Approach

Women-led
The cornerstone of all of SEWA’s health activities is to effect an improvement in women’s health status. The emphasis is on initiating health activities based on local women’s needs. While the “entry point” is women’s health, the entire family’s health is also safeguarded.

Sustainability
Lok Swasthya Mandali has always believed in sustainability of its activities i.e. running these in a financially viable manner and by local women themselves. Local volunteers are developed as Sevikas (health workers), Aagewans (local leaders) and Arogya Saathis (health promoters). It is through these local women that all the health activities of SEWA Health are implemented.

Services at Women’s Doorsteps
Services are provided at the doorsteps of our members as like primary healthcare, diagnostic camps, health education or any other service. The purpose behind this approach is to make health services accessible to maximum number of women and their families and preserve their hard earned resources. This approach results in reaching the poorest as the services are provided at the timings suitable to them unlike the public health services which are more centralized and at timings not convenient to the poor. In fact health care-seeking behaviour of the women improves, if the service is available to them closer to their homes and at their convenient time.

Integrated and holistic approach
We firmly believe that no health programme can run in isolation if it is not intertwined with other aspects of the lives of women. In particular, all activities are developed keeping the primacy of work and work security in mind. In addition, activities have been interwoven to address needs of members like insurance, childcare and housing. For example the dais who are both members of the health co-operative as well as work as Swasthya Sathis in their own villages provide a range of health services like health education, primary health services, ensuring access to public health services like immunization and ante-natal care, referral services, curative services like diagnostic and treatment camps, traditional medicines etc. Along with a holistic package of health services, health workers also work as insurance promoters in their villages by enrolling women and their families in insurance schemes which cover health, life and assets, along with VimoSEWA’s SEWA insurance cooperative

Partnership with government and private health providers
Many activities of Lok Swasthya SEWA are running in partnership with government and private health providers with the dual purpose of strengthening the existing government health network and its optimum utilization and obtaining greater access to quality services at a low cost from private providers. Collaboration with many national and international partners such as the Ahmedabad Municipal Corporation, the Government of India, the United Nation Population Fund (UNFPA) and the World Health Organization (WHO), have benefited SEWA and its members, by providing financial and technical support to develop capacity for providing healthcare, and by facilitating access to government services and other resources that might otherwise have been inaccessible. In return, Shri Gujarat Mahila Lok Swasthya SEWA Sahakari Mandali Ltd has been able to help these organizations in reaching some of the poorest informal sector workers, ultimately contributing to their better health and well being.

Policy Action
The need to organize, unite and demand just policies for its members has always been an important part of our activities. Thus, women are provided a platform to voice their concerns before the policy makers. For example, Shri Gujarat Mahila Lok Swasthya SEWA Sahakari Mandali Ltd has been engaged in organizing dais or traditional midwives. They have collectively demanded and obtained recognition in the field of healthcare. Dais were able to demand identify cards as recognition of their services towards better health of their own communities. A Government Resolution was passed in 2005 recognizing the state level Dai Sangathan which was formed to safeguard the interests of dais and to recognize them as health care providers.

Area-based Approach
Initially, we tried to provide services in neighbourhoods or villages where SEWA members were most concentrated. In these areas, the cooperative provided healthcare to all women who sought it – members and non-members alike. All women making use of the services were encouraged to become full-fledged members of SEWA. This approach meant that only scattered pockets within the general population were covered. In recent years, Lok Swasthya SEWA has adopted a more geographical approach, providing services to larger blocks of the population, and enrolling almost all women in these areas as SEWA members. The “scattered” approach that was initially employed made it difficult to ascertain whether mortality and morbidity levels declined due to our health interventions – by comparing populations that had received our services with those which had not. The geographical approach taken more recently, combined with an evolving management information system, has helped us to track our services, their efficiency and quality.

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