According to a study conducted by Lancet, almost half of India’s pregnancies 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.
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 behaviors?
To understand the needs 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 behavior 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 behavior of clinic staff.
The research aims to understand if providing training and a safe space to discuss SRH related topics in the factory destigmatizes SRH. Our Partner Shahi Exports, India’s biggest apparel export house, along with the 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. The clinic will provide a range of contraceptives, services like general consultations, immunization, counseling for GBV, and make any necessary referrals to government health services. The clinic will cater to solving 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 be completed in 16 sessions of 30 minutes each. The training sessions will be delivered in groups of 10 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 the change in knowledge, behavior, and attitude towards SRH after the four months of training.
Image credits: Nayantara Parikh