Teleconsultation for the Underserved – A SEWA Model

Healthcare in India is vastly unequal when it comes to issues of access, quality of care, cost, and reach. 75% of the healthcare infrastructure is concentrated in urban areas where only 27% of the total Indian population is living, leaving large swathes of India underserved and overburdened. Underserved populations therefore must forsake medical care or “are forced to spend a higher proportion of their income on health care than the better off.”2 As with patriarchal social structures world over, women end up bearing the brunt of this inadequacy- increased unpaid care work, limited access to health care, debt burdens and long term impacts on health. The COVID pandemic in particular has highlighted the inadequacies of our global health systems, with underserved populations recording higher death rates, more severe side effects, and now unequal vaccine access.Within this context, the SEWA movement has had to grapple with unique challenges in reaching their members. As a movement and a corresponding member based organisation, our work is rooted in communities and hyperlocal. The pandemic however made it impossible to continue our work as is and SEWA had to innovate so we could continue to support and reach our innumerable members throughout both waves of the pandemic, adopting multiple modalities. Our core innovation boils down to the combining of our core legacy of ommunity focused and deep community based work, with modern innovations in telemedicine and the digitisation of society.