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| PART – B |
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SEWA’S UNITS |
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6. SEWA Social Security Net |
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6.1 Health Care |
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Introduction |
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Recognizing and responding to the need for intervention, SEWA expanded its activities and started a community based, women-led primary health care programme in 1984. Continuing since then, SEWA has remained committed to its objective of ensuring health to its members to ensure better economic activities. The focus has been on primary health care and maternal and child health initiatives. SEWA believes that unless the women take care of their own bodies and are educated enough to dispel the myths and misconceptions, no amount of curative or preventive service can have any impact on them. Therefore, SEWA involves them in training and awareness programmes conducted by health workers.
A primary objective of the health services is to provide healthcare to the very poor, particularly those living in areas not otherwise served by government or non-governmental organisations (NGOs). |
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Approaches |
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SEWA has helped its members obtain health care, which is run by women themselves. Our approach emphasizes health education as well as medicinal care. It also involves synchronization and collaboration with government health services for immunization; micronutrient supplementation, family planning, tuberculosis control and referral care at public hospitals, dispensaries and primary health centers.
Linking health security to work security, which means that all economic activities at SEWA have a health component and all health action, in turn, is linked to producer's groups, workers' trade committees and self-help groups and their economic activities.
SEWA has taken the following initiatives in various fields
· Capacity building programmes for local women especially traditional midwives, so that they become the barefoot doctors of their communities/villages.
· Women-centered health care led by local women, including occupational health, reproductive health, maternal health, mental health and nutrition.
· Addressing common health problems like tuberculosis among poor families.
· Promotion of health and well-being by providing access to health information and health education.
· Linking health services to insurance, provision of basic amenities like sanitation literacy and other developmental programmes.
· Emphasizing self-reliance both in economic terms and in terms of women themselves owning, controlling and managing their own health activities. |
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Growth Through Fruitful Partnerships |
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SEWA Health’s infrastructure and services have arisen largely to meet the healthcare needs voiced by SEWA members. But SEWA Health has also been shaped by its collaboration with many different partners. For example, the mobile reproductive and child health camps are funded largely by the United Nations Family Planning Agency (UNFPA). SEWA Health has been working in collaboration with the World Health Organization (WHO), the Government of India (GOI) and the Ahmedabad Municipal Corporation in providing DOTS (Directly Observed Treatment, Short Course) for tuberculosis to residents of the North Zone of Ahmedabad. The GOI, UNFPA and the Ford Foundation support the health education efforts. These collaborations 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, SEWA Health has been able to help these organizations in reaching some of the poorest informal sector workers |
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SEWA's Contribution to Tuberculosis Control Program |
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The Public Health Cooperative of SEWA has been involved in the Revised National Tuberculosis Control Program (RNTCP) since 1999 in association with Ahmedabad Municipal Corporation.
SEWA is privileged and proud to be the only organization in Gujarat to be a part of this program. About 5,00,000 people in the eastern parts of Ahmedabad such as Isanpur, Meghaninagar, Civil, Amraiwadi, and Chamanpura are covered under this project. SEWA's 20 organizers including health workers, area leaders, and aanganwadi workers are providing their services in this program as TB DOTS (Tuberculosis Direct Observe Treatment Short time) workers. Percentage of patients who have been cured from TB by SEWA's organizers has risen from 85% to 88% this year.
The self-employed women members are associated with agricultural sector, salt harvesting, readymade garment, construction work etc. Because of their occupations, they have to face many hurdles and risk SEWA Health care is providing them heath education, immunization, training for family planning, referral care, health insurance service, ayurvedic treatment, and other health services. SEWA also provides low cost standard quality medicines.
SEWA Health Unit is in the process of organising health education camps for their members and the members’ families through interactive methods using computers, audio-visual equipments, SAT-COMM and other intermediate technology tools. SEWA Health Unit feels that these innovative methods will be particularly useful in disseminating vital information of modern world scourges such as TB & AIDS. The activities as per the 11 questions are detailed below.
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| Particulars |
(No. Of Members/Rs.) |
| Employment |
302 |
| Income |
Rs.27,76,500/- |
| Nutritious Food |
82,655 |
| Healthcare services |
4,50,287
(837 Camps) |
| Childcare |
5,01,550 |
| Housing |
75 |
| Assets/ Ownership |
Rs.75,61,884/- |
| Organised Strength |
29,011 |
| Leadership |
565 |
| Self-reliance |
302 |
| Education |
2,562 |
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6.2 Childcare |
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Introduction |
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At SEWA it is well understood that without childcare, including child development, its goal of full employment and self-reliance will remain unfulfilled. Working mothers can not take their children to their workplaces without jeopardizing their own work efficiency and their children’s safety. SEWA believes that women’s struggle to emerge out of poverty through the quest for work and income security, must be supported by quality childcare.
SEWA’s childcare program emerged in mid 1970 from the needs expressed by its members. These centers, formed with SEWA’s support, are managed by co-operatives of childcare providers. Each center serves 40-50 children in the age group of 0-6 years; and focus on the overall development of the children, including their physical and intellectual growth. |
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Major Activities |
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The main activities undertaken by the childcare centers run by SEWA are as under. |
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Teachers of the childcare center hold regular meetings with the mothers; and discuss their children’s development and give their suggestions. |
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Children are regularly weighed and records of their growth are properly maintained. |
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The children are provided with nutritious meals (milk in case of infants) |
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The childcare centers are also centers for child immunizations, antenatal and postnatal care. SEWA works closely with the government health programs for providing these services. |
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Children in the centers are involved in pre-primary creative activities like drawing, painting and craftwork. |
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Exhibitions of the children’s work are held at regular intervals. |
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The teachers make a conscious attempt to create a stimulating and supportive atmosphere at the centers |
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From the work experience of 3 decades in the Childcare Program, it has been seen that children who have been in SEWA childcare centers value learning and education. In two well-attended meetings of our childcare center, children freely spoke about importance of such centers in their lives. Thus SEWA’s Childcare Program not only provides safe childcare for working mothers, but also lays a strong foundation for the sound physical and intellectual growth of the children. |
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Activities Undertaken During The Year |
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This year health care facility covered 20,172 patients were treated in 55 villages. As a result of mobile health van services, women got medical services at their doorsteps and could economise their time and earn more income. These health care trainings were organised to emphasize the importance of health care in adolescent girls with they were made aware of the primary health care needs and sanitation at the same time. |
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1500 adolescent girls prearranged a fair for the adolescent girls in which they were given education about health awareness. This health care campaign undertaken helped the adolescent girls to learn the importance of primary health care and sanitation. |
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Child Care group felicitated passed out students of class 10 & 12 who were brought up at the Balseva Kendra and also arranged picnics for the children. Polio vaccination was given to 33,912 children, medicines and vitamins worth Rs.3,02,278/- were distributed. |
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Adolescents girls were given nutritious food and members participated in health training programs. As a part of the health care Health awareness was imparted amongst 52,560 members by visits at homes. |
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Currently there are 12 Balseva Kendra with 642 children. Various child development activities are carried out at these centres. At these centres the mothers are also taught how they can take good of their children. |
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Apart from physical and intellectual growth of children and safe child care for working mothers, various other trainings related to pregnant women, feeding mothers as well as health camps, regular trainings and meetings etc. are covered under SEWA’s child care program. |
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Under health care different kinds of trainings and camps were organised. 574 adolescent girls were covered under 12 villages for adolescent girls training.642 members were benefited from health awareness camps. |
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Under health care services members were given training on primary health education, adolescent girls training, midwives training. Activities such as immunization to children, family planning operation, adolescent and midwife’s training, eye and other operations, drug distributions were carried through out the year. |
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Gynec camps were organized in co-ordination with SEWA Health Department where check-up facility and required medicines were provided to the women members. |
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6.3 Insurance |
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Introduction |
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SEWA members face several aspects of vulnerability and risks resulting into huge economic leakages and losses, consequently thrusting the women and their families deeper into poverty. Considering this, SEWA has set up its insurance programme in 1992 as a support to tackle as many possible risks in the lives of poor women members. This gave birth to SEWA Insurance Unit or Vimo SEWA. Vimo SEWA is an integrated insurance program aiming to provide social protection for SEWA members to cover their life cycle needs and the various risks they face in their lives, through an insurance organisation in which they themselves are the users, owners and managers of all services. They activities undertaken during the year are mentioned herewith. |
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Vimo SEWA is an integrated insurance program aiming at providing social protection to members, covering their life cycle needs and the various risks they face in their lives; through an insurance organization in which they themselves are the users, owners and managers of all services. Vimo SEWA offers two types of payment schemes to its insurance members. Members can either pay their premium annually or through a fixed deposit with SEWA Bank. Under the fixed deposit option, members deposit a lump sum in fixed deposit in SEWA Bank. (The amount depends on the scheme selected by the member) The interest accrued on this deposit goes towards annual premium. Thus, a woman gets continuous insurance coverage of her choice and obtains much-needed, long-term social protection. The amount to be placed in fixed deposit is subject to revision in view of changing interest rates. |
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Activities Undertaken During the Year |
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| Fixed Insurance 2004 |
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Women only |
Women and Husband |
| Ahmedabad |
14,409 |
18,864 |
| Ahmedabad |
778 |
880 |
| Banaskantha |
1,256 |
1,478 |
| Gandhinagar |
291 |
451 |
| Kheda |
2,438 |
2,949 |
| Kutch |
5,681 |
5,784 |
| Mehsana> |
179 |
246 |
| Sabarkantha |
101 |
139 |
| Surendranagar |
416 |
518 |
| Vadodara |
64 |
79 |
| Total |
25,613 |
31,388 |
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Price of fixed insurance: Women 1000/-, Women and Husband 1650/- |
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| 2004
Insurance Claims Granted
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No. of Women members |
Amount Rs. |
| Ahmedabad
City |
1,950 |
34,45,880 |
| Ahmedabad |
381 |
7,22,376 |
| Banaskantha |
254 |
4,45,745 |
| Gandhinagar |
85 |
2,28,199 |
| Kheda |
1,235 |
24,41,078 |
| Kutch |
406 |
5,04,800 |
| Mehsana |
154 |
3,03,655 |
| Sabarkantha |
256 |
4,43,726 |
| Surendranagar |
90 |
1,72,186 |
| Vadodara |
258 |
3,36,383 |
| Total |
5069 |
90,44,028 |
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6.4 Housing |
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6.4.1 Mahila Housing Sewa Trust |
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Gujarat State Mahila Housing SEWA Trust was formed in 1994 to help women obtain housing finance and technical services. It advises members on house construction with many members accessing finance from SEWA Bank. It also works closely with the Municipal Corporation in Ahmedabad to help poor neighbourhoods obtain basic amenities and services like water, sanitation, street lights, garbage disposal, etc. In the rural areas, the Housing Trust assists in the implementation of the government programmes for house construction for below poverty line families. The following are the details of the various programmes |
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6.4.2 Programs / SCHEMES |
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a) Nayaghar Scheme |
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After the Earthquake SEWA introduced ‘Nayaghar Scheme’ which aims at construction of earthquake resistant housing facilities for the poor members of rural areas. During the year 4000 such houses in 40 villages of Kutch, Patan and Surendranagar were constructed. The construction of the houses under the Program is being done in collaboration with KFW-HDFC, ToI Foundation, ICICI Prudential and Swiss Red Cross Agency. The work of 1000 such houses are under construction. |
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Role of Building Centre in Nayaghar Scheme
i. Preparation of training manual was undertaken.
ii. Based on need assessment, the trainings were provided to the technical staff.
iii. Training manual for households and engineer were also made available. SOR were also made available in all the districts. |
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b) Parivartan Program |
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This Program aims at providing basic facilities like water, toilets, drainage, garbage disposal, storm water drainage, street light and road paving to the urban communities in slums. This Program is being implemented in partnership with Ahmedabad Municipal Corporation (AMC), area residents, MHT and corporates. In the whole Program MHT’s role is vital since it takes care of maintaining records, collecting the savings from the beneficiaries as future contribution for services, capacity building of the group and ensuring that the community is availed with all the basic services. |
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c) Ujala Program |
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Under the ‘Ujala’ program the Survey on “availability of electricity in the slum area” was conducted. The survey highlighted the fact that most of the houses in the slum area are having either illegal connection of the electricity or no connection at all.
Due to lack of electricity they have to face various problems, some of which are listed below.
· They are not able to work at night at their home, which is their work place in most of the cases.
· Due to dim light, the efficiency and quality of their work are affected.
· Lack of electricity affects the education of their children.
· They can not use the entertainment equipments regularly. |
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Thus, in order to facilitate the residents of the slum areas, MHT started the above program of slum electrification in participation with the CBO, AEC, USID and community. |
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The following table shows the progress of the various programmes undertaken: |
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| Sr. No. |
Activity |
Parivartan |
Ujala |
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Karmika |
NayaGhar |
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Ahmedabad |
Surat |
Ahmedabad |
District |
District |
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| 1. |
Employment |
1800 |
1315 |
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100 |
282 |
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Income |
Rs. 27,00,000 |
Rs. 4,50,000 |
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Rs.4,00,000 |
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Rs.9,37,226 |
| 3. |
Nutritious
Food |
1200 |
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| 4. |
Health
Care |
3953 |
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| 5. |
Child
Care |
200 |
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| 6. |
House |
1300
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Assets/
Ownership |
Rs. 73,67,89,000 |
Rs. 85,47,500 |
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Rs.13,55,76,000 |
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Organised
Strength |
622 |
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3000 |
382 |
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| 9. |
Leadership |
700 |
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28 |
282 |
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Self-reliance |
1800 |
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1000 |
100 |
282 |
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| 11. |
Education |
1100 |
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1000 |
100 |
282 |
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