India : Assessing the Reach of Three SEWA Health Services among the Poor
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World Bank, Washington, DC
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This is a study of how well health and
related services provided by a large, prominent Indian
non-governmental organization have reached the very poor.
The Self-Employed Women's Association (SEWA) is a trade
union of informal women workers located in Gujerat State.
The services are three primary components of SEWA's
health program: its mobile reproductive health camps,
tuberculosis detection and treatment program, and
women's education program. The project's
quantitative component compared the economic status of women
attending each of the three services with that of the
general population. Information about the economic status of
approximately 1,500 women attending the services was
collected through interviews at service provision sites.
Information on the general population's economic
situation came from pre-existing household data sets: a
Demographic and Health Survey (DHS), and a survey by
SEWA's insurance project. In urban areas, all three
SEWA services were used predominantly by people from poorer
households; about half the clients of each service belonged
to the poorest third of the population. In rural areas, the
economic status of those who used the two services offered
(reproductive health and women's education) did not
differ significantly from that of the general population.
The project's qualitative component featured focus
group discussions about the reasons why the services did or
did not reach the poor groups for whom they were designed.
In urban areas, the reasons identified for the
services' attractiveness to the poor included
proximity, delivery (in part) by the poor themselves,
promotion efforts in poor communities, relatively low cost,
and SEWA's favorable reputation. The barriers
identified in rural areas were the timing of service, which
coincided with working hours, and the services'
perceived high cost.
Palabras clave
CHILD HEALTH, CHILD MORTALITY, COMMUNITIES, DISABILITY, DISEASES, DISTRICTS, DOCTORS, DWELLING, ECONOMIC STATUS, EMPLOYMENT, EQUALITY, EXPENDITURES, FAMILY HEALTH, FAMILY PLANNING, FAMILY STRUCTURE, FIRST AID, HEALTH CARE, HEALTH CARE PROVISION, HEALTH CARE SECTOR, HEALTH CARE SERVICES, HEALTH CENTERS, HEALTH EDUCATION, HEALTH POLICY, HEALTH SERVICES, HOMES, HOSPITALS, HOUSEHOLDS, HUMAN DEVELOPMENT, HUMAN RESOURCES, HYGIENE, IMMUNIZATION, INPATIENT CARE, MANAGERS, MARKETING, MEDICINES, MENTAL HEALTH, MORBIDITY, NGOS, NONGOVERNMENTAL ORGANIZATIONS, NURSES, NUTRITION, PATIENTS, PHYSICIANS, PRIMARY HEALTH CARE, PRIVATE SECTOR, PROBABILITY, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC SECTOR, REPRODUCTIVE HEALTH, RURAL AREAS, RURAL WOMEN, SLUMS, TUBERCULOSIS, TUBERCULOSIS CONTROL, URBAN AREAS, URBAN HEALTH, VILLAGES, WORKERS