India’s nearly 5 million women garment workers are paradoxically too often on their own. Many are first-generation industrial workers from rural backgrounds. They are inadequately paid, face verbal abuse, physical and sexual violence, are forced to work when unwell and live in crowded, unsanitary conditions. Common physical health complaints include menstrual problems, headaches, eye strains, respiratory problems, muscular-skeletal issues, etc. Anemia and fatigue are widespread and get exacerbated through poor diets, which in turn increase risk factors of women during pregnancy and childbirth. Access to clean drinking water, clean sanitation facilities, well lit and ventilated spaces, and menstrual hygiene products like sanitary napkins at the workplace are limited, if available at all. Poor health is reflected in high attrition rates, low energy, and poor motivation of the workforce. It’s hard for workers to fight the battles for their well-being on their own—or even to know where to start, or whom to ask.https://swastihc.org/wp-admin/edit.php

This is where worker well-being initiatives by Swasti Health Catalyst intervene. The programs convene and converge the efforts of multiple institutions towards harmonizing positive outcomes for women workers in their careers, health, finance and personal lives:

• The brands, including Gap Inc, Walmart, Levi’s, Inditex, Debenhams, Z Labels, Marks and Spencer, Primark and others, draw up the agenda for the initiative and commit funds for its execution. They encourage uptake and support of the programs by the factories.
• The factories, including Shahi and Welspun, create program systems, providing space for women to participate with minimal disruption of production. They put in place worker-friendly policies that go above and beyond statutory compliances.
• As the implementing institution, Swasti Health Catalyst designs and delivers capacity development. It operates cross-learning platforms within and beyond the factory, collaborating with factory teams to share experiences and learn for impact maximisation.
• Workers collectives or unions, where they exist, represent the collective voice of workers for their wellbeing.
• The government, which is mandated to provide health services to workers through the ESI (Employees State Insurance) hospitals, ensures dignified, timely and quality care.

What Swasti Health Catalyst’s Worker Well-Being initiative has learnt through its experience of developing the life skills of 192,000 workers in 160 factories is that a win-win for all stakeholders builds buy-in and active involvement. For example, the engagement with Walmart Foundation and factories such as Welspun, Shahi, Banaswara Garments, Trident, Indian Designs Exports Pvt. Ltd., Asian Fabrix, Atlas, Ramesh Flowers, First Steps Baby Wear, Shell Apparels, etc, found that with just 15 hours of training, workers showed 5% productivity increase, 23% decrease in attrition, reduced gender pay gap by 40%, and showed increased sense of pride in work, teamwork and problem-solving. They were healthier, happier, and gained life skills that improved the quality of their life and that of their families. ESI hospitals began to provide more respectful care.

Women garment workers at a learning session on hand-washing.

The personal stories of women garment workers are heartwarming.

Manjuben, from Pardi village in Valsad in Gujarat, raised both her daughters to believe in and practice all the cultural taboos around menstruation that she herself followed. The HERhealth program tore through her traditional beliefs that limited girls’ mobility and forced isolation during menstruation.

After having successfully convinced her married daughters and their families against such practices, she realised that changing practices in her own home was a start, but not enough. Now she is determined to change minds in her community, and show them how to support rather than exclude girls and women during menstruation. Jothilakshmi is another community champion who changed the eating habits of the children of an entire school!  Starting with her own son’s tiffin box, she shared insights on nutrition that she received through the life skills training and proved to be a role model for parents of the children in her son’s school.

When the will to change environments is coupled with accurate knowledge and skills, the results can alter an entire society. Swasti values collaboration in achieving these results. We understand that no matter how effective the design of the capacity development program, without the cooperation of the brand and the factory, participation of workers would be a challenge. Without evidence of success, it would be difficult to ensure that factories press on with the program and brands expand it across suppliers. And without the support of government health facilities, access to health infrastructure would be a barrier to closing the loop of health-seeking behaviour.