2023 Seed Grant Award Problem Statements

Decent Work and Education

Problem #5: Scaling up Community Health Worker Programs to Respond to the Broader Needs of Low-income Female Laborers in India

Country/Region of execution:  India

Collaborating Organization: Self Employed Women's Association (SEWA)

Self Employed Women’s Association (SEWA), founded by the late Elaben Bhatt, is a member-based organization of 1.6 million poor women workers from the informal economy across 18 States of India. SEWA also has its presence in neighboring countries of Afghanistan, Bhutan, Pakistan, Nepal, Bangladesh, Maldives, and Sri Lanka. SEWA’s strategy involves working around the achievement of the twin goals of (a) Full employment - employment that provides work, income, and food security and Social Security and (b) Self-reliance – economic & decision-making. By organizing these women workers to attain full employment, SEWA helps them become autonomous and economically self-reliant, both individually and collectively, including decision-making ability. To achieve its goals, SEWA follows an integrated approach which does the following: (a) Organizing for collective strength, (b) Capacity building to stand firm in a competitive market, (c) Capital formation for risk mitigation & fight poverty, and (d) Social security to enhance well-being & productivity.

Problem Statement Description:  The Self-Employed Women’s Association (SEWA) is the largest trade union of women in the world and one of the most respected and impactful organizations in advocating for the rights of low-income female laborers in Southeast Asia. With the growing number of people in India with diabetes, India has the unfortunate designation of having one of the world’s highest burdens. While there are numerous barriers to managing the clinical aspects of diabetes, these barriers are further complicated by the social determinant of health barriers that the women of SEWA disproportionately face. Many of these women battle economic distress and family needs while navigating India's complex healthcare system. SEWA has tried to address these barriers for women and their families by hiring and training their union members to become community health workers (CHWs) who provide a comprehensive set of health-promoting services. This includes health education, socio-behavioral support and counseling, socioeconomic assistance, and direct provision of clinical services such as glucose screening. We are looking for additional collaborators to strengthen our community health worker program to better respond to the needs of the members we serve and the broader Indian public. Specific areas for improvement include more efficient data collection/collation, analysis of data, development of an M&E plan, development of novel language-adapted training, identification of scale-up strategies, integration of additional health conditions beyond the current set (primarily chronic non-communicable diseases), and better integration of care with clinics and other social determinant of health-related needs. The proposed responds to multiple Sustainable Development Goals as it improves clinical health and responds to the broader socioeconomic needs of low-income female laborers in India.