GBL Access

Nudging for Sexual and Reproductive Health

FOCUS AREA

Unlocking Female Labor

LOCATION

Bengaluru

REACH

4 factories, 9,000 workers

PARTNERS

Shahi Exports, Family Planning Association of India (FPAI), United Nations Foundation

STAGE

DESIGN

EVALUATE

ANALYZE

DISSEMINATE

SCALE-UP

According to a study conducted by Lancet, almost half of India’s pregnancy in 2015 were unintended. In data from a baseline survey conducted by us for another project that covered 260 randomly selected women in two factories, 60% of women said they use cloth instead of pads at work or other times, such as in cases of emergency or when they forget to bring a pad. Obstetric morbidity (disease due to pregnancy) is significant as well, underscoring the lack of adequate prenatal or ante-natal care.

Challenge

What role can major employers of women, such as garment factories, play in improving access to SRH services? Can providing a safe space in factories break the taboo around this topic and promote positive health seeking behaviours?

Scoping

To understand the need of the workers, we undertook exploratory research in six garment factories in the Peenya region of Bengaluru. We conducted open-ended structured interviews and focus group discussions with over 50 women workers, factory medical staff, welfare officers, and organizational development team members to understand their behaviour and attitude towards SRH. We found that the baseline level of knowledge regarding SRH among workers is quite low, especially for unmarried women. We also observed their decision making is more short term rather than long term, whereas investment in SRH is a long term decision. The other thing we noticed is that the first point of contact for SRH issues for migrants back in the village is the local community ASHA (Accredited Social Health Worker) or Anganwadi worker which they lose when they migrate to cities for work. Further, several other factors preclude women from accessing SRH services like price, distance, attitude and behaviour of clinic staff.

Design

The aim of the research is to understand if providing training and a safe space to discuss SRH related topics in the factory destigmatize SRH?

Our Partner Shahi Exports, India’s biggest apparel export house, along with Family Planning Association of India (FPAI) is opening up a sexual and reproductive health (SRH) clinic in the Peenya industrial region of Bengaluru. The clinic will serve around 9,000 Shahi workers and around 8,000 others living in the local community. The clinic will be funded by Shahi and managed by FPAI. Along with running the clinic, FPAI will implement a train-the-trainer (TOT) program for medical and welfare staff in six Shahi factories, to enable them to undertake sensitization workshops with 9,000 workers on SRH and Family planning (FP). The clinic will provide a range of contraceptives, services like general consultations, immunization, counselling for GBV, and make any necessary referrals to government health services.

The clinic will cater to solve the supply side shortcomings of the health ecosystem. To overcome the demand side constraints and needs of the workers, GBL has ideated on designing a safe space for workers to discuss various SRH issues, facilitated by expert trainers. This training will complement the FPAI basic sensitization workshop and will be completed in 16 sessions of 20-30 minutes each. The training sessions will be delivered in groups of 10-15 workers for a period of four months. The curriculum of the training will cover various topics like Sex, Menstrual hygiene, Contraceptions, STDs, Pre-natal and ante-natal care, abuse, consent etc.

We will evaluate the project, via randomized controlled trial, and see change in knowledge, behaviour, and attitude towards SRH after the four months of training

Image credits: Nayantara Parikh