and financial support.

Focus: Rashtriya Swasthya Bima Yojana (RSBY)

The roll out of the RSBY scheme has been slow and inefficient, ultimately failing poor families. RSBY is a health insurance scheme for families that live below the poverty line (BPL). Beneficiaries of RSBY are entitled to hospitalization coverage of up to Rs. 30,000/- for five family members for most diseases that require hospitalization.

Issues with RSBY delivery:

  • Voicing community issues with the scheme such as not receiving RSBY ‘Smart Card’: Acting as a bridge between relevant state-departments and local community
Key social security schemes
  • Basic identity: income certificate, caste certificate, birth certicate, voter ID, Adhaar card, death certificate
  • Health related: Janani Suraksha Yojana (JSY), maternity benefit for institutional delivery, insurance for BPL families,
  • Socio-economic schemes: minority schemes, RSBY,
  • Pension schemes: old age, widow, and handicapped pension
  • Education: Ladli Scheme (education of the girl child)
  • Housing: Indira Awaas Yojana
  • Livelihood-based schemes: such as bandhej artisan cards and bidi worker ID cards that help particular trade groups access social security entitlements; and Mahatma Gandhi National Rural Employment Guarantee Act (NREGA)

Health camps

SEWA fills the gap in government healthcare provision by organizing health camps where the poor can access free health services. SEWA Bharat works extensively with government officials at the local, Panchayat, block, and district level and with health providers such as doctors and counselors, in order to bring high quality services directly poor communities.

Main health camps:

  • General well-being
  • occupational health camps such as eye camps for home-based workers
  • Women’s health camps: gynecological, sexual health and reproductive rights, adolescent development

Adolescent development

adolescent

Adolescents are nation’s future and investment in their development is critical. The National Adolescent Reproductive and Sexual Health (ARSH) strategy provides a framework for a range of sexual and reproductive health services to be provided to the adolescents. The strategy incorporates a core package of services including preventive, promotive, curative and counseling services.

SEWA is ensuring the effective implementation of the program by linking Youth to ARSH Adolescent Friendly clinics where youth needs can be met through counseling services, routine check-ups at primary, secondary and tertiary levels of care is provided on fixed days and fixed time to adolescents, married and unmarried, girls and boys during the clinic sessions.

  • Counseling sessions to explain mental, physical and social changes for adolescents.
  • Community-level and mother-daughter meetings to demystify issues around pregnancy, contraception, and menstruation that are taboo.

Health advocacy

SEWA works extensively with government officials at the community, Panchayat, block and district level as well as service providers in the area, including doctors, counselors, and laboratory staff. SEWA Bharat develops close relationships with relevant departments and ministries to ensure that scheme benefits reach the needy.

Landmarks with Village Health and Sanitation Committees

SEWA Bharat’s local teams in Bihar have initiated 26 Village Health and Sanitation Committees (VHSC) – 10 in Munger, 6 in Katihar, and 10 in Bhagalpur. VHSCs are responsible or Panchayat-level healthcare under the National Rural Health Mission (NRHM). SEWA Bharat leaders have made landmark achievements in community healthcare by activating local health sub-centers under the VHSCs.

Water, drainage, and sanitation

The poor often live in areas with the worst sanitation and access to water. These key environmental determinants of health are systemic challenges, and thus require collaborative problem solving between community members, local government, and other stakeholders.

Campaign activities

Communication & Awareness raising for behavioral change

  • Workshops and meetings about hygiene, hand washing, community cleanliness, toilet use, waste disposal

Advocacy

  • Jan sunwais (Social Security camps) as a platform for locals to discuss issues with government scheme delivery
  • Meetings, demonstrations, and petitions to ensure the government delivers waste disposal infrastructure, staff, and support

Direct community intervention

  • Local events to clean the community
  • Pooling community funds for cleaning
  • Pipe testing to ensure potable and safe community water supply
  • Community anti-mosquito spraying to lessen malaria and dengue

Scheme Linkages

  • Enrollment of members for government toilet construction schemes
  • Connecting communities with

Reproductive Health

Sexual and reproductive rights are basic human rights, but without correct information, thousands of women in India die from birth complications and other maternal health issues. SEWA Bharat helps meet the need for reproductive healthcare through:

  • Connecting female gynecologists and local communities
  • Holding cervical cancer screenings with free treatment
    • Advocate local government for routine screening provision in districts where this service is missing
    • Work with private practitioners and healthcare providers to fill this gap

Meetings

Annual Report

SEWA Bharat Annual Report 2013

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