According to a study conducted by Lancet, almost half of India’s pregnancies in 2015 were unplanned. 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 emergencies 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.
What role can major employers of women, such as garment factories, play in improving access to sexual and reproductive health (SRH) services? Can providing a safe space in factories break the taboo around this topic and promote positive health seeking behaviours?
To understand the needs of 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. We noticed that the first point of contact for SRH issues for migrants back in their villages is the local community ASHA (Accredited Social Health Activist) or Anganwadi worker (a local community health worker who isn’t a trained medical staff but knows the setting and its norms), a person they lose touch with 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.
We want to understand how price sensitivity and providing a safe space in the factory to talk about SRH changes the ways in which workers access these services.
Our partner Shahi Exports, India’s biggest apparel export house, along with the Family Planning Association of India, is opening a sexual and reproductive health clinic in the Peenya region of Bengaluru. The clinic will serve around 9,000 Shahi workers and around 8,000 people living in the local community .
The aim of the research is to understand how we can increase footfall at the clinic. Would reducing prices affect the usage of services or generate buy-in by enabling initial visits? Or will providing a safe space to discuss SRH related topics in the factory destigmatize SRH? We will evaluate the project via randomized controlled trial, and observe the changes in knowledge, behaviour, and attitude towards SRH.
Our safe space model is based on peer-to-peer learning and aims to tackle the void women face when they move to new cities to work, leaving their social networks behind. We want to create a space where they can talk to each other about SRH-related issues and have access to the knowledge they had back in their villages from ASHAs and Anganwadi workers .
Image credits: Nayantara Parikh
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